ACTIVE LEARNING TEMPLATE:
System Disorder
STUDENT NAME______________________________________
Toxic Megacolon
DISORDER/DISEASE PROCESS___________________________________________________________
Alterations in
Health (Diagnosis)
Toxic Megacolon
Pathophysiology Related
to Client Problem
REVIEW MODULE CHAPTER____________
Health Promotion and
Disease Prevention
pathogenesis is unknown; mucosal inflammation initiates the process. It releases
inflammatory mediators, bacterial products and increases the production of inducible
nitric oxide synthase, which in turn increases nitric oxide, and thus causes dilation of the
colon; significantly high levels of inducible nitric oxide synthase in the muscularis
propria; leads to inflammation of the smooth muscle of the colon, which causes its
paralysis and eventually dilation; non obstructive dilation of the colon, which can be total
or segmental and is usually associated with systemic toxicity. It is rare and can be fatal
ASSESSMENT
SAFETY
CONSIDERATIONS
Risk Factors
Expected Findings
ulcerative colitis, Crohn's disease, infections
of the colon, Ischemia, colon cancer,
diabetes, organ transplants, kidney failure,
suppressed immunity, and chronic
obstructive pulmonary disease.
Laboratory Tests
diarrhea, hypotension, tachycardia, fever, diffuse abdominal
tenderness with distention and sluggish bowl sounds,
significant leukocytisus, metabolic alkalosis, and electrolyte
derangements, dilated trabsverse or right colon > 6cm, deep
mucosal ulceratuinsm segmentak colonic wall thinning,
air-fluid levels with abnormal haustral pattern and nodular
pseudo polyps
Diagnostic Procedures
Radiographic images (computed
tomography), CBC, electrolytes,
blood culture, fecal screenings, stool
samples for C. diff and A/B toxins
radiographic evidence of colonic
dilatation >6cm; test for fever,
tachycardia, leukocytosis or
anemia test;
PATIENT-CENTERED CARE
Nursing Care
serial labs, abdominal x-rays
(2x daily), drug therapy,
monitor vitals, aware of
potential complications, ,
Therapeutic Procedures
ACTIVE LEARNING TEMPLATES
Complications
Medications
sulfasalazine/5-ASA
compounds
(anti-inflammatory effect);
Glucocorticoids
(decrease diameter of
colon by reducing nitrous
oxide); Cyclosporine
(inhibits T-lymphocyte
function essential for
propagation of
inflammation);Infliximab
(blocks action of TNF-a
by preventing it from
binding to its recepto in
the cell, but it also causes
programmed cell death of
TNF-a-expressing
activatyed T lymphocytes
that mediate
inflammation)
Client Education
precipitating factors, potential
symptoms, preventative care,
risk factors and how to
maintain them
risk of rupture,
bowel perforation,
peritonitis,
abscess, and
abdominal
compartment
syndrome
Interprofessional Care
surgeon (in some cases),
gastroenterologist,
Therapeutic Procedure
A11