AH 2. Intestinal and rectal disorders

absorb nutrients and water and move waste toward elimination.

intestines

means bowel movements are less frequent or difficult to pass.

constipation

constipation risks

medications, disease, older age, and low fiber

constipation complications

hypertension, fecal impaction, hemorrhoids, anal fissures, and megacolon

nursing assesment constipation

the person's usual pattern, diet, fluid intake, activity, medication use, and signs of impaction or obstruction

more than three bowel movements per day, increased stool amount, or abnormally liquid stool.

diarrhea

types of diarrhea

secretory, osmotic, and mixed

danger of diarrhea

loss of water and electrolytes.

what to monitor diarrhea

stool pattern, hydration, skin, and signs of weakness or electrolyte disturbance

presented as a regulatory/motility problem involving neuroendocrine dysregulation and stress.

functional disorder; it should not automatically be treated as the same thing as inflammatory bowel disease.

Irritable bowel syndrome (IBS)

goals of IBS

relieve pain, control bowel-pattern changes, and reduce stress

involuntary passage of stool.

fecal incontincence

care for fecal incontinence

bowel retraining and meticulous skin care.

. Preserve dignity, explain care respectfully, and protect the skin from ongoing moisture and stool exposure.

digestive system cannot adequately absorb important nutrients, vitamins, or minerals

Malabsorption syndrome

frequent, loose, bulky, foul-smelling stools.

Malabsorption syndrome

managment Malabsorption syndrome

avoiding dietary substances that aggravate symptoms and providing substantial nutrient supplementation as prescribed.

A key systemic consequence Malabsorption syndrome

osteoporosis risk: poor absorption of minerals, especially calcium, can weaken bones.

potentially serious abdominal presentation that needs prompt assessment

acute abdomen

appendicitis, diverticulitis, and peritonitis all carry a risk of

acute abdomen- perforation.

appendix becomes obstructed, inflamed, and swollen

appendicitis

what to Watch for appendicitis

worsening abdominal symptoms and changes suggesting perforation or systemic illness.

are small sac-like pouches in the bowel wall

Diverticula

Food and bacteria can become trapped in diverticula , leading to inflammation and infection

significant acute cases of diverticulitis may require

hospitalization and surgery

inflammation/infection of the peritoneal cavity, often because contents leak from an abdominal organ.

bacterial contamination and acute abdominal symptom

Peritonitis

tx Peritonitis

fluids, pain relief, and antibiotics.

clinical priotiry periotinitis

For acute conditions, frequent, meticulous assessment of the acutely ill patient is a primary nursing priority because perforation can be life-threatening.

a surgically created opening from the ileum (the end portion of the small intestine) to the abdominal wall

has no controlling sphincter, so output flows continuously and is often liquid.

Ileostomy

skin and appliance ilieostamy

intestinal output contains enzymes that can irritate skin; protect the skin and ensure the pouch/appliance fits and functions.

• Hydration/electrolyte illeostomy

Liquid output can cause dehydration and electrolyte loss.

Nutrition illieostomy

support nutrition and watch for losses related to reduced absorption

nausea and abdominal distention suggest that

output may be physically blocked.

Muscle spasms and dehydration suggest

fluid/electrolyte loss.

: typically more rapid onse\

small bowel obstruction

is frequently used to remove fluid and gas collecting above the blockage for small bowel obstrution

NG decompression

: typically more gradual onset;

large bowel obstruction

large bowel obstruction requires

surgery, including creation of a colostomy.

these bowel sympotms need urgent evaluation.

Worsening pain, distention, vomiting, inability to pass stool/gas, and changes in vital signs

what to know about polyp

polyp is not automatically cancer, but it may need follow-up because some polyps can become malignant.

remove a section of bowel and reconnect the ends.

• Segmental resection with anastomosis:

removal of the rectum and anus, usually requiring a permanent colostomy.

• Abdominoperineal resection:

• Temporary colostomy followed by a

later reconnection/closure when appropriate.

: a surgically created reservoir using bowel, in selected cases.

• Construction of a colonic J-pouch

a small tear in anal tissue; the slide associates fissures with chronic constipation or local trauma.

anal fissure

an abnormal tract between the anal canal/rectum and nearby skin or tissue

anal fistula

fistulas and fissures grouped together as tissue problems often linked with

constipation/trauma.

: swollen vascular tissue associated with straining and chronic constipation

hemmorhoids

localized infectious conditions requiring targeted antimicrobial treatment

Sexually transmitted anorectal diseases:

a localized cyst/infection in the intergluteal cleft (the crease between the buttocks).

• Pilonidal cyst: