University:
York University
Course:
NURSING 2534 | Pathophysiology
Academic year:

2023
Views:

108

Pages:

4
Author:

Niklas

Ostomy: Surgical creation opening (stoma) on the abdomen for fecal elimination Skin not being used → body may react: reddened, irritated, vulnerable, would-be-sore Named for location, flared, not concave Changing factors: eating, temp, stoma output Types: Ileostomy: Stool very liquid, large amount of output Colostomy: Ascending colostomy: Stool semi-liquid, some fecal matter Descending colostomy: Stool firm, some fecal matter Transverse colostomy: Double barrel Post-op Care: Phlebitis, stone, gas, lines 1st sign ostomy is working: gas Empty pouch when minimal bloating Never place pouch directly on irritated skin Empty when 1/4 to 1/2 full Ileostomy: Stoma will build easily Output is liquid → filter, chew food thoroughly fluid intake & fiber, low-residue diet Ileal Pouch: Anal anastomosis: surgical procedure to restore gastrointestinal continuity After IPAR May have gas, diarrhea, fecal incontinence Avoid foods that cause diarrhea Perianal skin care Diverticulitis: Diverticula: small pouches in the colon wall Common in elderly adults Occurs in descending colon Manifestations: Abdominal pain in LLQ Fever Nausea/vomiting Constipation/diarrhea Blood in stool Risk Factors: Low fiber diet Obesity Smoking NSAID use Complications: Perforation of bowel wall Peritonitis Abscess Bleeding Diagnosis: CT scan, abdominal x-ray Colonoscopy Management: Fluids, IV fluids NPO, bowel rest Antibiotics Pain meds Nursing Management: Maintain fluid & electrolyte balance Control infection Manage I/Os Nutritional support Pain meds; some need surgery Common Complications: Abscess: triple threat: two hollow organs, skin Mortality & morbidity Extended hospital stay Early signs: fever + abdominal pain Hernias: Protrusion of tissues through an opening May cause pain, swelling, intestinal obstruction Incarcerated: hernia cannot be placed back into abdominal cavity Strangulated: blood supply cut off, requires emergency surgery Types: Inguinal Umbilical Incisional Hiatal Manifestations: Pain Swelling Discomfort Nausea/vomiting Constipation/diarrhea Difficulty voiding urine Treatment: Nonsurgical: observation, medications, support Surgical repair: hernioplasty, laparoscopic repair Emergency: immediate surgery Complications: Bowel obstruction Incarceration Strangulation Nursing Management: Prevent constipation Encourage deep breathing Sitz bath Pain control Stool softeners Liver: Jaundice: yellowing of skin, sclera, mucous membranes Itching Nausea, vomiting Dark urine Pale stools Weight loss Advanced liver disease Ascites Spider angiomas Palmar erythema Gynecomastia Liver encephalopahty Biliary Tract Problems: Cholelithiasis: gallstones Cholecystitis: inflammation of gallbladder Cholangitis: inflammation of bile ducts Pancreatitis Pancreatitis: Causes: gallstones, alcohol, viruses, scorpion sting Symptoms: severe pain in epigastric area radiating to back, nausea, vomiting, fever, jaundice Classification of severity Complications: pseudocyst, pancreatic necrosis, peritonitis Treatment: Supportive care Pain management IV fluids Antibiotics Nasogastric tube Surgery