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NUR 321 - Lower GI part 1
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NUR 321 - Lower GI part 1
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NUR 321 - Lower GI part 1How can patients manage IBS? - ANS-1. Diet
2. Exercise
3. Stress reduction - this can be a great help
4. Alternative medicine and probiotics
- Helps reinforce normal flora of their gut = probiotics
How can we diagnose UC? - ANS-1. You should be screened if you have a 1st degree
relative with UC because it can be genetic
2. Labs
3. Colonoscopy
4. CT scan
How can we diagnose/test for Crohn's disease? - ANS-1. Proctosigmoidoscopy (procto
= rectum)
2. Stool exam
3. Upper GI barium
4. barium enema
5. endoscopy - can do biopsies
6. colonoscopy - can do biopsies
7. intestinal biopsies
How can we emotionally support Crohn's/UC patients? - ANS-they should join support
groups
How can we help reduce inflammation for Crohn's/UC patients? - ANS-1.
Aminosalicylates - ex sulfasalazine
2. Sulfa-free aminosalicylates if patients are allergic to sulfa - ex mesalamine
Nursing considerations:
1. Always look at patients allergies especially for sulfa
2. Monitor kidney and liver function
3. Takes 2-4 weeks to see effects
4. Take with a full glass of water after meals
5. Goal = decrease the inflammatory response
How can we manage Crohn's and UC? - ANS-1. Nutriton
, 2. Pharmacology
3. Reduce inflammation
4. Treat secondary infections
5. Surgery
How can we treat secondary infections for Crohn's/UC patients? - ANS-1. Antibiotics -
ex metronidazole aka flagyl
2. Ciprofoxaline - may have tendon ruptures due to this antibiotics
Works better for Crohn's than UC
Patients may get a super infection like thrush so watch them closely
Watch side effects of both medications
How do we Control diarrhea and control inflammation for Crohns/UC patients? -
ANS-Inflammation = give sulfasalazine
Diarrhea = give loperamide (this is an opioid that slows peristalsis)
How do we Relieve pain and restore fluid for Crohns/UC patients? - ANS-Loperamide
can help with pain
How should we help our patients on bowel rest? - ANS-NPO/TPN status
to help them heal and have the bowel rest
TPN = hung every 24 hours
- Dietician will look at the patient's BMI and electrolyte levels and calorie needs so this is
very individualized for your patient
- Glucose is also in here so monitor BG levels
Tubing and everything needs changed every 24 hours
How should we watch for bowel perforation? - ANS-look at WBC, fever, pain, etc
What Anticholinergics and antimicrobials do we use for Crohns/UC patients? -
ANS-Anticholinergics = dries secretions because these patients have lots
What are nursing considerations for IBS patients? - ANS-1. Eduction
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