1) Define/explain fecal incontinence. Define faecal incontinence.
=> Fecal incontinence is a condition in which the control of bowel movement is unable. It causes involuntary stool passage.
=> Small amount of stool in fecal incontinence
From involuntary passing and loss of complete bowel control.
=> Faecal incontinence is mainly seen due to many factors
like
•> Rectum nerve and muscles are due to damage,
•>Due to disease of anal sphincter.
•> Due to certain types of medication.
•>Due to injury/trauma.
=> All these factors lead to the condition of fecal incontinence.
2) Explain the etiology/cause of fecal incontinence. State the cause of fecal incontinence.
1) muscles or nerve damage (due to muscle or nerve damage)
=> Due to injury/damage in the nerves and muscles of the rectum and anal sphincter, the control of bowel movement is impaired.
•>Child Both,
•>Pelvic surgery,
•>Some kind of
•>Medication damages the muscles and nerves of the rectum.
2) chronic constipation (chronic constipation)
=> Rectum is stretched due to long term constipation
•>muscles are week.and
•> Because of this, the ability of the rectum to hold the stool is impaired.
3) Anal sphincter dysfunction
=> Any injury, surgery and neurological condition in the muscles controlling the anal sphincter causes the dysfunction of the anal sphincter, which leads to the condition of fecal incontinence.
4)Rectum prolapse
=> There is impairment in holding stool due to protrusion of rectum from anus. and the condition of fecal incontinence occurs.
5) Inflammatory bowel disease (Inflammatory bowel disease)
=> chron’s disease (Crohn’s disease),
=> Ulcerative colitis (ulcerative colitis)
Due to this, inflammation occurs in the rectum and the rectum is damaged.
6) Neurological disorder
=> multiple sclerosis (multiple sclerosis),
=>spinal cord injury
=>spina bifida,
=>strock ( stroke ),
=> Diabetic neuropathies
Due to this, the nerve that controls the bowel gets damaged and the condition of fecal incontinence arises.
7)Rectocele and enterocele
=> When herniation of rectum and intestine occurs in vagina even bowel muscles are affected due to which the condition of fecal incontinence arises.
8) Anal fissure or Abscess (Anal Fissure Abscess)
=> Any infection and abnormality in the anal region compromises the function of the sphincter. And the condition of faecal incontinence arises.
9) Radiation therapy
=> Due to providing radiation therapy as a treatment for pelvic cancer, the condition of fecal incontinence arises due to radiation therapy affecting the bowel muscles.
10) Age related changes (Age related changes)
=> Pelvic floor muscles get loose due to age
11)other cause:=
diarrhea,
Stool impaction,
depression,
confusion,
disorientation,
Chronic Illness and Disability.
3) Explain the clinical manifestation/sign and symptoms of the patient with fecal incontinence. State the symptoms and signs of a patient with fecal incontinence.
Involuntary stool leakage.
Urgency to pass stool.
Difficulty controlling gas.
Stool consistency is impaired.
Skin irritation.
Changes in bowel habit.
Abdominal pain.
Abdominal discomfort.
4) Explain the diagnostic evaluation of the patient with fecal incontinence. Write the diagnostic evaluation of a patient with fecal incontinence
history taking and physical examination.
Digital rectal examination.
Anorectal manometry.
Anal electromyography.
Proctosigmoidoscopy.
Endoanal ultrasound.
defecography,
proctographic,
Stool study.
ct scan.
MRI.
rectal sensation test.
5) Explain the management of the patient with fecal incontinence. State the management of a patient with faecal incontinence.
1) Dietary modifications
=> Advising patient to take high fiber diet.
=> Giving advice for fluid intake in the patient’s amount.
=> Advising the patient to take proper nutritional diet.
2) Provide proper medication to the patient.
=> If the condition of faecal incontinence is primarily due to diarrhea, provide the patient with loperamide (loperamide) antidiarrheal medicine.
=> To provide proper bowel training to the patient.
3) Pelvic floor exercise
=> Giving advice to the patient to do pelvic floor exercises due to which the pelvic floor muscles are strengthened.
4) Botulinum toxin injection
Botulinum toxin injection is mainly provided in the anal sphincter due to which the tight anal sphincter relaxes and can contract properly.
5) surgery
=> Anal sphincter is corrected surgically when no other treatment has been effective.
In it
=>Sphincteroplasty,
=>Sphincter replacement,
=>Artificial anal sphincter implantation
Is included.
6) Biofeedback therapy
=> This mainly consists of guided exercises and feedback is taken. Biofeedback improves awareness and controls the pelvic floor muscles. Due to this, better control is gained in bowel movement.
7) injectable bulking agent
=> Injectable bulking agents mainly bulk up in the anal region and provide support to the tissues of the anal region and prevent stool leakage.
8) Colostomy and Bowel diversion
=> If any other treatment is not effective colostomy is done and diversion of bowel route is done.
6) Explain the nursing management of patients with the fecal incontinence. Write the nursing management of fecal incontinence.
Advise the patient to minimize soft drinks and beverages like tea, coffee, alcohol, fried foods and meat.
Advise the patient to take low fat food, high protein diet, fibrous food and green leafy vegetables.
Advise the patient to take a balance diet.
Advise the patient to avoid smocking, tobacco.
Advising the patient to reduce weight.
Advise the patient to avoid red meat, smoked fish, pickle, and highly condimental foods.
Advise patient to drink adequate amount of water.
Assess the patient for vomiting and diarrhea condition.
Advising the patient to take proper rest and sleep.
Avoid activities that increase intra-abdominal pressure.
To monitor patient’s vital signs properly.
Providing proper parenteral nutrition to the patient.
Provide intravenous fluid to the patient.
To assess the patient’s skin color, skin turgor and whether he has the condition of anemia or not.
Advise the patient to follow a high carbohydrate diet.
Advising the client to take fresh fruits, juices.
Provide psychological support to relieve the patient’s anxiety.
Advising the patient to exercise properly.
Providing prescribed medication and dietary supplements to the patient.
Providing a calm and comfortable environment to the patient.
Providing proper psychological support to the patient.
1) Define/explain irritable bowel syndrome (IBS). Define irritable bowel syndrome.
=> Irritable bowel syndrome (IBS) is primarily a disorder of the gastro intestinal system and mainly affects the large intestine (colon).
=> Complex symptoms are seen in irritable bowel syndrome which include,
•> Intermittent and Recurrent abdominal pain,
•>Abdominal bloating,
•>constipation,
•>Diarrhea
Similar symptoms are seen, along with altered bowel function.
=> Pain, discomfort, distress, irritation is seen in irritable bowel syndrome but it does not cause any serious disease and does not permanently harm the intestine.
=> Irritable bowel syndrome subsides in a few months and its symptoms worsen over time in some individuals.
2) Explain the etiology/cause of the patient with the irritable bowel syndrome. State the causes of irritable bowel syndrome.
Due to taking stress.
Due to problems in the muscles of the intestine.
Due to intake of excessive amount of food.
Due to any intestinal infection.
hereditary.
Due to immune system week.
Due to ingesting alcohol.
Because of smoking.
Due to irritable food intake.
Due to inflammation in the intestine.
Due to excessive intake of hot, spicy and caffeine food.
3) Explain the clinical manifestation/sign and symptoms of the patient with the irritable bowel syndrome. State the symptoms and signs of a patient with irritable bowel syndrome.
Abdominal pain.
Abdominal fullness.
Visible abdominal distension.
Patient complains of gas, bloating and diarrhea.
Loss of mucus from the rectum.
Passing hard and dry stools
(constipation).
an urgency to pass stool.
depression,
anxiety,
palpitations,
Passing loose and watery stools (Diarrhea),
Difficulty in passing stool.
A sense of incomplete evacuation.
Passing mucus in the stool.
other symptoms:=
Left side abdominal pain.
Passing urine in excess.
feel tired
tiredness.
headache.
Loss of appetite.
Sleep disturbance.
Anxiety and stress.
Getting depressed.
4) Explain the diagnostic evaluation of the patient with the irritable bowel syndrome. (Write the diagnostic evaluation of a patient with irritable bowel syndrome.)
history taking and physical examination.
Stool examination.
Barium enema.
upper GI series.
Sigmoidoscopy.
Colonoscopy.
Ultrasound.
5) Explain the management of the patient with the irritable bowel syndrome. Write the management of the patient with the irritable bowel syndrome.
medical management
Making lifestyle modifications and providing supportive care in irritable bowel syndrome.
Advising the patient on diet modification including advising the patient to avoid fatty food, spicy food, gas producing food.
Advise the patient to avoid alcohol and smoking.
Advise the patient to do regular exercise to improve sleep pattern and relieve anxiety.
Advise the patient to take proper rest.
Advise the patient to intake plenty of water.
Providing analgesic medicine to the patient to relieve abdominal pain.
Advise the patient to chew food slowly and properly.
Advise the patient to take food in small and frequent amounts.
Ask the patient to avoid overeating.
Advise the patient to avoid irritating foods.
Advise the patient to avoid foods like tea, coffee, chocolate, milk.
If the patient has the condition of constipation, provide laxative medicine.
If the patient has a condition of diarrhea, provide antidiarrheal medicine.
Provide anticholinergic medicine to the patient.
Provide antidepressant medication to the patient.
Explain the nursing management of patients with the irritable bowel syndrome. Write the nursing management of a patient with irritable bowel syndrome.
Collect complete health history of the patient.
Perform a complete physical examination of the patient.
Advise the patient to avoid smoking, alcohol and cigarettes.
Giving exercise advice to improve patient’s sleeping habit.
Advising the patient to maintain proper eating habit.
Advise the patient to avoid tea, coffee, soft drinks.
Advise the patient to intake plenty of fluids.
Advising the patient to take food in small and frequent amounts.
Advise the patient to avoid over eating.
Advise the patient to take ediquate food.
Advising the patient to avoid large meal, wheat, barley, rye, dairy products like milk.
Assess the volume, color and consistency of the patient’s stool.
Advise patient to avoid spicy and gas forming food.
Advise the patient to follow a high calorie, low fiber, and high protein diet.
Giving advice on meditation and yoga to reduce the patient’s anxiety and stress.
Provide anticholinergic medicine to the patient to reduce muscle spasm.
To provide psychological support to the patient and his family members.
Advise the patient to verbalize his feelings.
To clear all the doubts of the patient.
To provide complete information to the patient about his disease, its causes, its signs and symptoms, and its treatment procedures.
1) Explain/Define Appendicitis. Define appendicitis.
•••{Appendix (Appendix) := The appendix is a small finger-like structure near the beginning of the large interstyle}
=> Appendicitis is also called epityphilitis
=> Appendicitis means vermiform appendix
If infection and inflammation occurs in the vermiform appendix, it is called appendicitis.
=> Appendicitis is called an emergency condition.
=> Appendicitis conditions require immediate abdominal surgery.
=> due to •>abdominal pain,
•> Vomiting,
Discomfort,
•>nausea,
•> signs and symptoms like fever are seen.
2) Explain the Etiology/cause of the patient with the Appendicitis.
Due to obstruction in appendix lumen.
Due to bacterial infection.
Due to parasitic infection.
Due to inflammatory bowel disease.
Chron’s disease.
ulcerative colitis.
Due to trauma to the abdomen.
Due to fungal infection.
Due to environmental factors.
Due to genetic factor.
Due to trauma.
3) Explain the clinical manifestation/sign and symptoms of the patient with the appendicitis. State the symptoms and signs of a patient with appendicitis.
Right lower quadrant abdominal pain.
Pain in the periumbilical region.
Getting a low grade fever.
Severe abdominal pain.
Appetite is reduced.
nausea,
vomiting,
Pain at McBurney’s point.
Local tenderness.
Having rebound tenderness present.
Swelling of abdominals.
Filling pain while passing urine.
4) Explain the early signs of appendicitis. State the early signs of appendicitis.
1) Guarding sign (Guarding sign)
=> When the health care personnel palpate the lower abdominal area, the abdominal muscles are tensed and tightened.
2) Rebound tenderness
=> When the health care personnel palpates the abdominal area with the hand then release the hand.
(release)
When the patient experiences abdominal pain and tenderness even when doing this, it is called rebound tenderness.
3) Rovsing sign (Rovsing sign)
=> In Rovsing’s sign, when the health care personnel palpates the patient’s left lower abdominal side by hand and releases the pressure of the hand and the patient feels pain in the right lower abdominal site, it is Rovsing’s sign.
(Rovsing’s sign) indicates present.
4) psoas sign
=> Sous muscles are located in the pelvic cavity near the appendix. These sous muscles create abdominal pain when there is infection and inflammation in the appendix.
=> In sauce sign, the patient is asked to lie down on the left side, then the patient’s right foot, hip, and right hand are extended to the side.
(extend) is done if the patient feels pain then it indicates psoas sign (psoas sign).
5) Obturator sign
=> In this test, the patient is made to lie down in supine position.
=> Then internal rotation of the right hip joint is done. And if the patient
Right iliac fossa
(Right illic fossa)
Pain on it indicates obturator sign.
6) Aaron’s sign
=> In Aaron’s sign, when firm pressure is applied on continuous Mc Burney’s point, if there is pain in the epigastrium region, it is chronic appendicitis.
Indicates the condition of
7) Blumberg sign
=> In Blumbag sign, pressure is applied slowly on the abdominal wall,
=> Then the pressure is released rapidly and if the patient feels pain while releasing the pressure, it indicates a positive Blumbag sign.
4) Explain the diagnostic evaluation of the patient with the appendicitis. Write the diagnostic evaluation of the patient with the appendicitis.
history taking and physical examination.
Laboratory test.
Blood test.
Complete blood count test (CBC).
Urine Analysis.
Abdominal ultrasound.
Abdominal X Ray
Administrative CT scan.
Laparoscopy ( laparoscopy).
5) Explain the management of the patient with the appendicitis. State the management of a patient with appendicitis.
medical management
Provide antibiotic medicine to the patient.
Provide intravenous fluid to the patient.
Maintain patient’s fluid and electrolyte balance.
Providing analgesic medicine to the patient.
Administer antipyretic medicine to the patient.
Provide antiemetic drug to the patient.
Advising the patient to take proper bed rest.
surgical management
Appendectomy
=> In appendectomy, the infectious appendix is surgically removed.
=> Mainly two methods are used in it.
1) Older method := laparotomy
2) the newer method := Laparoscopic surgery
•
1) Older method := laparotomy
=> In laparotomy surgery, the infectious appendix is removed by placing a single incision on the lower right area of the abdomen.
2) the newer method := Laparoscopic surgery
=> In laparoscopic surgery, the infectious appendix is removed by making a small incision on the lower right abdominal area and using a special surgical instrument.
Nursing management
Nursing assessment
Assess the patient for signs and symptoms of abdominal tenderness, anorexia, nausea, vomiting, temperature increase.
Assessing the patient for signs of rebound tenderness.
Assessing whether the patient presents with Rovsing’s sign or not.
Assessing whether the patient has any other complications.
Nursing diagnosis
1) Acute pain related to disease condition.
2) Imbalance nutritional status less than body requirement related to nausea and vomiting.,
3) Impaired skin integrity related to fluid and electrolyte imbalance.,
4) Risk for fluid volume deficit related to excessive amount of fluid loss from the body.,
5) Risk for infection related to the disease condition.
Nursing interventions
1) Relieving pain of the patient.,
2) maintain nutritional status of the patient.,
3) maintain skin integrity of the patient.,
4) preventing fluid volume deficit.,
5) Reduce the risk of infection.
7) Pre operative and post operative nursing management
pre operative Nursing management:=
Consent of patient and his family member should be taken before surgery.
Keep the patient on oral suppository and do not provide anything by mouth.
Maintain patient’s hydration status by intravenous fluids.
Administering antibiotic medicine to prevent the patient from infection.
To monitor the patient’s bowel sounds.
Assessing the patient’s pain level.
Providing analgesic medicine to relieve the patient’s pain.
To perform proper laboratory investigation of the patient viz.
•>Blood Investigation,
Complete blood count,
•>Abdominal ultrasonography,
•>Urinalysis,
•>Abdominal x ray,
•>Doing tests like Abdominal ct scan etc.
To prepare the surgery side area properly.
Maintain patient’s fluid and electrolyte balance.
post operative nursing management
To receive the patient comfortably in the recovery room.
To monitor patient’s vital signs properly.
Properly monitor the patient’s operative site.
Assess the patient for any bleeding and suture gapping on the operative side.
Monitoring the patient’s intake output chart.
Advising the patient on deep breathing technique.
To auscultate the patient’s bowel sounds.
Providing analgesic medicine to the patient.
Providing antibiotic medicine to the patient.
Provide antiemetic medicine to the patient.
Providing intravenous fluid to the patient
Postoperatively, provide the patient with a side-lying position to prevent aspiration of secretions.
Keeping the patient oral on the neel after the operation.
Provide feeding to patient through nasogastric tube.
Provide oxygen to the patient until the effect of anesthesia.
Dressing the operative side of the patient by proper sterile technique.
Providing skin care to patients.
Advise the patient to do moderate walking.
Assessing the patient for any signs and symptoms of infection.
Involving the patient in daily routine activities.
Advise the patient to maintain personal hygiene.
Providing psychological support to the patient.
1) Explain/define Diverticulitis. (Define diverticulitis.)
{ Diverticulum ( diverticulum) :=
•••> Diverticulum is mainly a defect of the muscles of the intestine, extending the sac like pouch lining the intestine.
(streach) is formed due to it is called diverticulum.}
=> If this sac like structure is one then it is called diverticulum.
=> If it is multiple pouches then it is called Diverticula.
=> Diverticulitis is mainly when any food, bacteria,
Or if the micro organism is retained in the diverticulum structure and it is retained for a prolonged time, it creates infection and inflammation in the diverticulum, it is called diverticulitis.
{ Diverticulitis:= infection and inflammation of the diverticum its called Diverticulitis. }
2) Explain the Etiology/cause of the patient with the Diverticulitis. State the causes of diverticulitis.
Due to low fiber food intake.
hereditary.
Due to congenital abnormality.
Because of obesity.
Due to gallbladder disorder.
In persons who smoke cigarettes and alcohol.
In individuals who have high intake of processed food
Ex:=
white rice,
white bread,
Cereals,
Crackers, etc.
Due to constipation.
Aging:= most common in older adults.
Due to genetic factors.
Due to less physical activity.
Due to disorder of connective tissues.
3) Explain the clinical manifestation/sign and symptoms of the patient with the Diverticulitis. (State the symptoms and signs of a patient with diverticulitis.)
Abdominal bloating.
Abdominal cramping.
Abdominal tenderness.
Bowel irregularity.
Diarrhea.
Nausea.
Vomiting.
Cramping Abdominal pain.
Constipation.
Getting a low grade fever.
chills.
Loss of appetite.
bright red blood present in the stool (hematochazia).
Burning and pain during urination.
Bleeding from the rectum.
Weakness.
feeling tired
narrow stool and septicemia
(blood infection)
4) Explain the diagnostic evaluation of the patient with appendicitis. (Write diagnostic evaluation of appendicitis.)
history taking and physical examination.
blood test.
stool test.
colonoscopy.
Abdominal ultrasound.
x-rays.
ct scan.
Barium enema.
5) Explain the management of the patient with the Diverticulitis. (Write management of patient with diverticulitis.)
medical management
Advise the patient to follow a nutritional diet.
Advise patient to take high fiber diet, low fat diet.
Providing fiber supplements to relieve the patient’s constipation.
Providing antibiotic medicine to the patient.
Ex:=
•>Ciprofloxacone (cipro),
Metronidazole (flagyl),
•>Cephalexin (keflex),
•>Doxycycline (vibramycin) etc.
If the patient has abdominal pain, provide antispasmodic medicine to the patient.
Ex:=
•>Dicyclomine (Bentyl),
•>Chlordiazepoxine (librax),
•>Phenobarb (Donnatal),
•>Hyoscyamine (levsin),
Atropine,
•>Scopalamine.etc.
Providing laxatives to the patient.
If the patient is immunosuppressant and elderly, hospitalize him immediately.
Provide evacuant suppository to the patient.
6) Surgical management
1) Primary Bowel Resection (Primary Bowel Resection)
=> In this procedure, the surgeon mainly removes the diseased part of the intestine and reconnects it with the healthy segment of the colon.
(anastomosis) does.
2) Bowel Resection with colostomy
=> This procedure is mainly done when there is a lot of inflammation in the colon.
=> In a colostomy procedure, the surgeon makes an opening (stoma) in the abdominal wall.
=> And then the unaffected part of the colon is connected to the stoma and due to this the waste can pass from the stoma to the bag.
3) Two stage resection.
4) fecal diversion.
5) Double barrel colostomy.
7) Explain the Nursing management of the patient with the Diverticulitis.
Advise the patient to take low fat, high protein diet, fibrous food, and green leafy vegetables.
Giving advice to avoid irritating food like coffee, tea, hot food, spicy food.
Advise the patient to avoid cigarettes and smoking.
Advise patient to intake fluid in adequate amount.
Advise the patient to avoid roughage food.
Advise the patient to take fresh juice like and fruits like apple, papaya, orange.
Advise the patient to do regular physical activity and exercise.
Advising the patient to do yoga and meditation.
Advise the patient to avoid beans, coarse grains, corn, dry fruits, tomatoes, pickles which are responsible for constipation.
Provide antispasmodic medicine to the patient.
Provide laxatives medicine to the patient.
Advise the patient to take adequate bed rest.
If the patient is in pain, provide analgesic medicine.
If the patient has constipation, provide a tool softener such as lactulose (Regulose).
To provide a calm and comfortable environment to the patient.
1) Explain/Define crohn’s disease. (Define Crohn’s disease.)
=> chron’s disease (Crohn’s disease).
•••> Regional enteritis (Regionalenteritis) and,
•••> Granulomatous enteritis (Granulomatous enteritis)
is known as
=> Chron’s disease is an inflammatory bowel disease (IBD).
=> Crohn’s disease mainly affects any area of the gastro-intestinal track (gasterointestinal track) i.e. from the mouth to the anus, but it mainly affects the lower part of the small intestine (ileum).
=> Swelling occurs in Crohn’s disease and it mainly extends to the deep lining of the affected organ.
=> This swallowing causes pain and frequent intestinal emptying due to which the condition of Diarrhea arises.
2) Explain the etiology/cause of the patient with chronic disease. (State the causes of Crohn’s disease.)
The exact cause of chron’s disease is unknown.
Due to genetic factor.
Due to environmental factors.
The disease mainly occurs at any age but is more common in the age group of 15 to 35 years.
Being a family history.
Because of smoking.
Non steroidal Anti inflammatory drug drug (NSAID Drug).
Due to immune system dysfunction.
3) Explain the types of chronic disease. (State the types of Crohn’s disease.
There are four types of Crohn’s disease.
1) colonic disease,
2) perianal disease
3) small bowel disease (small bowel disease),
4) Gastroduodenal crohn’s disease.
•••••••>
1) colonic disease,
=> In colonic diseases there is involvement of the colon.
=> Diarrhea, general malaise, anorexia, and weight loss are among the most common symptoms of colonic diseases.
2) perianal disease
=> Perianal Crohn’s disease is mainly observed in Crohn’s disease in 2/3 patients.
=> Peri-anal disorders are mainly painless and asymptomatic
(asymptomatic) are.
=> Perianal disease is mainly painful only when there is formation of local abscess or when there is formation of active fissure in the anal region, pain is seen.
3) small bowel disease (small bowel disease),
=> Abdominal pain, diarrhoea, general malaise, anorexia and weight loss and peripheral edema are mainly seen in small bowel disease.
=> Mainly in this the amount of serum albumin is also low.
=> In this, the patient has fever and pain in the right lower abdominal quadrant.
4) Gasteroduodenal crohn’s disease.
=> This mainly affects the gastroduodenal region.
=> Symptoms include mainly AP gastric pain, nosia, and post prandial pain.
4) Explain the clinical manifestation/sign and symptoms of the patient with chronic disease. (State the symptoms and signs of a patient with Crohn’s disease.)
Crampy abdominal pain.
Getting a fever.
feeling tired
Loss of appetite.
pain with passing stool (tenesmus).
Persistent watery diarrhea.
Weight loss.
Generalized malaise.
Intra-abdominal and anal abscess formation.
Mouth ulcers.
Crampy abdominal pain.
other symptoms:=
Constipation.
Inflammation in the eye.
Fistula, anal fissure and abscess formation.
Joint pain (Arthritis).
Liver inflammation.
Rectal bleeding and passing bloody stool.
Presenting soreness in the skin.
5) Explain the diagnostic evaluation of the patient with the chronic disease. Write the diagnostic evolution of a patient with Crohn’s disease.
history taking and physical examination.
Complete blood count.
Barium enema.
CT scan.
x ray
Sigmoidoscopy.
Colonoscopy.
Blood test.
stool analysis.
6) Explain the management of the patient with chronic disease. Write the management of a patient with Crohn’s disease.
medical management
Provide anti-inflammatory drug to the patient.
Providing corticosteroid medicine to the patient.
Providing immune system suppressor medicine to the patient.
Providing antibiotic medicine to the patient
Ex:=
•>Ampicillin,
•>Sulfonamide,
•>Tetracycline etc.
Provide antidiarrheal medicine to the patient.
Maintain proper fluid volume and electrolyte volume of the patient.
Advising patient to take nutritious diet in adequate amount.
Advising the patient to take adequate amount of vitamins and minerals in food intake.
Providing calcium and vitamin D supplements to patients with Chron’s disease.
Providing total parenteral nutrition to the patient.
surgical management
If there is formation of any obstruction, stricture, abscess or fistula then surgical treatment should be provided to the patient to correct it.
surgical procedure include •>Resection of the affected area with the anastomosis,
•> Colostomy,
Ileostomy,
•>Colectomy with •>ileorectal anastomosis.
Nursing management of patients with Chron’s disease. Write the nursing management of a patient with Crohn’s disease.
Maintain patient’s fluid and electrolyte balance.
Provide intravenous fluid to the patient.
Documentation of stool color, consistency, frequency, amount.
Monitor the patient’s weight regularly.
Maintain patient’s intake output chart.
To maintain the nutritional status of the patient by providing total parenteral nutrition to the patient.
Provide vitamin supplement to the patient.
Advise the patient to avoid alcohol, tea coffee, nicotine, smoking etc.
Advising patients to maintain personal hygiene.
To promote physical and emotional comfort of the patient.
To give complete information to the patient about the disease, its causes, its symptoms and signs and its treatment.
Providing psychological support to the patient.
To provide a calm and comfortable environment to the patient.
To clear the doubts of the patient and his family members.
Providing mind diversional therapy to the patient.
Providing psychological support to the patient and his family members.
1) define/explain the ulcerative colitis. (Define ulcerative colitis.)
=> Ulcerative colitis is a chronic inflammatory bowel disease.
=> Ulcerative colitis mainly affects the lining of the large intestine (colon) and rectum.
=> Ulcerative colitis mainly creates ulcer and inflammation in the digestive track.
=> Superficial inflammation of large intestine in ulcerative colitis occurs due to ulceration and building up.
=> Ulceration causes inflammation in the colon line and the cells of the colon are killed, and inflammation occurs in them. Due to this, bleeding, and production of pus occurs.
=>inflammation
Due to this, the colon is frequently emptied and due to this the condition of diarrhea arises.
=> When ulcerative colitis occurs in the lower part of the rectum and colon, it is called ulcerative proctitis.
=> If entire colon is affected then it is called pancolitis.
If only the left side of the colon is affected, it is called limited or distal colitis.
2) Explain the etiology/cause of ulcerative colitis.
the exact cause is unknown.
hereditary.
Due to infection.
Due to immunological factors.
Due to taking stress.
Due to consumption of certain types of food.
Due to environmental factors.
Thus,
Pesticides,
•>Tobacco,
•>Radiation,
Food additives.
Due to allergic reaction.
Due to autoimmune response.
Due to psychological factor.
3) Explain the clinical manifestation/sign and symptoms of the patient with the ulcerative colitis. (State the symptoms and signs of a patient with ulcerative colitis.)
Bleeding occurs due to ulceration.
loss of appetite.
Diarrhea.
Weight loss.
rectal bleeding.
Nozia.
Abdominal cramping.
Malnutrition.
Weakness.
Electrolyte imbalance.
bloody stool.
low red blood cell count.
Nausea.
Nutritional deficiency.
Weight loss.
eye pain or redness.
Mouth ulcers.
Skin rashes occur.
Liver disease.
Rectal pain.
Inability to pass stool.
Severe abdominal pain.
Blood in vomiting.
Gastrointestinal bleeding.
Loss of appetite.
Dehydration.
Hypocalcemia.
Having rebound tenderness present.
Skin lesion to be seen.
4) Explain the diagnostic evaluation of the patient with the ulcerative colitis. (Write the diagnostic evaluation of a patient with ulcerative colitis.
history taking and physical examination.
Stool test.
Hemoglobin level test.
Sigmoidoscopy.
Barium enema.
Endoscopy.
Leukoside count assessment.
Erythrocyte Sedimentation Rate (ESR) Assessment.
Colonoscopy.
Flexible sigmoidoscopy.
5) Explain the management of the patient with ulcerative colitis. State the management of patients with ulcerative colitis.
Provide oral fluid to the patient.
Provide high protein diet to the patient.
Provide high calorie diet to the patient.
Provide iron replacement to the patient.
Provide proper nutrition therapy to the patient.
Avoiding food which is responsible for diarrhea.
Giving advice to the patient about milk, cold food and smoking.
To provide total parenteral nutrition to the patient.
Provide sedative medicine to the patient.
Provide anti diarrheal medicine to the patient.
Providing an immunosuppressive agent to the patient.
Anti-inflammatory to the patient
Providing an agent.
Providing antibiotic medicine to the patient.
Providing corticosteroid medicine to the patient.
surgical management
Total Colectomy, (Removal of the entire colon).
segmental Colectomy.
ileostomy.
Resection of the affected area.
6) Nursing management of the patient with the ulcerative colitis. Write the nursing management of a patient with ulcerative colitis.
Provide citrus fruit to the patient.
Advise the patient to take fresh fruit.
Advise the patient to take whole grain, cereals, raw or lightly cooked vegetables.
Advise the patient to rinse the mouth properly.
Advise the patient to maintain proper hand hygiene.
Advise patient to take liquid diet.
Advise the patient for clear liquid and bland diet.
Advise patient to consume high fiber diet like fruits and vegetables.
Advise patient to take vitamin C rich diet.
Advise the patient to take lemon water.
Advise the patient to avoid condiments, pickle, refiend processed food, meat and smoking.
Giving advice to avoid irritating foods like tea, coffee, soft drinks, foods that are responsible for irritation.
Giving advice to the patient to avoid anxiety, stress, tension, aggressive behavior.
Advise patient to maintain fluid volume.
Advise patient to maintain intake output chart.
Advise patient to intake fluid in adequate amount and advise patient to take coconut water, oral rehydration solution.
Advising the patient to take proper rest and sleep.
Advise the patient to reduce anxiety.
Provide the patient with prescribed medicine like corticosteroid, proton pump inhibitor, antibiotic medicine.
Keep assessing the patient’s weight daily.
To provide psychological support to the patient and his family members.
Define/explain intestinal obstruction. (Define intestinal obstruction.)
=> Intestinal blockage is a condition in which the bowel is partially or completely blocked due to mechanical impairment, due to which the contents of the intestine cannot pass out of the intestine properly.
=> Mechanical obstruction is divided into two parts.
Large bowel obstruction
Small bowel obstruction
=> Intestinal obstruction a
•>Partial obstruction (partial obstruction)
There is complete obstruction.
•>Partial obstruction (partial obstruction)
=> Partial obstruction can be treated without any surgical intervention.
Complete obstruction
=> If complete obstruction is not treated, shock and vascular collapse can occur and death can also occur.
=> Complete obstruction requires surgical intervention.
2) Explain the types of intestinal obstruction. State the types of intestinal obstruction.
=> There are total three types of intestinal obstruction.
1) simple intestinal obstruction (simple intestinal obstruction),
2) strangulated intestinal obstruction,
3) Closed-loop intestinal obstruction
1) simple intestinal obstruction (simple intestinal obstruction),
=> Simple intestinal obstruction is a type of mechanical obstruction in which the normal flow to pass the intestinal contents is impaired.
=> Simple intestinal obstruction mainly
•> Small intestine (small intestine) or
Can occur in the large intestine.
2) strangulated intestinal obstruction,
=> Strangulated obstruction is a type of obstruction in which the blood supply to the obstructed section is impeded/cut off.
=> Impaired blood supply in strangulated intestinal obstruction occurs mainly when the obstruction is so tight.
=> Strangulated intestinal obstruction is primarily an emergency condition that requires immediate intervention.
3) Closed-loop intestinal obstruction
=> In closed loop intestinal obstruction, both ends of the intestine are obstructed.
=> Due to the obstructed parts of the intestine on both sides, the blood supply to that place is impaired.
Due to this, conditions of ischemia (lack of oxygen) and necrosis (tissue death) arise.
3) Explain the etiology/cause of the intestinal obstruction. State the cause of intestinal obstruction.
1) Adhesion
=> After any abdominal surgery, the formation of scar tissues (scar tissues) occurs due to which the walls of the intestine stick to each other and create obstruction.
2) Hernia
=> An obstruction is created when a part of the intestine protrudes from the receding part of the abdominal wall.
3) Tumor
=> When there is formation of mass like structure due to tumor on the wall of intestine and it obstructs the intestine.
4) Impacted feces
=> When hard stool accumulates in the large intestine, obstruction of the intestine also occurs.
5)volvulus (volvulus)
=> When intestine
Obstruction occurs due to the twist of the same.
=> This occurs mainly in the colon and creates intestinal obstruction.
6) Inflammatory bowel disease
=> Inflammatory Bowel Disease eg
•>Chron’s disease, •>Ulcerative colitis (ulcerative colitis) causes inflammation in the intestine which is responsible for obstructing the intestine.
7) Stricture
=> Intestinal obstruction is also seen mainly due to narrowing of intestine.
4) Explain the clinical manifestation/sign and symptoms of the patient with the intestinal obstruction.
=> State the symptoms and signs of a patient with intestinal obstruction.
Abdominal pain.
Vomiting.
Abdominal distension.
Constipation.
Diarrhea.
inability to pass stool.
Getting a fever.
Tenderness.
Hiccups.
Dehydration.
Loss of appetite.
Weight loss.
Impaired peristalsis moment.
Generalized malaise.
shock.
5) Explain the Diagnostic evaluation of the patient with the intestinal obstruction Write the diagnostic evaluation of the patient with the intestinal obstruction.
history taking and physical examination.
Blood test.
Urine test.
Electrolyte test.
Abdominal ultra sound.
Abdominal X Ray
Abdominal CT scan.
Abdominal MRI.
upper GI
small bowel series.
Barium contrast study.
Colonoscopy.
Endoscopy.
6) Explain the management of the patient with intestinal obstruction. State the management of a patient with intestinal obstruction.
medical management
Provide intravenous fluid to the patient.
Inserting a nasogastric tube to suck out stomach contents and air to reduce abdominal swallowing.
Maintaining patient no intake output chart.
Colonoscopy of the patient.
Provide antiemetic medicine to the patient.
Providing analgesic medicine to relieve the patient’s pain.
Provide anticholinergic drug to the patient.
7) Explain the surgical management of patients with the intestinal obstruction. Write the surgical management of patients with intestinal obstruction.
•>1) Exploratory laprotomy (exploratory laparotomy)
=> This is an open abdominal surgery in which the abdomen and intestines are opened
can be visualized directly.
=> In this, the abdomen is opened and the cause of intestine obstruction is identified.
2) Adhesiolysis ( Adhesiolysis)
=> Scar tissue causing obstruction in the wall of intestine in adhesiolysis
(Adhesion) formation is separated.
3) Bowel Resection
=> In this mainly the damaged part of the intestine is removed.
=> This is mainly done when any necrosis, tumor and irreversible condition arises in the intestine.
4) Hernia repair
=> In this mainly correction of hernia is done which is responsible for obstruction.
=> In this mainly herniated tissues are placed at their normal place.
5) strictureplasty
=> In stricture plasty, the narrowing intestine is mainly widened without removing any segment of the intestine.
=> This is mainly used when there is inflammatory bowel disease.
6) Bypass surgery
=> Bypass surgery mainly involves bypassing the part of the intestine that is strictured so that the contents of the intestine can flow freely.
7) colestomy or iliostomy
=> When there is a condition of serious intestinal obstruction, a stoma (an opening in the abdominal wall) is mainly formed and the normal flow of stool is diverted.
8) Explain the nursing management of patients with intestinal obstruction. (Write nursing management of patient with intestinal obstruction.)
Nursing assessment
To properly assess the patient’s vital signs.
Ask the patient about abdominal pain, abdominal distension, vomiting and any other signs and symptoms.
To auscultate the patient’s bowel movements and sounds.
Monitor the patient’s abdominal girth.
Monitor the patient’s fluid and electrolyte balance.
To monitor patient’s blood pressure, temperature, pulse and respiratory rate.
•Nursing Diagnosis
1) Pain related to surgical incision.
2) fluid and electrolyte imbalance related to vomiting.
3) Impaired skin integrity related to fluid volume deficit.
4) Imbalance nutritional status less than body requirement related to avoidance of food.
5) Risk for infection related to surgery.
Nursing interventions
1) Pain management of the patient.
=> Provide the prescribed analgesic medicine to the patient.
2) Intravenous fluid administration.
=> Provide prescribed intravenous fluid to the patient to maintain the patient’s hydration status.
=> Provide food to patient through nasogastric tube.
3) Monitoring the urine out.
=> To maintain intake output chart of patient.
=> To assess the patient’s urinary output regularly.
4) Patient positioning
=> To provide position in such a way that the patient is comfortable.
5) Collaboration with the other health care providers.
=> Collaborating with the physician and other health care personnel regarding the patient’s condition to improve the patient’s condition.
6) Patient education
=> To provide education to the patient and his family members about the patient’s disease condition, its causes, its signs and symptoms, and its treatment.
7) Emotional support
=> Provide emotional support to the patient and his family members.
=> Providing him with proper psychological support.
1) Explain/ define hernia. Define hernia.
=> Hernia is a condition in which a body organ or muscular wall of the organ protrudes from its normal cavity.
=> Abdominal cavity has a muscular wall which plays an important part for the support of the abdominal organs.
=> When this muscular wall develops from some place, then the abdominal organ protrudes from the week area into another cavity.
=> Hernia means any organ protrudes from its normal cavity into another cavity, it is called hernia.
••{Hernia := hernia may be defined as a protrusion of the organ from its normal body cavity to the other body cavity. }•••.
2) Explain the type of hernia. State the type of hernia.
There are total three types of hernia.
1)Reducibal hernia (reducible hernia),
2) Irreducible hernia,
3) strangulated hernia
••••••>
1)Reducibal hernia (reducible hernia),
=> Reducible hernia can be placed back to its normal place.
=> Reducible hernia can return to its normal place if the protruding organ is pushed.
=> People with this type of hernia wear a special type of hernia belt due to which the protruding organ stays in its normal place.
2) Irreducible hernia,
=> Irreducible hernia is a type of hernia in which the protruding organ cannot be placed back to its normal place.
=> This is irreducible mainly because the organ is blocked by another intestine at the protruded site.
=> Irreducible hernia mainly requires surgery to treat.
3) strangulated hernia
=> The main protruding organ in strangulated hernia is the intestine
There is a twist (twist) and the blood supply is impeded there.
=> Due to this blood supply being impaired, formation of ischemia, necrosis and gangrene occurs.
=> Strangulated hernia requires immediate surgery.
3) Explain the classification of the hernia. (State the classification of hernia.)
=> There are total ten classifications of hernia.
1) inguinal hernia (inguinal hernia),
2) Femoral hernia,
3) umbelical hernia,
4) Incisional hernia (incisional hernia),
5) Hiatal hernia,
6) Epigastric hernia,
7) Obturator hernia (obturator hernia),
8) Spigelial hernia,
9) ventral hernia
10) Herniation of intervertebral disc.
1) inguinal hernia (inguinal hernia),
=> Inguinal hernia This is mainly groin region
(the area between the abdomen and thigh) occurs.
=> Inguinal hernia is mainly when the intestine protrudes from the week point of the inguinal canal and the abdominal muscles near the groin region in a triangular shape.
(triangle shape) is made.
=> Mainly
•>Obesity (obesity),
•> Pregnancy (pregnancy),
•> Heavy lifting (heavy lifting),
•> Straining during stool pass (Strain during stool pass) is seen at the time.
2) Femoral hernia,
=> Inguinal hernia is mainly
It is found in the area between abdomen and thigh (situated between abdomen and thigh).
=> Femoral hernia is a bulge-like structure that appears mainly in the upper part of the thigh.
=> Femoral hernia occurs in the lower part of the inguinal ligament.
=> Femoral hernia is mainly found in •>women, •>pregnant women and •>obese people.
3) umbelical hernia,
=> Umbilical hernia is mainly seen when the umbilical cord
Abdominal wall around a
Wicked.
=> Umbilical hernia mainly protrudes from umbilical cord and nearer area of umbelical cord.
=> Umbilical hernia is mainly seen in newborns, children, and adults.
4) Incisional hernia (incisional hernia),
=> Incisional hernia is mainly when the intestine protrudes from the surgery area after previous abdominal surgery, it is called incisional hernia.
=> This hernia is mainly seen in elderly or overweight person.
5) Hiatal hernia,
=>Hiatal hernia is mainly an abdominal organ that protrudes from the abdominal cavity through the diaphragm (Diaphragm) muscles into the chest cavity.
=> Due to this symptoms like heart burn and stomach acid are seen.
6) Epigastric hernia,
=> Epigastric hernia mainly when upper middle abdomen
(upper middle abdomen) As muscles are weak, abdominal organ protrudes.
=> Epigastric hernia is mainly seen more in women than man.
=> This is mainly seen in people between 20 to 50 years of age.
7) Obturator hernia (obturator hernia),
=> Obturator hernia is mainly the front part of the pelvis and the abdominal organ protrudes from the gap in the bone.
8) Spigelial hernia,
=> In Spigelian hernia, the abdominal organ protrudes mainly from the Spigelial facia.
9) ventral hernia
Ventral hernia is mainly when scar tissues develop in the abdominal wall.
If it becomes wick and the abdominal organ protrudes from there, it is called ventral hernia.
10) Herniation of intervertebral disc.
=> It is said due to increase in pressure in inter vertebral disc.
=> Inter vertebral disc herniation is mainly seen when lifting any heavy object.
3) Explain the etiology / cause of the patient with the hernia. (Give reasons for hernia).
Because of obesity.
Due to lifting heavy objects.
persistent coughing or sneezing.
Straining with defecation or urination.
due to diarrhoea.
Due to constipation.
Due to Acites (Accumulation of fluid in the abdominal cavity).
Having a family history of hernia.
Due to peritoneal dialysis.
Because of smoking.
Due to Chronic Obstructive Pulmonary Disease (COPD:= Chronic obstructive pulmonary disease).
=> Due to poor nutrition.
4) Explain the clinical manifestation/sign and symptoms of the patient with the hernia.
Visible bulge and lump.
Abdominal pain.
Abdominal tenderness.
Swelling is observed.
Abdominal tenderness.
Gastrointestinal symptoms.
Nausea.
Vomiting.
Changes in bowel habit.
Abdominal distension.
5) Explain the diagnostic evaluation of the patient with the hernia. Write the diagnostic evaluation of hernia vada patient.
history taking and physical examination.
complete blood count.
blood urea nitrogen (BUN).
Assessment of electrolyte level.
Assess the creatinine level.
Ultrasonography.
Ct scan.
Upright chest radiography.
Urinalysis.
6) Explain the medical management of the patient with the hernia. (Write medical management of hernia vada patient.)
Advise the patient to avoid heavy object, weight lifting.
Advise the patient to wear a supporting belt.
Monitoring the patient regularly.
Provide proton pump inhibitor medicine to the patient.
Advise the patient to take fruit and high fiber fruit.
Advise the patient to perform nasogastric suctioning.
Providing analgesic medicine to relieve the patient’s pain.
Provide antibiotic medicine to the patient.
Explain the surgical management of patients with the hernia. Write the surgical management of the patient with the hernia.
1) Herniorraphy
=> Surgical repair of hernia is done in herniorrhaphy.
=> The protruding organ in the hernia is returned to its proper place.
2) Hernioplasty (Hernioplasty)
=> In hernioplasty mainly the weeked body part is reinforced by mesh, mainly artificial mesh is used. This mesh is made of synthetic materials or sometimes biological material.
=> The mesh mainly supports the protruding body part which keeps the body organ in its place. And prevents recurrence.
3) Laproscopic Repair
=> Laparoscopic repair is a minimally invasive procedure. In which a laproscope (a thin lighted tube with the camera) is used.
=> The main benefit of laparoscopy procedure is minimally invasive procedure and post-operative complications are less. And pain is less.
=> And in laparoscopic procedures, infection is also less common.
=> mess is used in laparoscopic procedure.
4) Robotic assisted surgery
=> Robotic assisted surgery is basically similar to laparoscopic surgery but uses a robotic arm.
5) Open repair
=> In open hernia, a large incision is made at the hernia site.
=> Open hernias are mainly used when laparoscopic procedures are not possible or for small hernias.
6) Tension free repair
=> In tension free repair, massage is provided to the repaired hernia due to which the tension on it can be released.
7) Hiatal hernia repair
=> Gastero intestinal reflux disease (GERD) mainly occurs in hernia.
=> Fundoplication is done to prevent gastroesophageal reflux disease (GERD).
=> In which the upper part of the stomach is wrapped around the lower esophagus due to which acid reflux can be prevented.
8) Emergency surgery
=> Emergency surgery is done to repair strangulated hernia and blood flow is restored in it.
Explain the nursing management of patients with the hernia Write the nursing management of the patient with the hernia.
Proper health assessment of the patient.
Assess the patient’s hernia type.
Assess the patient for signs and symptoms of any hernia.
To provide complete information about the surgical procedure to the patient.
To prepare the patient properly for surgery.
Provide analgesic medicine to relieve the patient’s pain.
Advising the patient to perform daily routine activities in properly small amounts and frequent amounts.
Monitor the patient whether there is redness, itching, infection in the surgical incision or not.
Proper wound assessment of the patient.
Provide high fiber diet, high fluid and stool softener to the patient.
To assess whether the patient has any kind of complication or not.
Provide proper psychological support to the patient.
Advise the patient to follow up regularly.
Properly dressing the patient’s surgical area.
To provide a calm and comfortable environment to the patient.
Provide fluid intravenously to the patient properly.
Provide proper mind diversional therapy to the patient.
Advise the patient to do small amounts of physical activity.
Advise the patient to do moderate daily routine activities.
1) Explain/Define tuberculosis of abdomen. (Define abdominal tuberculosis.)
=> TB ( Tuberculosis):= caused by mycobacterium Tuberculosis ( Mycobacterium Tuberculosis).
=> When tuberculosis affects the gastrointestinal track and abdominal cavity, then it is called abdominal tuberculosis.
=> Abdominal tuberculosis is extrapulmonary (affect the tuberculosis other organ than lungs) tuberculosis which mainly •>Gastrointestinal track,
(Gastrointestinal track),
Spleen,
Pancreas
Liver,
•> Peritoneum (peritonium),
Omentum
•> Affects the lymph node (lymph node).
=> Abdominal tuberculosis is mainly seen due to drinking water containing pathogens of tuberculosis and intake of unpasteurized milk.
=>Abdominal tuberculosis spreads primarily from the lungs through the blood stream but also to the intestines.
2) Explain the types of abdominal tuberculosis. State the types of abdominal tuberculosis.
=> There are three types of abdominal tuberculosis.
1) Ascites tuberculosis,
2) obstructive tuberculosis (obstructive tuberculosis),
3) Glandular tuberculosis.
1) Ascites tuberculosis,
=> Ascites Tuberculosis is mainly when ascites in the abdominal cavity
(Acities: = accumulation of fluid in the abdominal cavity) is seen when present.
=> It is also called wet (wet) abdominal tuberculosis
2) obstructive tuberculosis (obstructive tuberculosis),
=> Obstructive tuberculosis is mainly seen due to adhesion in omentum and loop of intestine.
=> Obstructive tuberculosis is also called dry tuberculosis.
3) Glandular tuberculosis.
=> Glandular tuberculosis mainly affects the lymph nodes due to which the size of the lymph node increases, and it becomes firm, hard and less mobile.
3) Explain the etiology/cause of the abdominal tuberculosis. State the causes of abdominal tuberculosis.
Caused by Mycobacterium tuberculosis.
Caused by Mycobacterium bovis.
Due to impaired immune system.
Due to spread from the lungs to the intestines.
Due to close contact with a person with tuberculosis.
Because the immune system is compromised.
3) Explain the clinical manifestation / sign and symptoms of the patient with the abdominal tuberculosis. (State the symptoms and signs of a patient with abdominal tuberculosis.)
Pain in abdominal cavity.
Weight loss.
Loss of appetite.
Diarrhea.
expectoration
Abdominal distension.
Fever.
Night sweating.
feeling tired
Constipation.
Abdominal swelling and tenderness.
Dysphagia (difficulty in swallowing).
5) Explain the diagnostic evaluation of the patient with abdominal tuberculosis. (Write the diagnostic evaluation of a patient with abdominal tuberculosis.)
history taking and physical examination.
Mantoux test.
Biopsy.
Dominal ultrasound.
Abdominal x-ray.
Abdominal ct scan.
fine needle aspiration cytology of abdominal tissue.
Endoscopy (endoscopy),
colonoscopy,
Laparoscopy (leproscopy),
Ascitic fluid tested for presence of bacteria.
Barium enema.
Quentiferon-TB.
6) Explain the management of the patient with abdominal tuberculosis. Write the treatment of abdominal tuberculosis.
Provide antitubercular drugs to the patient for 2 months and keep it continuous after 7-10 months.
In the initial drug
Isoniazid,
Rifampicin,
Pyrazinamide,
Ethambutole.
After providing isoniazid to the patient,
Rifampicin,
Pyrazinamide
Provide medicine.
Continuous weight monitoring of the patient.
Liver function test of the patient.
Advise patient to take high protein and balance diet.
Assessing the patient for any side effects of drugs.
If there is obstruction, treat it surgically.
Continuous monitoring of patient
7) Explain the nursing management of patients with the abdominal tuberculosis.
Continuous monitoring of patients with tuberculosis.
To provide continuous treatment to the patient.
Assessing whether the patient has any side effects of drugs or not.
Keeping patients with tuberculosis in isolation.
Advising patients with tuberculosis to take a balanced diet.
Avoiding patient going to over crowded places.
Avoiding going to places with unhygienic condition of the patient.
Treating the patient in a hospital room with ultraviolet light.
Advise the patient to take high protein diet and green leafy vegetables.
Assess the patient for any side effects of the medicine.
Advise the patient to maintain personal hygiene.
Advise the patient to follow up regularly.
1) Explain / Define colorectal cancer.
INTRODUCTION
=> COLON is an organ of the gastrointestinal system.
=> Abnormal in the cells of the colon and
Uncontrollable growth and tumor formation and this tumor can be both benign and malignant.
=> In colorectal cancer, cancerous growths occur in the colon, rectum, and appendix and affect the digestion of food.
2) Explain the etiology/cause of the patient with the colorectal cancer.
age :=above 50 years old age,
diet,
Genetic disorders,
Family history,
personal history of polyps,
history of inflammatory bowel disease,
obesity,
viral,
smocking,
alcohol,
excessive one of fatty and spicy food,
male are more affected than female,
excessive use of fat.
3) Explain clinical manifestation / sign and symptoms of the patient with the colorectal cancer.
feel tired,
weakness,
difficulty breathing,
Changes in bowel habit.
small-caliber or ribbon-like stool,
Diarrhea,
constitution
(constipation),
red and dark blood in stool,
nausea,
vomiting,
weight loss,
rectal pain,
abdominal pain,
Distension,
Cramp
Bloating
4) Explain the Diagnostic evaluation of the patient with the colorectal cancer:= (Write the diagnostic evaluation of the patient with colorectal cancer.
history tacking and physical examination,
stool test,
fecal occult blood test,
colonoscopy,
Genetic testing,
5) Explain the management of the patient with the colorectal cancer.
radiation therapy,
chemotherapy,
biotherapy,
gene therapy,
immuno therapy.
Surgical management of the patient with colorectal cancer
Surgery is the choice for colorectal cancer.
Radical bowel resection,
partial colostomy,
hemicolectomy,
laparoscopic surgery.
prevention
regular screening,
Genetic counselling,
lifestyle and nutrition,
quit smoking,
6) Pre operative and post operative nursing management:=
preoperative nursing management
Explaining the procedure to the patient and his family members.
Perform all laboratory tests of the patient.
Preparing the patient for the operation.
Setting up an IV line to the patient.
Keep the patient on Nbm (nill per oral).
Catheterizing the patient.
Maintaining patient no intake output chart.
Shaving the operative body parts of the patient in a proper manner.
Clean the operative body parts of the patient with Savlon and spirit.
Provide IV fluid to the patient.
Give the patient total parantrol nutrition.
Keeping the patient’s nutritional status and food balance normal.
Provide the prescribed Analgesic and Antibiotic medicine to the patient.
Obtaining consent of the patient and his family members.
Post operative nursing management
Keeping the patient comfortable and under close observation after operation.
To provide work and comfortable environment to the patient.
Ask the patient to do deep breathing exercises.
Keep the patient’s fluid balance normal.
Maintain aseptic technique to the patient.
To maintain the nutritional status of the patient.
Maintain patient’s intake output chart.
Properly dressing the operative area of the patient.
Checking the operative area of the patient for any kind of infection or inflammation.
Seeing if the fashion has any weekne s painting or nosia and vomiting.
To check patient’s vital signs.
The patient’s I.v. Provide fluids.
Changing the patient’s dressing every twenty-four hours.
Provide the patient with prescribed analgesic and antibiotic medicine.
Maintain hygienic condition of patient.
Change the patient’s position every two hours to prevent bed sores.
Ask the patient to walk slowly.
Do not ask the patient to do any kind of hard activity.
Ask the patient to rest properly.
Providing Mind Diversional Renal Therapy to the patient.
Provide liquid semi-solid food to the patient first and then solid food.
Keeping the patient’s head elevated to prevent any heart burn.
Providing psychological support to the patient and his family members.
1) Explain/ define polyps of colon and rectum. Define polyps of colon and rectum.
=> Colon and rectal polyps (polyps) are mainly abnormal growths that arise in the lining of the large intestine (colon) or rectum.
=> And this abnormal growth is protruding in the intestinal canal.
some polyps are flat.
some polyps are stalk.
=> Polyps are mainly found in throwout large interstyle (colon) and rectum but they are mainly found in left colon, sigmoid colon and rectum.
2) Explain the types of polyps. (State the type of polyps.)
There are total four types of police.
1) Adenomoutous polyps,
2) Hyperplastic polyps (Hyper plastic polyps),
3) serrated polyps (serrated polyps),
4) Inflammatory polyps
•••••>
1) Adenomoutous polyps,
=> Adenomatous polyps are the most common type of polyps which are also called precancerous polyps.
=> Adenomatous polyps are mainly known as Caesarean polyps / Adenomoutous.
2) Hyperplastic polyps (hyperplastic polyps),
=> Hyperplastic polyps are benign.
=> Polyps are mainly small, left side and hyperplastic polyps do not develop into cancer.
=> Large hyperplastic polyps are mainly seen on the right side.
3) serrated polyps (serrated polyps),
=> There is involvement of various subtypes in serratd polyps.
•> traditional serrated adenomatous,
Sessile serrated adenomatous,
•>hyperplastic polyps,
=> Some types of ciliated polyps are cancerous.
4) Inflammatory polyps
=> Inflammatory polyps are mainly seen due to inflammation in the colon.
=> Like Inflammatory Bowel Disease (IBD). Inflammatory polyps are seen due to diseases like
3) Explain the etiology of the patient with the polyps of colon and rectum. (State the causes of polyps of rectum and colon.)
Being a family history.
Color rectal cancer or polyps.
Due to genetic factors.
Due to high fat diet consumption.
Due to low fiber diet intake.
Due to inflammatory bowel disease.
Because of obesity.
Because of smoking.
Age.
Due to smoking and excessive alcohol consumption.
Due to inflammatory conditions.
Due to inactive life style.
4) Explain the clinical manifestation/sign and symptoms of the patient with the polyps of colon and rectum. (State the clinical manifestations/signs and symptoms of colon and rectal polyps.)
Rectal erection.
Bowel habit changed.
Alterations in bowel function.
Abdominal pain.
Abdominal discomfort.
Anemia.
Finding visible polyps.
5) Explain the management of the patient with the polyps of colon and rectum. (State the management of patients with colon and rectal polyps)
1) monitoring and surveillance
=> Advise a person with colorectal cancer to undergo regular medical screening.
=> Advising the patient to follow up regularly.
2) Polyps removal (polypectomy)
=> In police removal, the abnormal polyps that have arisen are removed.
3) Generic counseling (genetic counselling)
=> Genetic counseling of a person with a family history of colorectal cancer.
4) Life style modifications
=> Giving advice to the patient to adopt a healthy life style.
=> Advising patients to provide high fiber rich fruit and vegetables diet.
Explain the nursing management of patients with the polyps of colon and rectum. (State the nursing management of patients with colon and rectal polyps.)
1) Assessment
=> Proper assessment of the patient to assess the physical and emotional status of the patient.
=> To monitor patient’s vital sign properly.
=> Proper laboratory investigation of the patient.
2) Patient education (Patient education)
=> Provide complete information to the patient about his disease, its causes and signs and symptoms.
3) Emotional support
=> Provide proper emotional support to the patient.
=> To clear all the doubts of the patient and his family members.
4) Pain management
=> To assess the patient’s pain level.
=> Administering analgesic medicine to the patient.
5) Nutritional support
=> Provide proper nutritional support to the agent.
=> Advising the patient to take a nutritious diet.
=> Giving advice to the patient to avoid smoking and alcohol.
=> Who should check whether the patient has any signs and symptoms of Malnutrition or not.
6) Management of treatment of “side effects”.
=> To assess whether the patient has any kind of side effect of medicine or not.
7) wound care
=> Provide proper wound care to the patient.
=> Keeping the patient properly aseptic technique and dressing the wound properly.
8) promoting physical activities
=> Advising the patient to do proper physical activity.
=> Giving advice to the patient to do daily routine activities little by little.
9) Provide proper medication
(Giving advice to patient to take proper medication)
=> Giving advice to the patient to take medicine properly.
=> Advising the patient to follow up regularly.
=> To provide psychological support to the patient and his family members.
=> Provide calm and comfortable environment to the patient
1) Explain/Define Anorectal Abscess. (Define anorectal abscess.)
=> Anorectal abscess is a condition in which there is a collection of localized pus around the tissues of the rectum and anus.
=> Anorectal Abscess is mainly caused due to infection in anal and rectal gland.
=> Anorectal absence is a painful condition in which pus collects near the anus.
2) Explain the Etiology/cause of the patient with the Anorectal Abscess. (Give reasons for anorectal abscess.)
1) Due to inflammation and infection in the anal gland.
2) Due to anal fissure.
3) Due to inflammatory bowel disease.
4) Due to weakening of the immune system.
5) Due to pelvic inflammatory disease.
6) Due to infection of hair follicle curls.
7) Due to trauma.
8) Due to anal gland block.
9) Due to infection by micro organism.
•> Escherichia coli (Escherichia coli),
•>proteas (Proteus),
•>streptococci (streptococci),
•>staphylococci (staphylococci),
•>Sexually transmitted disease
3) Explain the clinical manifestation/sign and symptoms of the patient with the Anorectal Abscess. (State the symptoms and signs of a patient with anorectal abscess.
constant pain.
Swelling and redness.
Tenderness.
Skin irritation around the anus.
discharge of pus.
Constipation.
Getting a fever.
chills.
Generalized malaise.
Difficulty in sitting and moving.
drainage of purulent discharge.
Changes in bowel habit.
4) Explain the diagnostic evaluation of the patient with the Anorectal Abscess. (Write the diagnostic evaluation of a patient with anorectal abscess.)
history taking and physical examination.
Digital rectal examination.
Blood test.
Ultrasound.
ct scan.
MRI.
complete blood count test.
culture.
5) Explain the medical management of the patient with the Anorectal Abscess. (State the medical management of a patient with anorectal abscess.)
Providing analgesic medicine to relieve the patient’s pain.
Ex:=
=> Acetaminophen,
=> Non-Steroidal Anti-Inflammatory Drug (NSAID),
Providing antibiotic medicine to the patient.
Conduct culture sensitivity test of collected pus.
Assessing the patient for any other complications.
Advise the patient to maintain proper hygiene.
Advise patient to take high fiber diet.
Advise patient to intake fluid in adequate amount.
Advise to minimize straining during bowel movement.
Advise the patient to follow up regularly.
Advising the patient to take medication properly.
6) Explain the nursing management of patients with Anorectal Abscess. (State the nursing management of a patient with anorectal abscess.)
Providing analgesic medicine to reduce the patient’s pain.
Advise patient to take sitz bath.
Advise the patient to keep the wound area clean and dry.
To assess whether the patient has any condition like swelling, redness, itching on the wound side or not.
Advise the patient to maintain proper personal hygiene.
To provide complete information to the patient about the disease, its causes, its symptoms and signs, and also its treatment.
Advise patient to take high fiber diet.
Advise patient to intake fluid in adequate amount.
Provide proper emotional support to the patient.
Properly provide the prescribed medication to the patient.
Assess the patient for any side effects of meditation.
Advising the patient to exercise properly.
Advising the patient to perform daily routine activities.
Advise the patient to avoid excessive straining during bowel movements.
Advising the patient to maintain a healthy lifestyle.
Advise the patient to take sitz bath three to four times a day.
If the patient has a complaint of constipation, provide a stool softener.
Providing the prescribed medication to the patient.
To provide calm and comfortable environment to patients and their family members.
1) Explain/ define anal fissure (tear)
=> Anal fissure is a condition in which a small cut and fissure is formed on the line of the anus.
=> Ulceration occurs on the posterior wall of the anus (the opening through which the stool passes out of the body) in anal fissure.
=> Anal fissure is mainly caused by any trauma.
=> Pain, bleeding and itching are also seen due to anal fissure.
2) Explain the etiology/cause of the patient with the anal fissure. (State the cause of anal fissure.)
Trauma due to passage of hard stool.
Due to passage of large and hard stool through the anal canal.
Due to constipation.
during child birth.
Due to straining during bowel movement.
due to diarrhoea.
Due to overuse of laxatives.
Anal sex.
Due to anorectal surgery.
Due to low fiber diet.
proctitis (proctitis := inflammation of the lining of the stomach),
Due to low fluid intake.
Due to vitamin B6 (pyridoxine) deficiency.
Due to trauma to the anal area.
excessive spasm of anal sphincter.
Due to inflammatory bowel disease.
Caused by hemorrhoids.
Age or gender.
3) Explain the clinical manifestation/sign and symptoms of the patient with the anal fissure. (State the symptoms and signs of a patient with anal fissure.)
Pain during defecation.
sharp, stinging or burning pain during and following bowel movement.
Bleeding during defecation.
Anal itching.
a lump or mass at the anal area.
A visible crack around the anus.
Rectal bleeding and mucosal discharge.
4) Explain the diagnostic evaluation of anal fissure. (State diagnostic evaluation of anal fissure.)
history taking and physical examination.
Sigmoidoscopy.
Colonoscopy.
Anal manometry.
Flexible sigmoidoscopy.
5) Explain the medical management of the patient with the anal fissure. (State the medical management of a patient with anal fissure.)
Provide high fiber diet to the patient.
Provide patient with stool softener.
Provide plenty of fluids to the patient which relieves constipation.
Provide warm bath to the patient for 10 to 20 minutes.
Provide sitz bath to the patient.
If the patient is in pain, provide analgesic medicine.
Advise the patient to avoid spicy food.
Apply a local anesthetic agent (2% ligbocaine) over and around the fissure to relieve the patient’s pain.
If the pain is not relieved by simple measures, apply relaxation ointment.
Apply nitroglycerin (0.2%) to the fissure area twice a day for six weeks.
Application of nitroglycerin ointment to the fissure area of the anus causes the blood vessels to widen and blood flow to the fissure area is increased, thus promoting healing.
Providing the patient with botulinum toxin injection into the internal anal sphincter, which causes less pressure in the internal anal sphincter.
5) Explain the surgical management of patients with the anal fissure.
If there is a chronic fissure, it is treated surgically.
In the surgery, general anesthesia or spinal anesthesia is provided, a small portion of the internal sphincter is cut (internal sphincterectomy).
7) Explain the nursing management of patients with the anal fissure. (State the nursing management of a patient with anal fissure.)
Providing analgesic medicine to relieve the patient’s pain.
Advise patient to apply topicalol analgesic medicine.
Provide warm compression to the patient.
Provide sitz bath to the patient.
Advise the patient to use laxatives.
Provide stool softener to the patient.
If the patient has a condition of constipation, advise him to have a high fiber diet and more fluid intake.
If the patient is in pain, provide analgesic medicine.
Apply local dilatation to the patient.
Advise the patient to maintain proper hygiene.
Maintain patient’s hydration status.
To provide a calm and comfortable environment to the patient.
To clear all the doubts of the patient and his family members.
1) Explain/define anal fistula.
=> Fistula* is a condition in which there is an abnormal connection in any organ, vessel intestine and other structure.
=> Fistula is mainly caused due to any injury and surgery.
=> Anal fistulae mainly
Tunnel like track/abnormal connection (tunnel like track/abnormal connection) is mainly found in the area of the rectum and anal canal and the skin around it is known as anal fistula.
=> Anal fistula is mainly formed due to infection and inflammation in the anal gland.
2) Explain the types of anal fistula. (State the type of anal fistula.)
1) inter sphincteric fistula,
2) Trans spinceric fistula,
3) supra sphincteric fistula,
4) Extra sphincteric fistula,
5) Horse shoe fistula.
1) inter sphincteric fistula,
=> Internal sphincteric fistulae are mainly found in the internal sphincter of the anal.
=> This type of fistula is mainly found in the anal canal and inter sphincteric space.
=> Inter sphincteric (intersphincteric) fistula can heal by treatment.
2) Trans spinceric fistula,
=> Transsphincteric fistulae are mainly found in internal anal sphincter and external anal sphincter.
=> A transsphincteric fistula starts mainly from the anal canal and extends to the internal anal sphincter and then to the external anal sphincter.
=> Transsphincteric fistula is very complex.
=> It is carefully managed and treatment is provided.
=> Due to which incontinence can be prevented.
3) supra sphincteric fistula,
=> Suprasphincteric fistula affects the internal and external sphincter.
=> Supra sphincteric fistula originates mainly from the anal canal then affects the internal sphincter and then the external sphincter.
=> Supra sphincteric is less common and more complex and requires special surgical intervention.
4) Extra sphincteric fistula (Extra sphincteric fistula),
=> Extrasphincteric fistula mainly forms outside of external anal sphincter.
=> Extra sphincteric fistulae are less common and are mainly associated with Crohn’s disease and require specialized surgical hospitalization.
5) Horse shoe fistula
=> Horseshoe fistula is mainly extended around the anus and affects both sides.
=> Horseshoe fistula is very complex. It requires special measures to provide treatment.
3) Explain the etiology/cause of the patient with the anal fistula. (Give cause of anal fistula vada patient.)
Due to infection,
Due to trauma,
Due to fissure,
regional enteritis,
Due to the formation of abscess in the anal canal.
Due to infection in the anal gland.
Due to chronic inflammatory conditions.
Due to anal trauma.
Due to a weakened immune system.
Due to genetic factor.
4) Explain the clinical manifestation/sign and symptoms of the patient with the anal fistula. (State the symptoms and signs of a patient with anal fistula.)
to be in pain
Irritation of the skin around the anus.
Swelling, redness, and tenderness.
Getting a fever.
Passing bloody and purulent discharge.
Loss of appetite.
Weight loss.
Nausea.
Vomiting.
Passing of pus and discharge.
Difficulty in sitting and moving.
5) Explain the diagnostic evaluation of the patient with the anal fistula. (Write the diagnostic evaluation of a patient with anal fistula.)
history taking and physical examination.
Rectal examination.
Barium enema.
Colonoscopy.
Sigmoidoscopy.
Intra venous pyelogram.
Fistulography.
probing.
CT scan.
MRI.
Ultrasound.
Proctoscopy.
6) Explain the management of the patient with the anal fistula. (Write management of patient with anal fistula.)
Providing antibiotic medicine to the patient.
Providing the patient with an immunosuppressive agent.
Advise the patient to take a nutritious diet.
Providing analgesic medicine to relieve the patient’s pain.
Advise the patient to maintain personal hygiene.surgical management
1) Fistulotomy
=> Fistulotomy is the most common surgical procedure for the treatment of anal fistula.
=> In this procedure, the surgeon makes an incision on the track of the fichula and opens it, then merges it with the anal canal.
2) seton
=> If the fistula is deep then the surgeon uses seton to treat it.
=> Seton is a suturing material.
3) Fibrin glue
=> In some types of anal fistula, injectable fibrin-glue is used to close the fistula.
=> By injecting this glue, a clot is formed in the part of the fistula which mainly helps the fistula to heal.
7) Explain the nursing management of patients with the anal fistula Write the nursing management of the patient with the anal fistula.
Advise the patient to take an adequate nutritious diet.
Advise the patient to take plenty of fluids.
Advise the patient to maintain personal hygiene.
Advise the patient to avoid strain while defecating.
To provide a calm and comfortable environment to the patient.
Providing stool softener to the patient.
Provide a mild laxative to the patient.
Provide sitz bath to relieve patient’s discomfort.
Provide a comfortable position to the patient.
To provide hot compresses to the patient.
Advise the patient to take high fiber rich food, vegetables, fruits.
Advise the patient to avoid spicy food, soft drinks, alcohol, tea, coffee, and dairy products.
Advise patient to exercise to increase peristalsis moment.
Advise patient to walk for 30 minutes after meal.
To be provided to the patient properly daily at least 3 times after sitz.
Properly administer antibiotic medicine to the patient.
To provide a calm and comfortable environment to the patients and members.
Provide proper psychological support to the patient.
1) Explain/ define Hemorrhoids. (Define hemorrhoids.)
=> Hemorrhoids are also known as piles.
=> Painful, swollen, enlarge, bulging, dilated blood vessels in hemorrhoids are found in the lower portion of the rectum and anus and are known as hemorrhoids.
=> Swelling in the vein of rectum and anus is known as hemorrhoids.
2) Explain the type of hemorrhoids. (State the type of hemorrhoids.)
=> There are two types of hemorrhoids.
1) Internal hemorrhoids (Internal hemorrhoids).
2) External hemorrhoids
••••>
1) Internal hemorrhoids (Internal hemorrhoids).
=> Internal hemorrhoids mainly develop inside the lining of the anus.
=> The most common symptoms of internal hemorrhoids are painless bleeding and protrusion during bowing movement.
=> Internal hemorrhoids are not visible because they are inside the anus.
=> Internal hemorrhoids can protrude and peolepse from the anus.
2) External hemorrhoids
=> External hemorrhoids are mainly found on the outside of the anal sphincter and are mainly covered by very sensitive skin.
=> External hemorrhoids are mainly painless but when a blood clot forms on it, the hemorrhoids turn into a hard lump and become painful.
=> External hemorrhoids are mainly small pea sized lumps that are felt in the anal area.
=> Bleeding is seen when these external hemorrhoids rupture.
3) Explain the degree of severity of the hemorrhoids. State the degree of severity of hemorrhoids.
Level : 1 =>
••> Bleeding occurs from the hemorrhoids in level one but the hemorrhoids do not prolapse.
level:=2
••> Hemorrhoids in label two are prolepse but can be pushed back into the anal wall. Bleeding is also seen less in it.
level:=3=>
••> In level three hemorrhoids cannot be backed back into the anal cavity, but can be pushed back to its original position manually or by medical procedures.Bleeding from hemorrhoids is also seen in level three.
level:=4=>
••> In level 4 all conditions are present. But blood clot is also present in it, this type of blood clotted hemorrhoids is called thrombosed hemorrhoids.
4) Explain the etiology/cause of the hemorrhoids. (Give reasons for hemorrhoids.)
Due to constant pressure in rectal and anal area.
Due to chronic constipation.
Hereditary.
Due to continuous sitting and standing position for long time.
Aging.
Due to heavy cuffing.
Due to regularly lifting any heavy object.
Due to low fiber intake.
due to chronic diarrhoea.
Due to chronic liver disease.
Due to intestinal tumors.
Any infection of the anal area.
Due to straining during bowel movements.
Being an intestinal tumor.
Because of obesity.
Being irritable bowel syndrome.
Being overweight.
Due to the use of laxatives and enemas in excessive amounts.
5) Explain the clinical manifestation/sign and symptoms of the patient with hemorrhoids. (State the symptoms and signs of a patient with hemorrhoids.)
Painless bleeding during bowel movements.
Bright red blood in the stool.
Itching and irritation in the anal region.
to be in pain
Discomfort.
anal ache or pain.
Burning and itching sensation around the anus.
Swelling around the anus.
Lumpy feeling near anus.
Leakage of feces.
6) Explain the diagnostic evaluation of the patient with hemorrhoids. (Write the diagnostic evaluation of a patient with hemorrhoids.)
history taking and physical examination.
Complete blood count test.
Digital rectal examination.
Anoscopy.
Proctoscopy.
Colonoscopy.
Sigmoidoscopy.
Barium enema
x ray
7) Explain the management of the patient with hemorrhoids. (Write management of patient with hemorrhoids.)
1) Dietary management:=
=> Advise patient to take fiber rich diet.
=> Advise patient to take adequate amount of vegetables, fruits and high fiber rich diet due to which constipation can be relieved.
2) Adequate amount of fluid
=> Advise patient to intake fluid in adequate amount.
=> Advise the patient to consume at least 8 glasses of water throughout the day.
=> Stool becomes soft due to intake of water and fluids, due to which the condition of constipation is relieved.
3) educate about the warm sitz bath
=> Providing education to the patient to take seed bath for 15 to 20 minutes three times a day.
=> sitz bath helps in reducing inflammation in hemorrhoids.
=> Dry the anal area completely after taking the seats due to which skin irritation can be reduced.
4) activity suggestion
=> Encouraging the patient to exercise due to which peristalsis movement increases and the condition of constipation is relieved.
5) provide stool softener
=> Provide proper school softener meditation to the patient.
=> To provide the patient with topicalol cream and suppositories which are responsible for lubrication and pass stool properly and easily.
8) Explain the surgical management of patients with hemorrhoids. (Write surgical management of patient with hemorrhoids.)
1) Rubber band ligation
(Rubber Band Ligation)
=> Rubber band ligation mainly around the base of hemorrhoids
One or two small rubber bands are banded.
=> By ligating the base of hemorrhoids with rubber, the blood circulation in the hemorrhoids is cut off, so the hemorrhoids shrink and fall down in a few weeks.
2) Laser therapy
=> Laser therapy mainly uses light beam to burn off hemorrhoids.
3)Sclerotherapy
=> Sclerotherapy is administered directly to hemorrhoids by injection of the chemical solution.
=> Repeated use of this injection causes the hemorrhoids to shrink and fall down in a few bites.
4) Infrared photocoagulation
(Infrared photocoagulation)
=> Infrared photocoagulation is mainly used to treat small and medium sized hemorrhoids.
=> This treatment is coagulation therapy
(coagulation therapy) is also called.
=> In this procedure mainly using infrared light beam, hemorrhoids are converted into scar tissue and its blood supply is cut off.
5) Cryotherapy
=> In cryotherapy, hemorrhoids are shriveled by providing cold therapy using liquid nitrogen.
other surgical procedure:=
1) Anal dilation
=> Anal dilation relieves pain and hemorrhoids
There is improvement in healing.
=> In anal dilation, the anal sphincter is dilated or stretched due to which pressure on hemorrhoids and rectal area can be reduced and other complications can be prevented.
2) staple hemorrhoidectomy
=> This is a type of surgical technique in which the blood flow to the hemorrhoids is blocked.
=> In this procedure hemorrhoids are stapled internally and excised internally.
=> Due to this, blood flow in hemorrhoids can be prevented.
3) Hemorrhoidectomy
=> Haemorrhoidectomy mainly involves removal of excess tissue which is responsible for bleeding.
=> This procedure is mainly performed by providing local anesthesia or sedation and spinal anesthesia.
8) Explain the nursing management of patients with hemorrhoids. (Write nursing management of patient with hemorrhoids.)
Advise the patient to take high fiber rich foods, vegetables, fruits.
Advise the patient to apply a suppository to the site of hemorrhoids.
Advise patient to avoid refined food like rice, pastry, cake.
Advise the patient to avoid alcohol.
Advise the patient to maintain personal hygiene.
Advise patient to avoid acid forming food like sugar, dairy products, protein, caffeine containing food and beverages.
If the patient is in pain, provide analgesic medicine.
Provide medicines like Acetaminophen, Aspirin, Ibuprofen etc. to the patient to relieve the discomfort.
Advise the patient to shower daily.
Advise the patient to take plenty of fluids.
Advise the patient athlete to consume 6 to 8 glasses of water throughout the day.
Advise the patient to do physical activity in a small amount due to which the peristalsis moment increases and constipation can be relieved.
Ask the patient to avoid prolonged sitting and standing position.
Advise the patient to avoid straining during bowel movements.
Advise the patient to take sitz bath regularly.
For sitz bath ask patient to take sitz bath in plain warm water for 10 minutes at least 3 times a day.
Provide proper psychological support to the patient.
To clear all the doubts of the patient and his family members.
.