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NUR2392_MDC_II_Focused_Review_Exam

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  • November 9, 2021
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  • 2021/2022
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NUR2392 MDC 2 Exam 3 Focused Review

Modules 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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