Chapter 60
Terms
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- Irritable Bowel Syndrome
- *A chronic gastrointestinal disorder *Characterized by presence of chronic or recurrent diarrhea, constipation, and/or abdominal pain and bloating *Referred to as spastic colon, mucous colon, or nervous colon *Motility changes, result in changes in the normal bowel elimination pattern to a pattern of diarrhea, constipation, or alternating diarrhea and constipation
- Manning Criteria-IBS
- *Abdominal pain relieved by defecation or associated with changes in stool or frequency or consistency *Abdominal distention *Sensation of incomplete evacuation of stool *Presence of mucus with stool passage
- Flare-Ups-IBS
- *Flare ups consist of worsening cramps *Abdominal Pain *Diarrhea or constipation *Symptoms:Pain in LEFT LOWER QUADRANT OF ABDOMEN *Reports increased pain after eating and relief after a bowel movement *Complaints of belching, gas, anorexia, and bloating
- Diet Therapy-IBS
- *Eliminate offending or upsetting foods *Limit Caffeine *Avoid Alcohol *Beverages that contain sorbitol or fructose; other gastric irritants *Eating regular meals *Drinking 8 to 10 cups of liquid each day *Chewing food slowly promote normal bowel function
- Complementary and Alternative Therapies-IBS
- Peppermint and Caraway oil combination *Evening primrose oil *Chamomile *Yoga and other relaxation techniques *Hypnosis *Acupuncture
- Herniation
- Weakness in the abdominal muscle wall through which a segment of bowel or other abdominal structure protrudes
- Common types of hernias
- -Indirect Inguinal Hernia- sac formed from the peritoneum that contains a portion of the intestine or omentum -Direct Inguinal Hernias- In contrast, pass through a weak point in the abdominal wall -Femoral hernias- protrude through the femoral ring *Umbilical Hernias-congenital(appear in infancy) or acquired(result from increased intraabdominal pressure) *Seen most commonly in obese individuals -Incisional, or ventral, hernias- site of previous surgical incision- inadequate healing of insicision
- Classification of Hernias
- Reducible- Contents of the hernial sac can be placed back into the abdominal cavity by gentle pressure(hernia moves back into peritoneal cavity) Irreducible(incarcerated)- Cannot be reduced or placed back into the abdominal cavity-Requires immediate surgical evaluation if not reducible Strangulated-Blood supply to the herniated segment of the bowel is cut off by pressure from the hernial ring-EMERGENCY SITUATION- Ischemia and obstruction of the bowel loop-Signs_ Abdominal distention, nausea, vomiting, pain, fever, and tachycardia
- Significant Contributing Factors-Hernia-Increased intra-abdominal pressure
- *Obesity *Pregnancy *Lifting of heavy objects
- Surgical Management-Hernias
- Minimally invasive inguinal hernia repair (MIIHR)-Through laparoscope(herniorraphy)-Surgery of Choice
- Postoperative-Hernias
- - May be discharged from center in 3 to 5 hours; Rest for several days before returning to work and a normal routine *Report redness, induration, heat, drainage, and increased pain to surgeon AVOID COUGHING Encourage deep breathing and ambulation for lung expansion In immediate postoperative period-Client may experience difficulty voiding Male clients should stand to allow a more natural position
- Colorectal Cancer
- Cancer of the colon or rectum 95% of CRC are adenocarcinomas- tumors that arise from the glandular epithelial tissue of the colon Tumor may invade neighboring blood vessels and cause frank bleeding Low, fat high fiber diet A high fat diet, particulary from animal fat from red meats, increases bil acid secretion and anaerobic bacteria- carcinogenic in bowel