2 weeks

Diarrhea  status

Stool form

Abdomen

Anus

small bowel disease 

Stool form is 

Complication of Diarrhea

Electrolyte

v/s

Alert

Appetite

IBS

Medical goal for an IBS Patient(4)

Ulcerative Colitis

Ulcerative Colitis

stool  occult blood

patient is placed in semi- fowler’s

oral fluids as tolerated

pain medication (usually morphine)

discharge teaching

Inflammation of the peritoneum, the serous membrane lining of the abdominal cavity and covering the viscera.  Usually, result of bacterial infection from the GI tract or in women, the reproductive tract.

Peritonitis

Abdomen extremely tender and distended and rigid.

Elevated WBC 

abdominal x-ray

CT scan of the abdomen

peritoneal aspiration

CBC & Lytes

Diagnostic test for

Peritonitis

sepsis

intestinal obstruction

wound dehiscence

wound evisceration

abscess formation

Medical managment for Peritonitis

fluid, colloid, and electrolyte replacement

analgesics, antiemetics

intestinal intubation and suction

O2 therapy

massive antibiotic therapy

surgical intervention

Pain - any change in location or nature should be

       reported.  Patient should be placed on side

       with knees flexed.

Vital signs - decrease in temperature and pulse rate,

softening of the abdomen,

sounds, passing of flatus,

and bowel movements

return of peristaltic sound

       indicate subsiding ......

intraluminal or mural

Intestinal obstruction(Mechanical)

What type of obstruction is this? 

intestinal musculature

cannot propel the contents

along the bowel

Functional Intestinal obstruction

 BM or flatus

Small Bowel Obstruction

abdominal x-ray

electrolytes

CBC

Medical Management  for Small Bowel movement

decompression of the bowel

fluid and electrolyte replacement

surgical intervention

Nursing Care for Small Bowel Obstruction.

maintaining function of NG tube

assessing and measuring NG output

accurate I&O

monitoring fluid and electrolytes

monitoring nutritional status

assessing for improvement or regression

Large Bowel Obstruction

abdominal x-ray

 are poor surgical risk

Nursing care for Large Bowel Obstruction

Dilated portions of veins in the anal canal

may be internal or external.  Most common

cause of bright red bleeding with defecation.

Hemorrhoids

severe pain from inflammation and

edema, thrombosis, itching.

bright-red bleeding with defecation,

not usually painful until they bleed or become

prolapsed

Good personal hygiene

avoid excessive straining

high-residue diet

stool softener

sitz bath

ointments

suppositories

bedrest

Infrared photocoagulation

bipolar diathermy

laser therapy

injection sclerosing solutions

rubber-band ligation

cryosurgical hemorrhoidectomy

Nd:YAG laser

Hygiene

high fiber diet

increase water, fluid intake

wet dressings

 (petroleum jelly app. To anal area

Discharge planning

The protrusion or projection of an organ or a part of an organ through the wall of the cavity which normally contains it.

around the umbilicus or previous surgical incision

80% of all hernias

intestine protrudes into

the inguinal canal often

descending into the

scrotal sac

Inguinal Hernia

Irrigating a colostomy

Cone care

Irrigating a colostomy

Carther insertion

Irrigating a colostomy

Fluid insertion

type:

flowing time:

Irrigating a colostomy

Cramping?

  resolved

Irrigating a colostomy

Post Clamping bag

Irrigating a colostomy

Bag duration  

Irrigating a colostomy

Cleaning

Irrigating a colostomy

Replacement

contaminated water

incubation 2 - 4 weeks

grows in the lumen or wall of the intestines

symptoms:

intermittent diarrhea, lasting months to

years, may contain mucus or blood, lower abdominal

cramping, flatulence

hepatic

pleuropulmonary

pericarditis

peritonitis

Amebiasis: Severe infection: 

ingestion of insufficiently cooked foods, especially

pork and beef.  Incubation 10 - 14 days

Symptoms:

when large numbers have been ingested,

abdominal pain, nausea, vomiting, serous diarrhea.

Severe infection:

Muscles:

swollen,

firm

extremely painful.   inhibited movement, dyspnea

results from involvement of respiratory muscles,

facial edema, profuse sweating and high fever.

Don’t drink the water unless it has been boiled

for 1 min., wash your hands after going to the

bathroom, changing a diaper, before you handle

food, and cook your meat until well done!

usually caused by the

trauma of passing a large, firm stool or

from persistent tightening of the anal

canal secondary to stress and anxiety,

leading to constipation

Other causes of Anal Fissure 

 .

childbirth, trauma,

overuse of laxatives

extremely painful defecation, burning, and bleeding.

Anal Fissure 

stool softeners

  bulk agents,

  increase water intake,

  sitz baths,

   emollient suppositories. 

Anal dilation under anesthesia

  Surgical excision of the fissure when      conservative treatment fails.

Pus or stool may leak constantly

from the cutaneous opening.

Possible passage of flatus or feces from the

vagina or bladder.

Treatment: 

Fistulectomy

Few fistulas heal spontaneously

Foul smelling pus and pain. 

  Swelling redness and tenderness if superficial. 

Deeper abscess may result in toxic symptoms, lower

abdominal pain, and fever.

Anorectal abscess:

May vomit coffee ground looking vomitus

Upper GI:

Dark tarry stools with foul order

Complication of Diarrhea

Electrolyte

v/s

Alert

Appetite

IBS

IBS Diagonistic test

Medical goal for an IBS Patient

Ulcerative Colitis

patient is placed in semi- fowler’s

oral fluids as tolerated

pain medication (usually morphine)

discharge teaching

Inflammation of the peritoneum, the serous membrane lining of the abdominal cavity and covering the viscera.  Usually, result of bacterial infection from the GI tract or in women, the reproductive tract.

Peritonitis

Abdomen extremely tender and distended and rigid.

Elevated WBC 

abdominal x-ray

CT scan of the abdomen

peritoneal aspiration

CBC & Lytes

Diagnostic test for

Peritonitis

sepsis

intestinal obstruction

wound dehiscence

wound evisceration

abscess formation

Medical managment for Peritonitis

fluid, colloid, and electrolyte replacement

analgesics, antiemetics

intestinal intubation and suction

O2 therapy

massive antibiotic therapy

surgical intervention

Pain - any change in location or nature should be

       reported.  Patient should be placed on side

       with knees flexed.

Vital signs - decrease in temperature and pulse rate,

softening of the abdomen,

sounds, passing of flatus,

and bowel movements

return of peristaltic sound

       indicate subsiding ......

intraluminal or mural

Intestinal obstruction(Mechanical)

intestinal musculature

cannot propel the contents

along the bowel

Functional 

Intestinal obstruction

 BM or flatus

Small Bowel Obstruction

abdominal x-ray

electrolytes

CBC

Medical Management  for Small Bowel movement

decompression of the bowel

fluid and electrolyte replacement

surgical intervention

Nursing Care for Small Bowel Obstruction.

maintaining function of NG tube

assessing and measuring NG output

accurate I&O

monitoring fluid and electrolytes

monitoring nutritional status

assessing for improvement or regression

Large Bowel Obstruction

abdominal x-ray

 are poor surgical risk

Nursing care for Large Bowel Obstruction

Dilated portions of veins in the anal canal

may be internal or external.  Most common

cause of bright red bleeding with defecation.

Hemorrhoids

severe pain from inflammation and

edema, thrombosis, itching.

bright-red bleeding with defecation,

not usually painful until they bleed or become

prolapsed

Good personal hygiene

avoid excessive straining

high-residue diet

stool softener

sitz bath

ointments

suppositories

bedrest

Infrared photocoagulation

bipolar diathermy

laser therapy

injection sclerosing solutions

rubber-band ligation

cryosurgical hemorrhoidectomy

Nd:YAG laser

Hygiene

high fiber diet

increase water, fluid intake

wet dressings

 (petroleum jelly app. To anal area

Discharge planning

The protrusion or projection of an organ or a part of an organ through the wall of the cavity which normally contains it.

around the umbilicus or previous surgical incision

80% of all hernias

intestine protrudes into

the inguinal canal often

descending into the

scrotal sac

Inguinal Hernia

Irrigating a colostomy

Irrigating a colostomy

Irrigating a colostomy

Cone care

Irrigating a colostomy

Carther insertion

Irrigating a colostomy

Fluid insertion

type:

flowing time:

Irrigating a colostomy

Cramping?

  resolved

Irrigating a colostomy

Post Clamping bag

Irrigating a colostomy

Bag duration  

Irrigating a colostomy

Cleaning

Irrigating a colostomy

Replacement

contaminated water

incubation 2 - 4 weeks

grows in the lumen or wall of the intestines

symptoms:

intermittent diarrhea, lasting months to

years, may contain mucus or blood, lower abdominal

cramping, flatulence

hepatic

pleuropulmonary

pericarditis

peritonitis

Amebiasis: Severe infection: 

ingestion of insufficiently cooked foods, especially

pork and beef.  Incubation 10 - 14 days

Symptoms:

when large numbers have been ingested,

abdominal pain, nausea, vomiting, serous diarrhea.

Severe infection:

Muscles:

swollen,

firm

extremely painful.   inhibited movement, dyspnea

results from involvement of respiratory muscles,

facial edema, profuse sweating and high fever.

Don’t drink the water unless it has been boiled

for 1 min., wash your hands after going to the

bathroom, changing a diaper, before you handle

food, and cook your meat until well done!

usually caused by the

trauma of passing a large, firm stool or

from persistent tightening of the anal

canal secondary to stress and anxiety,

leading to constipation

Other causes of Anal Fissure 

 .

childbirth, trauma,

overuse of laxatives

extremely painful defecation, burning, and bleeding.

Anal Fissure 

stool softeners

  bulk agents,

  increase water intake,

  sitz baths,

   emollient suppositories. 

Anal dilation under anesthesia

  Surgical excision of the fissure when      conservative treatment fails.

Pus or stool may leak constantly

from the cutaneous opening.

Possible passage of flatus or feces from the

vagina or bladder.

Treatment: 

Fistulectomy

Few fistulas heal spontaneously

Foul smelling pus and pain. 

  Swelling redness and tenderness if superficial. 

Deeper abscess may result in toxic symptoms, lower

abdominal pain, and fever.

Anorectal abscess:

May vomit coffee ground looking vomitus

Upper GI:

Dark tarry stools with foul order