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NUR2392_MDC_II_Focused_Review_Exam
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NUR2392 MDC 2 Exam 3 Focused ReviewModules 8, 9, & 10
*Please note this is just to be used as a guide. You are responsible for all material covered in class*
*Review all concepts related to the topics*
Disease/syndromes/problems (For each one, know the following: definition/causes/risks/signs and
symptoms/labs/treatment/possible complications/multidimensional care)
Chapter 56 Non-inflammatory intestinal disorders
Labs, Obstructions-mechanical; non-mechanical, IBS, Colon cancer, colostomy, colostomy care, abdominal hernias,
hemorrhoids, Malabsorption syndrome
Laboratory Studies:
Complete blood count – to determine the presence of infection or bleeding
C-reactive protein (CRP) – to determine the presence of inflammation
Erythrocyte sedimentation rate (ESR) – to determine the presence of inflammation
Liver function test – to determine the elevation of enzymes as result of hepatic inflammation
Stool culture – to determine the presence of blood and parasites
Serum Chemistry tests – to determine electrolyte imbalances
Serum Bilirubin – to determine the ability to metabolize bilirubin
Coagulation studies – to determine clotting ability
Serological test – to determine the specific virus causing the hepatitis
Carcinoembryonic antigen (CEA) – to determine the presence of colorectal cancer
Diagnostic Studies:
Computed tomography – to determine distention, abscess or perforation
Magnetic resonance enterorrhaphy – to determine changes in the bowel lumen, wall, and mesentery;
also assesses bowel motility
Ultrasound – to determine abnormalities in organs and blood flow
Colonoscopy – to determine abnormalities in the colon
Sigmoidoscopy – to determine abnormalities of the sigmoid colon
Biopsy – removal of tissues in order to determine the presence of malignancy
Barium enema – may reveal irregularities or narrowing of the colon or wall thickening
Abdominal x-ray – may reveal enlarged organs, free air or fluid in the abdominal cavity
-Red blood cell life: 90-120 days
-WBC life: 13-17 days
, Obstructions
-Intestinal contents continue to accumulate above the obstruction which results in the
distention of the abdomen. Results in decreased absorption of fluid and electrolytes.
Mechanical Obstruction: The bowel is physically blocked by problems outside of the intestine
(adhesions), in the bowel wall (Crohn’s disease), or in the intestinal lumen (tumors).
Complications of appendicitis
Hernias
Fecal impactions
Intussusception: telescoping of a segment of the intestine within itself
Volvulus (twisting of intestine)
Nonmechanical: (paralytic ileus or a dynamic ileus) peristalsis is decreased or absent as a result
of neuromuscular disturbance, resulting in a slowing of the movement or a backup of intestinal
contents.
Complication of surgery: day 3/4, no bowel sounds
Hypokalemia
Signs and Symptoms
Obstipation: severe constipation
Abdominal distention
Peristaltic waves
Borborygmic: gurgling or rumbling noise
High-pitched bowel sounds/none at all
Tachycardia
Hypokalemia
Complications
Metabolic alkalosis/acidosis
Hypovolemia
Peritonitis (more so from strangulated obstruction)
Septic Shock
Increased intrabdominal pressure or ACS
Interventions
Non-surgical management
o NG tube: at least every 4 hours, assess the patient with an NGT for proper
placement, tube patency, and output (quality and quantity). Also assess for
peristalsis.
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