GI Study Guide - Study Guide for GI Questions 1,2 Pg...

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Study Guide for GI Questions 1,2. Pg. 1345-1350, 1354-1361 Crohn’s Disease (15-40y/o) Ulcerative Colitis (15-25, 55-65y/o) Pathophysiology Aka: regional enteritis or infal. Bowel dz. Can occur an anytime but usually adolescents/young adults. Affects ileum, ascending colon, and cecum. As lesions heal, scar tissue may form which prevents food from being absorbed normally. Stricutes may also occur leading to intestinal obstruction as well as fistulas b/t segments. Most often in terminal ileum, with patchy involvement through all layers of the bowel. 7-10 stools/day. Inflammatory dz of small intestine, colon, or both. Involves all layers of bowel but most commonly involves the terminal ileum. Slowly progressive and recurrent with predominant involvement of multiple regions of the intestine w/ normal sections b/t. Chronic, nonspecific inflammation of the entire intestinal tract. Eventually deep fissures and ulcerations develop and extends through all bowel layers. Begins in rectum and proceeds in a continuous manner toward cecum. (10-20stools/day). Ulcerative and inflammatory disease of the colon and rectum. Affects distal colorectal area primarily left colon. Affects superficial mucosa of the colon w/ alternating period of remission and exacerbation. Ulcerative lesions are continuous, and eventually spread throughout the large intestine. Over time, the bowel will narrow, shorten, and thicken. Signs/Symptoms RLQ pain, anorexia, weight loss, malnutrition, fever, leukocytosis, stools may contain mucous, pus, and FAT. Diarrhea major symptom w/ 7-10 stools/day. Bowel sounds may be decreased/absent. Abdominal pain, diarrhea, stools that have blood, put, and mucous, but NO fat, fecal bleeding, anemia, fever, bowel obstruction, hemorrhage, abscess formation, malabsorption, perforation, increased risk for colon Ca. Medications Sulfasalazine, glucocorticoids, Flagyl, Imuran, Immunosuppressive drugs: Methotrexate, Infliximab Sulfasalazine, Mesalamine, Dipentum, Colazal.Rowasa enema, coorticosteriods (prednisone), Hydrocortisone rectal foam, hydrocortisone enema. Immunosuppressive drugs: not effective alone but good when in combo w/ steroids. cyclosporine, Purinethol. Antidiarrheal drugs: Lomotil, Imodium. Infliximab (used if no other drug is working. Treatments/Dx Barium enema, colonoscopy, stool specimen (+ for steatorrhea). Decreased H&H w/ bleeding. Low folic acid and B12 b/c decreased absorption. Decreased albumin levels b/c decreased amino acid absorption. Increased ESR b/c inflammation. Decreased electrolytes b/c diarrhea. Diet: TPN for bowel rest. Elemental diet using Vivonex to induce remission. Elemental diets are absorbed in the jejunum. Once in remission, a low residue diet is used. Supplements such as ensure can be sued for calories. Avoid caffeine, alcohol. Surgical management: resection by laparoscopy. Small bowel
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This note was uploaded on 03/31/2008 for the course NUR Nur 265 taught by Professor Basham during the Spring '08 term at Midlands Tech.

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GI Study Guide - Study Guide for GI Questions 1,2 Pg...

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