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Lower GI Disorders, image, image, image - Coggle Diagram

- - - - Teach the patient about the type of intestinal obstruction, its cause, and signs and symptoms.
        
        use photos/diagrams to ensure the patient understands
      - Eat small amounts of food several times a day. Do not eat 3 large meals.
        
        Space out your small meals.
        
        Add new foods back into your diet slowly.
        
        Take sips of clear liquids throughout the day.
      - AVOID FOODS that may cause gas, loose stools, or constipation as you recover
      - limit exercise or strenuous activity for at least 4 to 6 weeks
    - - lack of propulsion in the intestines
      - also known as paralytic ileus
      - there is no physical blockage
    - - Persistant abdominal pain
      - Bowel sounds are decreased or absent
    - - Peristalsis stops
        
        Causes distention of the intestines
        
        because fluids and electrolytes are accumulating
      - Usually results from a neurological impairment
      - Reflex spasms do not occur
      - Process is similar to mechanical
    - - after abdominal surgery
        
        because of effects of the anesthetic combined with inflammation or ischemia interfere with nerve impulse conduction
      - In initial stages of spinal cord injuries
      - inflammation related to severe ischemia
      - pancreatitis, peritonitis or infection in abdominal cavity
      - Hypokalemia
      - Mesenteric thrombosis
      - Toxemia
    - - Change in appetite
      - • Weight gain or loss
      - • Dysphagia
      - • Intolerance to certain foods
      - • Nausea and vomiting
      - Changes in Bowel Habits
      - Assess pain levels
    - - X-ray
      - CT scan
      - Physical exam
      - Ultrasound
  - - - may require decompression by suction for FUNCTIONAL OBSTRUCTION
      - Antibiotics therapy
        
        Required ASAP
      - Surgery
      - Fluid and electrolytes are replaced
      - Underlying cause is treated
      - NG tube insertion to remove contents
    - - Gradual obstruction from chronic inflammatory conditions
        
        ie. Crohn disease or Diverticulitis
      - Volvulus
        
        twisting of a section of intestines on itself
      - Intussusception
        
        intestine "goes inside itself" like a telescope would
      - Masses
        
        ie. tumors or foreign bodies
      - Strictures
        
        caused by scar tissue
      - Hernias
      - adhesions that twist or constrict the intestine
        
        From previous surgery, infection, or radiation
        
        MOST COMMON CAUSE OF OBSTRUCTIONS
      - commonly affecting elderly patients
    - - When this obstruction occurs gas and fluid accumulates near blockage...
        
        Intestines become distended which causes vomiting and hypovolemia (decrease in the volume of blood in your body) occurs
        
        If the obstruction is not removed the intestinal wall become ischemic (restriction in blood supply to tissues) and necrotic
        
        The obstruction promotes rapid reproduction of intestinal bacteria that can leak through the intestinal wall and enter the blood stream (causing bacteremia or sepcitemia) or peritoneal cavity (causing peritonitis) **
        
        causing bacteremia, sepcitemia or peritonitis
        
        decrease in bowel sounds indicate this change
        
        Intestines can not do their job
        
        this is not good because through vomiting electrolytes and fluids are lost
        
        intestinal wall becomes swollen with an excessive accumulation of fluid (edematous)
        
        start to compress the veins of the wall
        
        Prevents absorption
        
        causes strong contractions of the intestine to try to move the contents through
        
        Increasing fluid
        
        The intestines have nowhere to send the fluid and cannot absorb
        
        Causing the intestines to distend
    - - Large intestine obstruction
        
        mild lower abd pain
        
        constipation
        
        happens slowly and signs are mild
      - No stool or gas is passed
      - Distended abdomen
      - Vomiting
      - audible rumbling sounds
        
        Borborygmi
        
        caused by gas in the intestine
      - severe cramp-like pain (colicky) as intestinal muscles contract (peristalsis)
        
        comes in waves
    - - PARTIAL BLOCKAGE
      - COMPLETE BLOCKAGE