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NURS-194: Intestinal and Rectal Disorders Questions With Complete Solutions
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NURS-194: Intestinal and Rectal Disorders Questions With Complete Solutions
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NURS-194: Intestinal and Rectal Disorders Questions WithComplete Solutions
Anal fissure: Correct Answers a longitudinal tear or ulceration
in the lining of the anal canal; usually due to passing a large firm
piece of stool.
Other risk factors include anal intercourse, childbirth, and
trauma
Painful defecation, bleeding, and burning are indicative s/s;
bright red streaking on surface of BM is seen.
Anal fistula Correct Answers a small, tubular crack-like fibrous
sore in the skin of the anus that can cause severe pain during a
bowel movement
Usually resultant from an anorectal abscess
Passage of flatus or feces from vagina are huge reg flags.
May also cause fecal or septic drainage from a cutaneous
opening.
Surgery recommended; these are not likely to heal
spontaneously
50% recurrence rate post-op; keep watching.
,Anorectal abscess: Correct Answers Collection of perianal pus
resulting from an infection in the anal glands. Usually a result of
an obstruction (feces, foreign bodies, or trauma)
Higher risk with IBD and immunosuppressive conditions
Abscesses may tunnel and form fistulas, usually in the path of
least resistance
S/s:
- 25% report abnormal discharge
- 21% report fever, chills
- 50% present with perianal edema
- Most experience dull perianal discomfort, especially when
passing stool, and perianal pruritis
Antidiarrheal agents: Correct Answers Loperamide (drug of
choice)
Diphenoxylate/atropine
Appendicitis: Correct Answers Patho: Inflammation of the
appendix due to obstruction or infection or due to being kinked;
eventually it becomes ischemic, necrotic, and overrun by
bacterial overgrowth, and perforates.
S/s: low-grade fever, pain, paralytic ileus and abdominal
distention (if ruptured)
Statistic: the most common cause of acute abdomen and
emergency abdominal surgery.
, Pain:
- initially, vague and dull periumbilical pain
- RLQ pain that is sharp and well localized
- rebound tenderness
- palpation of LLQ causes RLQ pain (Rovsing's sign)
- if ruptured: s/s peritonitis
Dx:
- imaging (CT, US)
- rule out ectopic pregnancy with HCG
- UA to rule out renal calculi
Labs: C+S, CBC, CMP, Lactic, CRP
- CRP may be normal after 24hrs
Assessing constipation: Correct Answers Rome IV
Assessment: 25% of BMs with the following:
- straining during BM
- Bristol I stool (lumpy, hard)
- sensation of incomplete elimination
- manual maneuvers needed
- less than 3 BMs weekly
Diagnostic:
- Abdominal XR
- Endoscopy
avoiding gluten: Correct Answers 1. Choose naturally gluten-
free food:
- fruits
- veggies
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