Modification in disposal: Bowel maladySlide 2
Alteration in end inside Inflammatory gut illness Small gut hindrance Cancer of the colon and ostomies.Slide 8
Small digestive system Made up of three sections: ileum, jejunum, and duodenum. Fundamental capacity is ingestionSlide 9
Small digestive systemSlide 12
It is a side effect not an essential issue. It is the expansion in: liquid, volume, and liquid substance of the stool. Causes: Bacteria poisons Parasitic contaminations Malabsorption disorders Medication Systemic sickness Allergies Psychogenic DiarrheaSlide 13
Constipation Two or less BM\'s week after week or when poop is unnecessarily troublesome or requires straining. Most regular cause: Ignoring the inclination to poop. Treat this cause with training ( a day by day BM is a bit much for good wellbeing) practice and eating routine adjustment.Slide 14
Nursing evaluation Questions inquire? Have you been out of the nation? What meds have you utilized? At the point when did the runs begin? Are there any related manifestations?Slide 15
Nursing evaluation Observe the patient\'s stool for steatorrhea, blood, discharge, or bodily fluid. Screen recurrence and qualities of solid discharge. Measure stomach circumference and auscultate gut sounds each movement.Slide 16
Nursing finding Fluid volume shortfall Risk for weakened skin uprightness Altered sustenance: not as much as body prerequisites identified with loss of supplementsSlide 17
Fluid and electrolyte awkwardness r/t the runs The expanded water substance of the stool puts the patient at danger for liquid shortage. Record Accurate I&O Weight quiet QD Assess the patient\'s mucous film, skin turgor, and pee particular gravity. Screen and record crucial signs including orthostatic blood weights.Slide 18
Fluid and electrolyte unevenness r/t looseness of the bowels Postural (orthostatic) circulatory strain changes. At the point when the BP drops more than 10mmHg when evolving positions (deceiving sitting, sitting to standing). Orthostatic changes demonstrate liquid shortfall. Beat ordinarily increments in the meantime.Slide 19
Risk for weakened skin honesty Provide great healthy skin Assist the customer with cleaning the perianal region as required. Utilize warm water and delicate fabrics. Give defensive balm to the perianal territorySlide 20
Caution on pharmacological medications Laxatives ought to never be control to a patient with inside hindrance or impaction. Individuals with stomach agony of undetermined cause. Intestinal medicines can bring about mechanical harm and puncture the inside.Slide 21
Caution on pharmacological medicines Enemas are use for perpetual stoppage or fecal impaction. When in doubt utilize just for intense stage on a brief timeframe bases. Over the top utilization of bowel purge can prompt liquid electrolyte awkwardness. Never utilize bowel purges on the off chance that you think aperture.Slide 23
Chronic provocative entrail illness Two incendiary diseases(Crohn\'s malady and Ulcerative colitis )comparable on the accompanying : Etiology is obscure (immune system part include) hereditary segments/run families/ethnic gatherings Affect youthful grown-ups between the ages 15-35 years. The runs is the prevalent side effectSlide 24
Ulcerative colitis Affects the mucous and the submucosa of the colon and rectum. Principally influences the youthful (15-30) More regular in whites Cause obscure found in families with hx. of the same, hx crohn\'s, Hx certain joint inflammation.Slide 25
Pathophysiology of ulcerative colitis Inflamed tombs of Lieberkuhn in the distal internal organ and rectum Pinpoint tiny hemorrhages grow Then grave abscesses create. The abscesses infiltrated the shallow submucosa a spread along the side prompting mucosal corruption and sloughing.Slide 26
Pathophysiology of Ulcerative Colitis The provocative procedure prompts further tissue harm from exudate and the arrival of incendiary go betweens, for example, prostanglandins and cytokines. The mucosa gets to be red on account of vascular blockage, friable and edematous. It drains simple and discharge is regular.Slide 27
Pathophysiology of Ulcerative Colitis Edema darken the submucosal vessels and makes a granular appearance. Pseudopolyps tongue line projections are normal. Polypoid changes speak to zones of edematous tissue between zones of ulceration .. Unending irritation prompts shortening of the colon from fibrosis and loss of haustra.Slide 28
Pathophysiology of Ulcerative Colitis The provocative procedure starts at the rectosigmoid are of the butt-centric channel and advances proximal. May advance to include the whole colon. Blood, bodily fluid and discharge pool in he lumen of the colon (trademark loose bowels) The degree of the colon including relates with seriousness of the sickness.Slide 29
Polyps changes that happen in ulcerative colitisSlide 30
Ulcerative colitisSlide 31
Ulcerative Colitis signs and side effects Insidious onset Attacks last 1-3 months Occur at interims of months to years Diarrhea is the dominating side effects of a wide range of ulcerative colitis. Commonly 30-40 stools for every day, with blood and bodily fluid.Slide 32
Ulcerative Colitis signs and side effects When extreme infection is available may have other appearance, for example, joint pain (identified with the provocative procedure going on), uveitis, thromboemboli, injuries of the liver, gallbladder, and pancreas and in addition pericarditis. Patients with Ulcerative Colitis have an expanded danger of creating colon malignancy.Slide 33
Complications of Ulcerative Colitis Bowel aperture most savage Hemorrhage Toxic megacolon Increased danger of creating colon growth. The danger is higher when there is serious association of the colon with illness for >10 years.Slide 34
Diagnostic of Ulcerative Colitis Stool for mysterious blood Hemoglobin and hematocrit Colonoscopy**not on dynamic stage Barium enema**" A yearly colonoscopy is firmly suggested for any individual who has ulcerative colitis with 8-10years after the DX.Slide 35
Treatment of Ulcerative Colitis Pharmacological Dietary administration Surgical administrationSlide 36
Pharmacological treatment Sulfasalazine (Azulfidine) against inflamatory restrains prostaglandin creation in the gut. Mesalamine (Rowasa) & Olsalazine (Dipentum) - Same activity as above. Corticosteroids-calming impacts Use as a treatment amid intense assaults.Slide 37
Immunossupression Imuran (Azathioprine) Cyclosprine (Sandimmune) Antidiarrheal (not utilized amid an intense assault) Loperamide Diphenoxylate Pharmacological treatmentSlide 38
Dietary administration in ulcerative colitis No milk items No caffeine No gas creating or crude natural products & vegetables Bulk framing items, for example, psyllium or methylcellulose to diminished looseness of the bowels and decrease manifestations. TPN amid intense fuelSlide 39
Surgery as a treatment for ulcerative colitis. Method of decision is an aggregate colectomy with ileonal anastomosis. The whole colon and rectum are expel A pocket is shaped from the terminal ileumSlide 40
Surgery as a treatment for ulcerative colitis. The pocket is conveyed into the pelvis and anastomosed to the butt-centric trench. A transitory or circle ileostomy is performed and kept up for 2 to 3 months. At the point when the anastomosis destinations mend the ileostomy is shut and the patient has solid discharges through the butt.Slide 42
Ileonal anastemosisSlide 43
Surgery as a treatment for ulcerative colitis. The Kock\'s ileostomy(continent) an intra-stomach store is built from the terminal ileum. Stool gathers in the pocket until the patient channels it with a catheter An areola valve avoid spillage of stool.Slide 44
Continent ileostomiesSlide 45
Surgery as a treatment for ulcerative colitis. Complete proctocolectomy with changeless ileostomy. Colon, rectum, and rear-end are expel, and the end of the terminal ileum is exteriorized as a stoma on the right stomach divider.Slide 46
A sound showing up stomaSlide 47
Surgery as a treatment for ulcerative colitis. Brief or circle ileostomy is regularly used to wipe out defecation and permit mending for 2-3 months after an ileoanal anastomosis. A circle of the ileum is conveyed to the body surface and permits stool seepage into the outside pocket. At the point when the stoma is not required a second surgery is done to close the stoma and repair the gut. See Lemone content pp.826-829 for nursing consideration of patients with an ileostomy, for changing an ostomy pocket, and for ileostomy lavage.Slide 49
Relieving stomach cramping Providing passionate bolster Teaching about the ailment and uncommon needs. Nursing conclusion: Fluid and electrolytes awkwardness R/T looseness of the bowels Body picture aggravation R/T ailment process Nursing care in ulcerative colitisSlide 50
Monitor the appearance and recurrence of solid discharge. Survey and report nearness of blood in the stool by testing for mysterious blood and BRB Assess record Vital signs q4hrs. Record pt. wt. qd. Survey the pt. for indications of liquid deficiency. Keep up liquid admission by mouth or by parenteral means as demonstrated Fluid and electrolyte lopsidednessSlide 51
Encourage the patient to talk about physical changes and their outcomes. Acknowledge persistent feeling and impression of self. Energize exchange about concerns with respect to the impacts of the malady on cozy relationship. Support pt. to settle on decision and choice in regards to mind. Include pt. in the showing arranges and give guidelines as required. Organize cooperation with gathering of individuals with comparative issues. Show adapting methodologies. Unsettling influence in Body pictureSlide 52
Emphasize the need to keep up an admission of 2 to 3 quarter of liquids for every day to make up for liquid misfortunes. Give diet instructing allude to dietician if necessary If a surgical intercession is arranged, educate about the surgery and follow up consideration . Contact an ET medical caretaker. Talk about solutions , act
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