CCC1 - Inflammation, IBC, Appendicitis, Osteoarthritis

Inflammatory bowel disease (IBD) definition

Chronic inflammation of the GI tract with periods of remission and exacerbations

Cause of IBD

Unknown with no cure

Two main types of IBD

Crohn's disease and Ulcerative colitis

Peak age of IBD onset

15–25 years and second peak in the 6th decade

Does IBD affect males or females more?

Affects both sexes equally

Common clinical manifestation of IBD

Diarrhea

Which IBD symptom is more common in ulcerative colitis?

Bloody stools

Which IBD symptom is more common in Crohn’s disease?

Weight loss

Other symptoms of IBD

Abdominal pain, fever, fatigue

IBD in children

Poor growth, mild GI symptoms, anorexia

Key diagnostic tests for IBD

CBC, electrolytes, protein levels, stool studies, imaging

What may be found in stool with IBD?

Blood, mucus, pus

Sulfasalazine use

Decreases GI inflammation and maintains remission in mild–moderate IBD

Metronidazole and Ciprofloxacin use in IBD

Treat infections and reduce inflammation

Corticosteroids in IBD

Used to achieve remission during acute flare-ups

Examples of corticosteroids used in IBD

Prednisolone and Budesonide

Immunosuppressants in IBD

Suppress immune response and maintain remission

Examples of immunosuppressants

Azathioprine and 6-mercaptopurine

Important monitoring for immunosuppressants

Regular CBC monitoring

Methotrexate key teaching

Monitor CBC/LFTs and avoid in pregnancy

Biologics in IBD mechanism

Inhibit tumor necrosis factor (TNF)

Examples of biologics

Infliximab, Adalimumab, Certolizumab

Nutritional therapy during IBD flare

Liquid enteral nutrition, high-calorie, lactose-free

When are regular foods reintroduced in IBD?

Gradually after symptoms improve

Nursing assessment for IBD

Diarrhea, weight loss, meds, family history, mental health

IBD gerontologic concern

Increased risk for dehydration and electrolyte imbalance

Appendicitis definition

Inflammation of the appendix in the right lower quadrant

Common age range for appendicitis

5–45 years

Classic sign of appendicitis

Right lower quadrant (RLQ) pain

Other symptoms of appendicitis

Nausea, vomiting, fever, malaise, constipation or diarrhea

Appendicitis diagnostic tests

CBC, CRP, CT scan

Key physical assessment finding in appendicitis

Rebound tenderness

Pre-op care for appendicitis

Pain management, monitor changes, verify consent

Post-op priority after appendectomy

Monitor return of bowel sounds

Diet progression after appendectomy

Advance slowly

Post-op complication monitoring

Assess surgical site for infection

Osteoarthritis definition

Degenerative joint disease with cartilage breakdown

Is osteoarthritis inflammatory?

Noninflammatory unless localized

Common symptoms of osteoarthritis

Joint pain, stiffness, crepitus, enlarged joints

Heberden’s nodes location

Distal interphalangeal (DIP) joints

Bouchard’s nodes location

Proximal interphalangeal (PIP) joints

Risk factors for osteoarthritis

Aging, obesity, female, joint injury, genetics

Diagnostics for osteoarthritis

X-ray, CT, MRI, ESR, CRP

Nursing interventions for osteoarthritis

Maintain mobility, joint protection, posture, assistive devices

Nonpharmacologic management of osteoarthritis

Ice, low-impact exercise, weight loss

Inflammation definition

Protective immune response to injury, infection, or allergy

Purpose of inflammation

Neutralize harmful agents, remove dead tissue, promote healing

Five classic signs of inflammation

Redness, heat, pain, swelling, loss of function

Cause of redness in inflammation

Increased capillary permeability

Cause of pain in inflammation

Pressure from fluid and histamine stimulation

Systemic signs of inflammation

Fever, ↑ WBC, malaise, nausea, ↑ HR/RR

Acute inflammation duration

2–3 weeks

Dominant cells in acute inflammation

Neutrophils

Chronic inflammation duration

Can last years

Dominant cells in chronic inflammation

Lymphocytes and macrophages

Diagnostics for inflammation

CBC, CRP, ESR, imaging

Medications used for inflammation

Aspirin, Acetaminophen, NSAIDs, Corticosteroids

RICE stands for

Rest, Ice, Compression, Elevation

Inflammation healing components

Regeneration and repair