A client is admitted with peritonitis the priority of nursing care for this client is

-anorexia                                
-nausea & vomiting
-ABD pain RLQ
              *Press on RLQ will elicit no pain----> then                       release and will cause pain
-pain with coughing and sneezing

appendicitis nursing activities 

-no analgesics                           - NPO -no heat                                     -IV
pain -ice packs -knee or hip flex

appendicitis diagnostic wsstudies

- blood -urine -ultrasound

Complications of appendicitis

-perforation -rupture -peritonitis (most serious) -abscesses

-fecal material in ABD - rigid ABD

-discharge 24 hours
-regular diet
-3 dose antibiotics

The nurse would increase the comfort of the patient with appendicitis by:

a. Having the patient lie prone
b. Flexing the patient's right knee
c. Sitting the patient upright in a chair
d. Turning the patient onto his or her left side

                                B
The patient with appendicitis usually prefers to lie still, often with the right leg flexed to decrease pain.

"When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?
"a. Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.
b. Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
c. The appendix may develop gangrene and rupture, especially in a middle-aged client.
d. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage."

                                        B. A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up, increasing pressure in the appendix and compressing venous outflow drainage. Inflammation and bacterial growth follow, and swelling continues to raise pressure within the appendix, resulting in gangrene and rupture. Geriatric, not middle-aged, clients are especially susceptible to appendix rupture.

"A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location?

a) Left lower quadrant
b) Left upper quadrant
c) Right upper quadrant
d) Right lower quadrant

D Right lower quadrant"
Rationale: The pain of acute appendicitis localizes in the right lower quadrant (RLQ) at McBurney's point, an area midway between the umbilicus and the right iliac crest. Often, the pain is worse when manual pressure near the region is suddenly released, a condition called rebound tenderness.

**pouches in colon**-more common in men
symptoms -ABD pain and tenderness -temperature -flatulence

Food to avoid with diverticular disease

Nuts Popcorn Food with seeds

diverticuar disease nursing interventions

-NPO -IV -NG tube care -bed rest (bathroom privileges) -analgesic for pain

diverticular disease teaching

**avoid constipation**     -fluids   -ruffage     -avoid seeds     - exercise / lose weight     -bulk forming laxative **avoid intra-abdominal pressure**

diverticular disease diagnostic tests and treatment

• CBC
• Enema
• ** colonoscopy
• urine
• MRI

Which foods should the nurse encourage a client with diverticulosis to incorporate into the diet? Select all that apply.
1. Bran cereal.
2. Broccoli.
3. Tomato juice.
4. Navy beans.
5. Cheese.

                                    124
Clients with diverticulosis are encouraged to follow a high-fiber diet. Bran, broccoli, and navy beans are foods high in fiber. Tomato juice and cheese are low-residue foods

Which of the following laboratory findings would the nurse expect to find in a client with diverticulitis?

1. Elevated red blood cell count.
2. Decreased platelet count.
3. Elevated white blood cell count.
4. Elevated serum blood urea nitrogen concentration.

                                3.
Because of the inflammatory nature of diverticulitis, the nurse would anticipate an elevated white blood cell count. The remaining laboratory findings are not associated with diverticulitis. Elevated red blood cell counts occur in clients with polycythemia vera or fluid volume deficit. Decreased platelet counts can occur as a result of aplastic anemias or malignant blood disorders, as an adverse effect of some drugs, and as a result of some heritable conditions.

The nurse is aware that the diagnostic tests typically ordered for acute diverticulitis do not include a barium enema. The reason for this is that a barium enema:

1. Can perforate an intestinal abscess.
2. Would greatly increase the client's pain.
3. Is of minimal diagnostic value in diverticulitis.
4. Is too lengthy a procedure for the client to tolerate.

                                1.
Barium enemas and colonoscopies are contraindicated in clients with acute diverticulitis because they can lead to perforation of the colon and peritonitis. A barium enema may be ordered after the client has been treated with antibiotic therapy and the inflammation has subsided. A barium enema is diagnostic in diverticulitis. A barium enema could increase the client's pain; however, that is not a reason for excluding this test. The client may be able to tolerate the procedure but the concern is the potential for perforation of the intestine.

The nurse should teach the client with diverticulitis to integrate which of the following into a daily routine at home?

1. Using enemas to relieve constipation.
2. Decreasing fluid intake to increase the formed consistency of the stool.
3. Eating a high-fiber diet when symptomatic with diverticulitis.
4. Refraining from straining and lifting activities.

        4.
Clients with diverticular disease should refrain from any activities, such as lifting, straining, or coughing, that increase intra-abdominal pressure and may precipitate an attack. Enemas are contraindicated because they increase intestinal pressure. Fluid intake should be increased, rather than decreased, to promote soft, formed stools. A low-fiber diet is used when inflammation is present.

After instructing a client with diverticulosis about appropriate self-care activities, which of the following client comments indicate effective teaching? Select all that apply. 1. "With careful attention to my diet, my diverticulosis can be cured."
2. "Using a cathartic laxative weekly is okay to control bowel movements."
3. "I should follow a diet that's high in fiber."
4. "It is important for me to drink at least 2,000 mL of fluid every day."
5. "I should exercise regularly."

                                    3, 4, 5.
Clients who have diverticulosis should be instructed to maintain a diet high in fiber and, unless contraindicated, should increase their fluid intake to a minimum of 2,000 mL/ day. Participating in a regular exercise program is also strongly encouraged. Diverticulosis can be controlled with treatment but cannot be cured. Clients should be instructed to avoid the regular use of cathartic laxatives. Bulk laxatives and stool softeners may be helpful to maintain regularity and decrease straining.

A client with diverticular disease is receiving psyllium hydrophilic mucilloid (Metamucil). The drug has been effective when the client tells the nurse that he:

1. Passes stool without cramping.
2. Does not have diarrhea any longer.
3. Is not as anxious as he was.
4. Does not expel gas like he used to.

                                    1.
Diverticular disease is treated with a high-fiber diet and bulk laxatives such as psyllium hydrophilic mucilloid (Metamucil). Fiber decreases the intraluminal pressure and makes it easier for stool to pass through the colon. Bulk laxatives do not manage diarrhea, anxiety or relieve gas formation

A client with diverticulitis has developed peritonitis following diverticular rupture. The nurse should assess the client to determine which of the following? Select all that apply.
1. Percuss the abdomen to note resonance and tympany. 2. Percuss the liver to note lack of dullness.
3. Monitor the vital signs for fever, tachypnea, and bradycardia.
4. Assess presence of polyphagia and polydipsia.
5. Auscultate bowel sounds to note frequency.

                                  1, 2, 5.
Assessment during peritonitis will reveal fever, tachypnea, and tachycardia. The abdomen becomes rigid with rebound tenderness and there will be absent bowel sounds. Percussion will show resonance and tympany indicating paralytic ileus; loss of liver dullness may indicate free air in the abdomen. There is anorexia, nausea, and vomiting as peristalsis decreases.

inflammatory bowel disease

              **autoimmune disease**-Obstruction and/or dysfunction of lymph in intestines
types -Crohn's -ulcerativee colitis

- usually in people <30 -more common in women -inflammation of small intestine and/or colon - slow and progressive

signs and symptoms of crohn's disease 

-boody stool/ diarrhea -ABD pain -fever -weight loss
**chronic- with periods of remission

-inflammation of the colon -formation of ulcers

signs and symptoms of ulcerative colitis

inflammatory bowel disease assesment

• ABd pain
• hyperactive bowel sounds
• tender ABD
• diarrhea
• low temp
• weight loss
• weakness
• stool with blood

diagnostic studies for inflammatory bowel disease

• CBC- bleeding
  
• WBC- infection and inflammation
• electrolyte labs
• Barium enema
• colonoscopy

• 48 hrs before-clear liquid diet
  
• 24 hrs before- laxative (osmotic)
• morning before-fleets enema and ducolox supository

pre- bowel prep
post -monitor for blood -they will have chalky stool (from barrium) -teach increase fluids -reg diet -maybe milk of magnesia

PRE- bowel prep
POST- -monitor for blood -^ in flatuence -teach increase fluids -reg diet -maybe milk of magnesia

Nursing Activities for inflammatory bowel disease

• lomotil
• steroids- decrease inflammatory
• immuno-suppressant
• anti inflamatory drugs
• ^nutrition

nutrition activities for inflammatory bowel disease

• ^ fat soluable vitamins
• A- vision
• D- bones
• E- heart
• k- coagulation
• NPO ( TPN & IV)
• decrease smoking and fatty foods
• avoids grains, nuts, seeds, dairy

Nandas for inflammatory bowel disease

• nutrition-Less than
• dehydration-loss vit K
• impaired skin integrity- dehydration
• pain
• fatigue
• body image
• social isolation

nursing goals for inflammatory bowel disease

• NUTRITION
• rest bowel
  
• combat infection
• control inflammation
• decrease stress

-20-90% glucose concentration -essential Amino Acids-(protein)       -lipids electrolytes, vitamins, insulin -delivered via central line/ picc -NEVER stop or switch out for IVPB

-High blood glucose     -check Q4H     -insulin sliding scale -increase for infection     bacteria loves glucose

A client has been placed on long-term sulfasalazine (Azulfidine) therapy for treatment of his ulcerative colitis. The nurse should encourage the client to eat which of the following foods to help avoid the nutrient deficiencies that may develop as a result of this medication?

1. Citrus fruits.
2. Green, leafy vegetables.
3. Eggs.
4. Milk products.

                                    2.
In long-term sulfasalazine therapy, the client may develop folic acid deficiency. The client can take folic acid supplements, but the nurse should also encourage the client to increase the intake of folic acid in his diet. Green, leafy vegetables are a good source of folic acid. Citrus fruits, eggs, and milk products are not good sources of folic acid.

A client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an exacerbation of the disease. Which of the following factors was most likely of greatest significance in causing an exacerbation of ulcerative colitis?

1. A demanding and stressful job.
2. Changing to a modified vegetarian diet.
3. Beginning a weight-training program.
4. Walking 2 miles every day.

                                          1.
Stressful and emotional events have been clearly linked to exacerbations of ulcerative colitis, although their role in the etiology of the disease has been disproved. A modified vegetarian diet or an exercise program is an unlikely cause of the exacerbation.

When planning care for a client with ulcerative colitis who is experiencing an exacerbation of symptoms, which client care activities can the nurse appropriately delegate to an unlicensed assistant? Select all that apply.
1. Assessing the client's bowel sounds.
2. Providing skin care following bowel movements.
3. Evaluating the client's response to antidiarrheal medications.
4. Maintaining intake and output records.
5. Obtaining the client's weight.

                                2, 4, 5.
The nurse can delegate the following basic care activities to the unlicensed assistant: providing skin care following bowel movements, maintaining intake and output records, and obtaining the client's weight. Assessing the client's bowel sounds and evaluating the client's response to medication are registered nurse activities that cannot be delegated.

Which goal for the client's care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis?

1. Promoting self-care and independence.
2. Managing diarrhea.
3. Maintaining adequate nutrition.
4. Promoting rest and comfort.

                                    2.
Diarrhea is the primary symptom in an exacerbation of ulcerative colitis, and decreasing the frequency of stools is the first goal of treatment. The other goals are ongoing and will be best achieved by halting the exacerbation. The client may receive antidiarrheal agents, antispasmodic agents, bulk hydrophilic agents, or anti-inflammatory drugs.

The client with ulcerative colitis is following orders for bed rest with bathroom privileges. When evaluating the effectiveness of this level of activity, the nurse should determine if the client has:

1. Conserved energy.
2. Reduced intestinal peristalsis.
3. Obtained needed rest.
4. Minimized stress.

                                  2.
Although modified bed rest does help conserve energy and promotes comfort, its primary purpose in this case is to help reduce the hypermotility of the colon. Remaining on bed rest does not by itself reduce stress, and if the client is having stress, the nurse can plan with the client to use strategies that will help the client manage the stress.

A client's ulcerative colitis signs and symptoms have been present for longer than 1 week. The nurse should assess the client for signs and symptoms of which of the following complications?

1. Heart failure.
2. Deep vein thrombosis.
3. Hypokalemia.
4. Hypocalcemia.

                                        3.
Excessive diarrhea causes significant depletion of the body's stores of sodium and potassium as well as fluid. The client should be closely monitored for hypokalemia and hyponatremia. Ulcerative colitis does not place the client at risk for heart failure, deep vein thrombosis, or hypocalcemia.

A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for:

1. Hyperalbuminemia.
2. Thrombocytopenia.
3. Hypokalemia.
4. Hypercalcemia.

                                        3.
Hypokalemia is the most expected laboratory finding owing to the diarrhea. Hypoalbuminemia can also occur in Crohn's disease; however, the client's potassium level is of greater importance at this time because a low potassium level can cause cardiac arrest. Anemia is an expected development, but thrombocytopenia is not. Calcium levels are not affected.

The nurse is developing a plan of care for a client with Crohn's disease who is receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include? Select all that apply.
1. Monitoring vital signs once a shift.
2. Weighing the client daily.
3. Changing the central venous line dressing daily.
4. Monitoring the I.V. infusion rate hourly.
5. Taping all I.V. tubing connections securely.

                                2, 4, 5.
When caring for a client who is receiving TPN, the nurse should plan to weigh the client daily, monitor the I.V. fluid infusion rate hourly (even when using an I.V. fluid pump), and securely tape all I.V. tubing connections to prevent disconnections. Vital signs should be monitored at least every 4 hours to facilitate early detection of complications. It is recommended that the I.V. dressing be changed once or twice per week or when it becomes soiled, loose, or wet.

Which of the following should be a priority focus of care for a client experiencing an exacerbation of Crohn's disease?
1. Encouraging regular ambulation.
2. Promoting bowel rest.
3. Maintaining current weight.
4. Decreasing episodes of rectal bleeding.

                                2.
A priority goal of care during an acute exacerbation of Crohn's disease is to promote bowel rest. This is accomplished through decreasing activity, encouraging rest, and initially placing client on nothing-by-mouth status while maintaining nutritional needs parenterally. Regular ambulation is important, but the priority is bowel rest. The client will probably lose some weight during the acute phase of the illness. Diarrhea is nonbloody in Crohn's disease, and episodes of rectal bleeding are not expected.

The nurse notes that the sterile, occlusive dressing on the central catheter insertion site of a client receiving total parenteral nutrition (TPN) is moist. The client is breathing easily with no abnormal breath sounds. The nurse should do the following in order of what priority from first to last?
1. Change dressing per institutional policy.
2. Culture drainage at insertion site.
3. Notify physician.
4. Position rolled towel under client's back, parallel to the spine.

                                  3, 4, 2, 1.
A potential complication of receiving TPN is leakage or catheter puncture; notify the physician immediately and prepare for changing of the catheter. If pneumothorax is suspected, position a rolled towel under the client's back. If there is drainage at the insertion site, culture the drainage and change the dressing using sterile technique.

Which of the following should the nurse interpret as an indication of a complication after the first few days of TPN therapy?

1. Glycosuria.
2. A 1- to 2-pound weight gain.
3. Decreased appetite.
4. Elevated temperature.

                                        4.
An elevated temperature can be an indication of an infection at the insertion site or in the catheter. Vital signs should be taken every 2 to 4 hours after initiation of TPN therapy to detect early signs of complications. Glycosuria is to be expected during the first few days of therapy until the pancreas adjusts by secreting more insulin. A gradual weight gain is to be expected as the client's nutritional status improves. Some clients experience a decreased appetite during TPN therapy.

colectomy with permanent ileostomy

-in small bowel -use colostomy bag -liquid stool

total colectomy with a continent (Kock's) ileostomy

-internal ileal resevoir intr-abdominal pouch stores stool -1 way valve

colectomy surgery pre and post op

PRE- bowel prep
POST -take v.s q4 -IV -Stoma care - bag -increase fluids

• assess stoma
• prevent and treat skin irritation
• odor- use tabs and diet to reduce
• drainage- liquidfor ileostomy, solid for lower in colon
• NO enteric capsules
• irrigation
• NO irrigation for ileostomy
• irrigate to stimulate parastlsis for desending bowel
• check out put------ not as important lower in bowel
• change bag every 5-7 days

The client with a new colostomy is being discharged. Which statement made by theclient indicates the need for further teaching?
1.“If I notice any skin breakdown I will call the HCP.” 2.“I should drink only liquids until the colostomy starts to work.” 3.“I should not take a tub bath until the HCP okays it.” 4.“I should not drive or lift more than five (5) pounds.”

                                  2 The client should be on a regular diet, andthe colostomy will have been working for several days prior to discharge. The client’sstatement indicates the need for further teaching

The nurse is teaching the client how to care for her ileostomy. The client asks the nurse how long she can wear her pouch before changing it. The nurse responds:
1. "The pouch is changed only when it leaks."
2. "You can wear the pouch for about 4 to 7 days."
3. "You should change the pouch every evening before bedtime."
4. "It depends on your activity level and your diet."

2.
Unless the pouch leaks, the client can wear her ileostomy pouch for about 4 to 7 days. If leakage occurs, it is important to promptly change the pouch to avoid skin irritation. It is not necessary to change the pouch daily or in the evening. Diet and activity typically do not affect the schedule for changing the pouch.

A client who is scheduled for an ileostomy has an order for oral neomycin (Mycifradin) to be administered before surgery. The intended outcome of administering oral neomycin before surgery is to:
1. Prevent postoperative bladder infection.
2. Reduce the number of intestinal bacteria.
3. Decrease the potential for postoperative hypostatic pneumonia.
4. Increase the body's immunologic response to the stressors of surgery.

                                      2.
The rationale for the administration of oral neomycin is to decrease intestinal bacteria and thereby decrease the potential for peritonitis and wound infection postoperatively. Neomycin will not alter the client's potential for developing a urinary or respiratory infection. Neomycin does not affect the body's immune system.

A client has returned to the medical surgical unit after having surgery to create an ileostomy. Which goal has the highest priority at this time?

1. Providing relief from constipation.
2. Assisting the client with self-care activities.
3. Maintaining fluid and electrolyte balance.
4. Minimizing odor formation.

                                            3.
A high-priority outcome after ileostomy surgery is the maintenance of fluid and electrolyte balance. The client will experience continuous liquid to semiliquid stools. The client should be engaged in self-care activities, and minimizing odor formation is important; however, these goals do not take priority over maintaining fluid and electrolyte balance.

The nurse should instruct the client with an ileostomy to report which of the following signs and symptoms immediately?

1. Passage of liquid stool from the stoma.
2. Occasional presence of undigested food in the effluent. 3. Absence of drainage from the ileostomy for 6 or more hours.
4. Temperature of 99.8 ° F (37.7 ° C).

                                    3.
Any sudden decrease in drainage or onset of severe abdominal pain should be reported to the physician immediately because it could mean that an obstruction has developed. The ileostomy drains liquid stool at frequent intervals throughout the day. Undigested food may be present at times. A temperature of 99.8 ° F is not necessarily abnormal or a cause for concern.

The nurse evaluates the client's understanding of ileostomy care. Which of the following statements indicates that discharge teaching has been effective?

1. "I should be able to resume weight lifting in 2 weeks."
2. "I can return to work in 2 weeks."
3. "I need to drink at least 3,000 mL a day of fluid."
4. "I will need to avoid getting my stoma wet while bathing."

                                  3.
To maintain an adequate fluid balance, the client needs to drink at least 3,000 mL/ day. Heavy lifting should be avoided; the physician will indicate when the client can participate in sports again. The client will not resume working as soon as 2 weeks after surgery. Water does not harm the stoma, so the client does not have to worry about getting it wet.

A client with a well-managed ilesostomy calls the nurse to report the sudden onset of abdominal cramps, vomiting, and watery discharge from the ileostomy. The nurse should:
1. Tell the client to take an antiemetic.
2. Encourage the client to increase fluid intake to 3 L/ day to replace fluid lost through vomiting.
3. Instruct the client to take 30 mL of milk of magnesia to stimulate a bowel movement.
4. Advise the client to notify the physcian.

                                      4.
Sudden onset of abdominal cramps, vomiting, and watery discharge with no stool from an ileostomy are likely indications of an obstruction. It is imperative that the physician examine the client immediately. Although the client is vomiting, the client should not take an antiemetic until the physician has examined the client. If an obstruction is present, ingesting fluids or taking milk of magnesia will increase the severity of symptoms. Oral intake is avoided when a bowel obstruction is suspected.

cancer of bowels risk factors

• low fiber intake
  
• sweets and red meat
• smoking
• obesity
• family history
• inflammatory bowel disease
• pollops

how to reduce the risk of bowel cancer

• ^ grains and veggies
• test for occult blood (melena)
• colonoscopy q 10 years

• decrease in weight
• chills and vomiting
• diarrhea or constipation
• fatigue
• anemia and occult blood

diagnostic studies of colon cancer

• CBC
  
• WBC
• ocult blood
• barrium enema
• colonoscopy
• MRI
• electrolytes

colon cancer Medical management 

• radiation
  
• chemo
• surgery
• **if in lymph nodes
• colostomy/ node removal
• **if in colon
• anastamosis

• rids bowel of normal flora
• reduces post-op infections
• given 1-3 days before surgery

PRE -bowel prep -neomycin
POST -NPO till bowel sounds -V.S. -IV fluids -NG tube- prevent ABD disention

"11. The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?

"a. Duodenal ulcers
b. Hemorrhoids
c. Weight gain
d. Polyps"

                                      D. Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren't preexisting conditions of colorectal cancer. Weight loss — not gain — is an indication of colorectal cancer.

A client with cancer of the colon who is receiving chemotherapy tells a nurse that some foods on the metal tray taste bitter. The nurse would try ti limit which of the following foods that is most likely to cause this taste for the client? "a) cantaloupe
b) potatoes
c) beef
d) custard"

            Cbeef: meat is perceived as bitter by clients with cancer

"A gastrectomy is performed on a client with gastric cancer. Int he immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. Which of the following is the appropriate nursing intervention.
"1. Notify the physician
2. Measure the abdominal girth
3. Irrigate the nasogastric tube
4. Continue to monitor the drainage

                                    4. Continue to monitor the drainage Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours postoperatively, changes to brown-tinged, and is then to yellow or clear. Because bloody drainage is expected in the immediate post-operative period, the nurse should continue to monitor the drainage. The nurse does not need to notify the physician at this time. Measuring abdominal girth is performed to detect the development of distention. Following gastrectomy, a nasogastric tube should not be irrigated unless there are specific physician perscriptions to do so.

A nurse is teaching a client about the risk factors associated with colorectal cancer the nurse detemines that further teaching related to colorectal cancer is necessary if the client identifies which of the following as an associated risk factor? 1. Age younger than 50 2. history of colorectal polyps 3. family history of colorectal cancer 4. chronic IBD

                      1 Correctal cancer risk factors include age older than 50, a family history of the disease, polyps, and chronic IBD

Which symptom, if reported by a client, would lead the nurse to suspect colon cancer?
1) abdominal cramping 2) constant hunger 3) feeling of fullness, 4) weight gain .

                                3 feeling of fullness the client with gastric cancer may report a feeling of fullness in the stomach, but not enough to cause him to seek medical care. Abdominal cramping isn't associated with gastric cancer and weight loss (not increased hunger or weight gain) are common with gastric cancer

The nurse is teaching a client about the modifiable risk factors than can reduce the risk for colorectal cancer. The nurse places the highest priority on discussing which risk factor with this client?

"A. Age older than 30 years
B. High fat and low fiber diet
C. Distant relative with colorectal cancer
D. Personal history of ulcerative colitis or GI polyps"

                                        B
Rationale: Common risk factors for colorectal cancer that cannot be changed include age older than 40, first-degree relative with colorectal caner, and history of bowel problems such as ulcerative colitis or familial polyposis. Clients should be aware of modifiable risk factors as part of general health maintenance and primary disease prevention. Modifiable risk factors are those that can be reduced and include a high fat and low fiber diet."

bowel obstruction risk factors and causes

mechanical- -adhesions -tumor -fecal compact -volvulus
NON mechanical-
paralytic ilius

symptoms of bowel obstruction

• ABD distention
• pain/ cramping
• vomit
• decrease in gas
• weight loss
• nutrition deficient
• fluid and electrolyte imbalance

diagnostic studies for bowel obstruction

• History and Physical • Abdominal x-rays/US • Barium enemas • Colonoscopy • Labs : CBC, CMP, stools for occult blood

nursing activities for bowel obstruction

• NPO- before surgery
• IV
• bowel sound
• NG tube for decompression
• V.S.
• TPN- depending on severity

surgery for bowel obstruction

** colectomy/ anastamosis**
POST -OP -NPO- till bowel sounds -ambulation after 24 hours -SCD's

What treatment should the nurse expect to include for the client with peritonitis?

Which nursing action addresses the problem experienced by patients with peritonitis?

Which of the following symptoms would a client in the stages of peritonitis exhibit?

Which of the following nursing interventions should be prioritized to manage a client with appendicitis?