CONDITIONS OF THE LARGE INTESTINE

Ulcerative Colitis - Recurrent ulcerative and inflammatory condition of the mucosal and submucosal layers of the colon and rectum - The colon becomes edematous and develops bleeding ulcerations - Scarring develops overtime with impaired water absorption and loss of elasticity Clinical Manifestations SEVERE diarrhea (10-20 liquid stools/day) with Rectal bleeding 1. Weight loss 2. Fever 3. Anorexia 4. Anemia and Hypocalcemia 5. Dehydration 6. LLQ Abdominal pain and cramping 7. Tenesmus Assessment and Diagnostic Findings - assess for tachycardia, tachypnea, hypotension, fever and pallor, level of hydration and nutritional status - stool exam- (+) for blood - hematocrit and hemoglobin and albumin - WBC - Sigmoidoscopy, colonoscopy - Barium enema - MRI and CT scan Complications - toxic megacolon, perforation, bleeding, osteoporotic fracture

Nursing Interventions For Cd And Uc 1. Maintain NPO during the active phase 2. Monitor for complications like severe bleeding, dehydration, electrolyte imbalance 3. Monitor bowel sounds, stool and blood studies 4. Restrict activities= rest and comfort 5. Administer IVF, electrolytes and TPN if prescribed Monitor complications of diarrhea 6. Instruct the patient to AVOID gas-forming foods, MILK products and foods such as whole grains, nuts, RAW fruits and vegetables especially SPINACH, pepper, alcohol and caffeine 7. Diet progression- clear liquid LOW residue, high protein diet 8. Administer drugs- anti-inflammatory, antibiotics, steroids, bulk-forming agents and vitamin/iron supplements

Appendicitis - Inflammation of the vermiform appendix

Etiology: usually fecalith, lymphoid hyperplasia, foreign body and helminthic obstruction Pathophysiology - Obstruction of lumen increased pressure decreased blood supply bacterial proliferation and mucosal inflammation ischemia necrosis rupture Assessment Findings 1. Abdominal pain: begins in the umbilicus then localizes in the RLQ (Mc Burneys point) 2. Anorexia 3. Nausea and Vomiting 4. Fever 5. Rebound tenderness and abdominal rigidity (if perforated) 6. Constipation or diarrhea