LOWER GI STUDY GUIDE
COLONOSTOMY
- Prep: 8 hours of being NPO
- Do not use a sap suds enema, they can damage the lining of the colon. Just use
water
- Seen by putting air into the bowels to dilate it
- The anus all the way to the cecum
o NOT JUST THE ANUS, RECTUM, OR SEGMOID
IRRITABLE BOWEL SYNDROME
- Diet: 20g of fiber a day & gluten free
o High fiber, no gluten
- They CAN have yogurt!
- Know low fiber foods
o Anything that is refined:
Pancake batter
Juices
White rice
- Residue: Whatever is left over after being chewed
up and being exposed to acids and digestive
enzymes and intestinal tract.
- LOW RESIDUE: Nothing left over
INFLAMMATORY BOWEL DISEASE
*Crohn’s and ULCERATIVE COLOTIS*
- Lower residue and low fat, low lactose, and low
fiber foods (fiber makes you poop and we don’t want their process to be sped up)
- Residue is what is left over after digestion and what is left over is what wasn’t
absorbed
o Low residue goes with the low fiber (ibd diet)
- Supplement with high protein snacks with insure drinks and high protein sacks
- Can have cottage and cheese
- High protein and canned drinks
- Calorie dense foods
- Small frequent meals
- Crohn’s vs. Ulcerative Colitis
o Similarities: both inflammatory diseases
o Differences:
Part of anatomy affected and how much:
Crohn’s: Anus to the mouth
Ulcerative Colitis: from the colon (large intestines) which causes
a low H&H
o 10-20 stools a day
o Losing a lot of lining of the anatomy
DIVERTICULITIS
, - Inflamed diverticulum
- Pain location is in the LLQ
- Treatment can be at home
- High fiber foods
o Broccoli
o Cauliflower
o Cabbage
o Whole wheat bread
o Whole grain rice
o Things that would make you go to the bathroom more frequently
- Severe diverticulitis:
o Need to be NPO with IV fluids (crystalloids)
o No laxatives, psyllium, diet, and food
o If they do get antibiotics, they need to be broad spectrum
o Pain control by IV
FISTULA TO THE BLADDER
ACUTE ADBOMEN
- Vital signs:
o Perforation shows LOW BP (deal with this before anything else)
- Treatment would be IV fluid crystalloids
- Apply oxygen
- Don’t send to CT unless their BP goes up
ADBOMINAL SURGERY
- At risk for dehiscence and wound infection
o S/S of infection:
Increased temperature
Redness
Drainage coming from the area (clear/ purulent/ or green)
o Risk for dehiscence:
Overweight pts
Pts that were malnutrished prior to abd surgery
- If a pt has decreased peristalsis, they will have a decrease of gas movement through
the colon
o They will be dilated, bloated, and distended
o Ambulation helps this!
o You can also do a tube to relief gas: NG tube, cantor tube, or miler abbot tube
- A patient that IMMEDIATELY has had abd surgery, what would be the first nursing
priority?
o Morphine would be a good IV medication
4mg every 4 hours
NOTHING PO if they are coming from surgery
o Maintained NPO status until bowel sounds return
Begin with ice chips
o SCDs and TEDs are appropriate
SCD discontinued when they begin ambulation
COLONOSTOMY
- Prep: 8 hours of being NPO
- Do not use a sap suds enema, they can damage the lining of the colon. Just use
water
- Seen by putting air into the bowels to dilate it
- The anus all the way to the cecum
o NOT JUST THE ANUS, RECTUM, OR SEGMOID
IRRITABLE BOWEL SYNDROME
- Diet: 20g of fiber a day & gluten free
o High fiber, no gluten
- They CAN have yogurt!
- Know low fiber foods
o Anything that is refined:
Pancake batter
Juices
White rice
- Residue: Whatever is left over after being chewed
up and being exposed to acids and digestive
enzymes and intestinal tract.
- LOW RESIDUE: Nothing left over
INFLAMMATORY BOWEL DISEASE
*Crohn’s and ULCERATIVE COLOTIS*
- Lower residue and low fat, low lactose, and low
fiber foods (fiber makes you poop and we don’t want their process to be sped up)
- Residue is what is left over after digestion and what is left over is what wasn’t
absorbed
o Low residue goes with the low fiber (ibd diet)
- Supplement with high protein snacks with insure drinks and high protein sacks
- Can have cottage and cheese
- High protein and canned drinks
- Calorie dense foods
- Small frequent meals
- Crohn’s vs. Ulcerative Colitis
o Similarities: both inflammatory diseases
o Differences:
Part of anatomy affected and how much:
Crohn’s: Anus to the mouth
Ulcerative Colitis: from the colon (large intestines) which causes
a low H&H
o 10-20 stools a day
o Losing a lot of lining of the anatomy
DIVERTICULITIS
, - Inflamed diverticulum
- Pain location is in the LLQ
- Treatment can be at home
- High fiber foods
o Broccoli
o Cauliflower
o Cabbage
o Whole wheat bread
o Whole grain rice
o Things that would make you go to the bathroom more frequently
- Severe diverticulitis:
o Need to be NPO with IV fluids (crystalloids)
o No laxatives, psyllium, diet, and food
o If they do get antibiotics, they need to be broad spectrum
o Pain control by IV
FISTULA TO THE BLADDER
ACUTE ADBOMEN
- Vital signs:
o Perforation shows LOW BP (deal with this before anything else)
- Treatment would be IV fluid crystalloids
- Apply oxygen
- Don’t send to CT unless their BP goes up
ADBOMINAL SURGERY
- At risk for dehiscence and wound infection
o S/S of infection:
Increased temperature
Redness
Drainage coming from the area (clear/ purulent/ or green)
o Risk for dehiscence:
Overweight pts
Pts that were malnutrished prior to abd surgery
- If a pt has decreased peristalsis, they will have a decrease of gas movement through
the colon
o They will be dilated, bloated, and distended
o Ambulation helps this!
o You can also do a tube to relief gas: NG tube, cantor tube, or miler abbot tube
- A patient that IMMEDIATELY has had abd surgery, what would be the first nursing
priority?
o Morphine would be a good IV medication
4mg every 4 hours
NOTHING PO if they are coming from surgery
o Maintained NPO status until bowel sounds return
Begin with ice chips
o SCDs and TEDs are appropriate
SCD discontinued when they begin ambulation
