bother Al
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phototube
Pain
.
Peritonitis
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CBC
•
complications
cause :
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life
:
-
1)
a)
a)
Pathology
Tx :
•
Abd
3)
4)
threatening
effect:
✗
ultrasound
CT
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contents
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Types
☒
a'dhesim
Sls
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blood
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diarrhea
81s
•
:
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physical
CT
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,
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→
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way
crest
develop
leads to
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-
IV
morphine/hydromorphine
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"
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anatomies
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4)
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,
)
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Tx
syndrome
,
seeds, nuts
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Day scan
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wise
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Complications
peritonitisobstructions
hospitalization
-
-
↑ fiber ↑ fluids
,
-
most
:
-
,
strictures /
fistulas
liquids
→
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fiber
softeners
high
probiotics
aroid
[
constipation)
-
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that
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or
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.
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stool
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.
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sepsis !
↓ fiber
s
Immoral
ventral /incisionat
8/8
:
shock
:
,
bleeding
=
-
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educate on disease
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perforation
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,
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more
•
.
.
,
diet
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-
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abx
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or
:
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of
,
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pain
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cause
•
,
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•
one
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,
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which can lead to
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{
"
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8) pancreatitis
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.
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%
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.
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meds
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,
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.
.
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01s
•
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normal saline
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us
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•
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→
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appendectomy
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surgery
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resolves
Interventions
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↳
@
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Yz
Tx
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more
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-
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serious !
rupture /perforation )
-
•
umbilicus
RLQ
to
MICHIE
Complications
•
4) IV pain meds [non opioids)
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'
exam
scan
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shock
tissue necrosis 4
sepsis
-
Diagnostics
E)
:
↓
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NG
,
hypokalemia
complications
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•
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-
,
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eventually shifts
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Interventions
•
appendix
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bowel sounds
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.
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ileus)
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cancer
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mon
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N
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ray
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LBD
chroma colitis
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referral
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weight
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-
vs
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time
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.
over
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suffer mild severe acute
exacerbations that occur @ unpredict 'L
pt
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MRI
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if
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'N
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-
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agents
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)
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intestinal
own
agent /combo
some
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of
periods
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.
any segment
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an
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of
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studies
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CBC
tract
colon
physical
hx
blood
rectum
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tract
response
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,
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=
intrans /Nh ulceration of
&
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Diagnostics
%
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cytokines hither
mediators
main
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-
,
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-
,
sultasalatine
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olsalazine
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,
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peritonitis)
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,
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weight gain
mood
corticosteroid induction
.
regular
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necrosis factor)
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side effects : ↑ risk of TB
cancer infect 'N
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,
,
biologic 4
bone , vascular an skin
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,
therapies
inflaming
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tissue
antimicrobials
Prednisone
cyclosporine
methotrexate
6- mercaptopurine
lnfliximab
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430
reals
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cancer
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for colorectal
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:
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-
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risk
-
-
5) fistulas
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8)
helpful for
acute
side effects
-
-
abscess
colonic
_
-
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7)
long
hydrocortisone
achenes remission
-
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,
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for
term UH !
,
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tachycardia dehydration
Complications
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inflam 'N
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-
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Natali 2-umab
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Tysabri )
Vedolizumab
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secondary
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olarithromycin
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antidiarrheal
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Luperamide
Dicyclomine
LBD
Surgical
↳
indicated
surgery
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-
pouch /anal
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not
procedure
major
-
↳
-
-
@ anal
complication
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removal
colon
,
return , hanus
wl
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opening
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on
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.
closure
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is
route
discharge
no
of
•
longer possible
.
.
4
malnutrition
prevent
fluid 4
electrolyte
loss
dlt :
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Vit
D
Ileostomy
vs
D
D
.
folic acid supplements
During
-
regular
liquid
-
-
-
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tolerated
be
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may
enteral
:
feedings preferred
:
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-
Characteristics of stoma
Exacerbations
Acute
osteoporosis
to prevent
supplements
Kt supplements
Ca
-
-
lactose
free
easily
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regular
Bread
foods reintroduced
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9
Applesauce
Toast
9
9
4)
9
5)
→
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9
7)
¢
onset
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,
.
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,
.
lifestyle on
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manage
Interventions
Nursing
+
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be
Can
up
Observe for
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to
fluid
ID
hemorrhage
abd
v7
,
,
'N
deficiency
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from manipulation
of anal canal
maybe
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c.
diff
.
infect'N
areas
of
inform 'N (skip lesions)
strictures
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care
skin
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risk
of 5.1
cancer
.
4
&
>
60
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attack
anemia
rave
mucosa
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areas of
Intamin
minimal
common
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up colon
-
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common
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mid 30s
common
severe
distribution
cancer
starts
-
in
during
involvement
abscess
bowel
,
teens
common,
entire thickness of bowel
wall
small bowel
imbalance
cramping CRLOD
depth
✗ Pus
dehydration
MUCOUS
.
,
1500 -1800mL / 24 hrs
hretectrolyte
small
Pale , gray
dusky purple
Knut
60
sometimes
common
:
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iv )
✗
✗
loss
malabsorpt
✗ cold
>
common
bleed
weight
✗ discolored
&
common
rectal
:
mid 30s
common ,
fever
:
UU
-
.
diarrhea
emotional support
-
Colitis
Ulcerative
.
attract
anywhere@along
usually distal ileum
pain
.
Post-operative Care Ileostomy
1) Monitor
i ) stoma
viability
✓red /pink
mucocutaneous
✓clean
juncture
moist
peristomes / skin integrity → ✓
✓shiny
-
vs
Crohn 's
teens
location
Patient Ed :
4) Din
Crohn 's
characteristic
9
-
labs
2) corticosteroids
•
•
probs
.
-
-
1)
on
of nutrients
exacerbating nut
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Colostomy
.
based
deficiencies
D
.
tell
☒ can
Meds
D
loss
Deficiencies
4)
•
consultant
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nut
meals )
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:
dietary
:
1) provide adequate
@ anastomosis site
w/
intervention __ consult
(small
that allows
normal elimination
His
5) 110
6) ↑ Ca
4) prevent weight
surgery
created
surgically
body waste
fat
Goals
☒
performed laparoscopically
continence impossible
:
,
Nutrition
↳
be
can
.
freq characteristics)
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4) daily weights
'
sphincter
acute /chronic
pouchitis
complication
Types
high
proto colectomy w/ permanent ileostomy
a) total
_
.
bowel mrmt
(sounds,
↓ fiber Graw foods
control of
,
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4) & caffeine dairy spicy
,
resume
↳
.
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,↑HR,↑RR abd pain, bloating
peritonitis / toxic mega colon
↳ fever
DX all { smoking
2) 4 pnteindh calories
managed
need to be
General :
1) monitor vs
Diet
permanent
Pt Able to
definition
☒
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3) support
groups
•
to anus
.
☒
ileal
diverting ileostomy performed
-
↳
eventually
,
,
.
common
directly
frustration depression anxiety
1) Therapy
ileal pouch created 9 anastomosed
-
*
need
.
.
colitis
1) Total proto colectomy w/
-
fails Most Pt
support
Emotional
Tx
Tx
Interventions
Nursing
↳
Uclerative
•
chrome colitis
'
•
↑ risk of colorectal
↑ risk 4
severity
cancer
severity
occasional
common
abscess → fistula
→
sepsis
malnourishment fissure
,
,
strictures → obstruction ,
issue
arthritis , stones rashes
,
,
psudopolyps
narrowing
,
>
scar
rupture / toxic
peritonitis
tissue
↓ hamstra
,
,
mega colon
,
0VVV↓Ñ✓y
↳ Auditory
Disorders
fftottblrttltn
SAFETY !!
consider
↳
1)
4 Considerations
Interventions
☐ Nursing
Pt
→
42 of
loses
.
4)
5)
sympt
2) use hearing aids
3) speak slowly Ganoid
high pitched speech
overview
.
b)
Postoperative care
1) careful wl sudden position
2) medicate for NIV
senses
!
write notes
minimize
extraneous
noise
avoid ototoxic meds
•
blowing
3) avoid
☐
nose
4) if cough answering uncontrollable → keep
5) avoid Valsalva maneuver (dH↑P )
6) avoid bending 4 lifting Chitty)
•
mouth open to tip
Patient Ed :
1) ↓ environmental noise
2)
immunizations
Rubella in 3rd trimester → deafness
3) ototoxic meds :
1) anti malaria
ivsalyoilatus
-
'
-
↓
1) trauma
2) inflaming infect 'N
3) cerumen hsforeiyn
•
benign paroxysmal
•
cancer
Otitis media
-
•
neuroma
tympanum
,
ossicles, airspace of
middle ear
:
Intamin /infec 'N of
4) Tinnitis
ringing
hearing
loss
in
5)
'
acoum LN
causing
noise
endolymph
to
in
drainage
Dear pain (otalgia)
2) discomfort
5) fewer
3) muffled hearing
1) conductive
,
genetic hnenviron
ringing
"
/lasix)
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hearing
head
factors
Neuroma
7) Benign Paroxysmal
positional
(Bppv)
unilateral
affecting
Common
benign
tumor
CNVIII
cause
vertigo
of
Vertigo
causing
tumor
M
CN V1"
in
pressure
balanced
→
coordination
1) unilateral, progressive hearing
4)
gtapedeotomy
a) ✗
loss of
aid
hearing
→ No
loss
touch sensation
balance
↓
-
-
to
ringing
!
vertigo
sympt
quiet
.
room
✗ sudden mvmts
✗
-
fluorescent /
-
resection
of CSF leak !
surgical
be
aware
canal ith
/
Epley
)
maneuver
repositioning
5) nausea
8) conductive hearing
loss
conditions in the
middle
outer or
1) otitis media w/ effusion Dpt speaks
softy (bio
/
leaky fluid)
spoken voice seems loud)
2) cerumen
3) perforation of tympanic 2) Pt hears better in noisy
ear
transmission
through
air
impair
of sound
→ inner
ear
memb
inner
of hunt of
ear or
_
CNMI
(vestibularcochlear)
cause
hearing
aid
.
ostosclerosis
ear
impairment
treat
enviro 'n
.
5) narrowing
loss
-
.
4)
9)sensorineural hearing
-
.
of
external
canal
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hears sound
factors
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trauma
3) aging
4) meniere's disease
5) Oto toxicity /loop diuretics
,
ASA , NSAIDs , abx,
chemotherapy>
6) systemic inflow (DM
bacterial meningitis
,
immune diseases )
but can't
understand speech
,
a) hearing high pitch
diminishes
/includes consonants)
sounds
g) sounds
become
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to
understand
muffled
-
.
flickering lights
✗ TV
-
*
cure
dark,
-
"
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corticosteroids
drown out
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canal
drops
&
abx
-
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debris
semicircular
moist heat
mild analgesic
loss
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4) progressive hearing loss
5) drop attacks
6) N / V
7) sweating, pallor
vertigo
free-floating
-
"
"
6)Acoustic
-
_
-
noise
1) Vertigo
tympanoplasty
-
-
Dred tympanum
exposure
meds
abx
eardrops
-
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tubes)
drainage
labyrinth
membranous
,
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autosomal dom
disease
ear
of
in contaminated
swimming
H2O
leading
,
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trauma
auricle
disorder
bulging painful -1M
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→
-
progressive
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allergies
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many
Disease
TX
-
,
epithelium hear canal
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SIS
of
auditory tube
swelling
dlt colds
,
develops from repeated
otitis media in childhood
narrowed stapes
Meniere 's
agents
loss
hearing
acoustic
cause
acute : infect 'N of
chronic
externa
NSAIDs
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v
or
definition
often in children
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sensorineural
Disease
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conductive
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v
antibiotics
Vertigo
positional
bodies
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diuretics
hearing
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or
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ability to care
next
(assistance
.
Retinopathy
↳ microvascular
-
R
closed
:
felt, prevent falls /
injury)
•
ointment ]
↑
that
arrange follow-up appt
assess
cornea
eye
prevention :
eye tube (drops
interventions
Instructions
'
can't close
dry eyes
home
1) bleeding
iD pain
HD Sls of infect 'N
↳
issue
ride
have
1) report Sls
contagion
hygiene
pupil
scratch
?
restore
MUST
Discharge
accommodation
phaco emulsification 410L
vision w/ lens
implant
Post-surgery
control
:
rubbing
blinking
snit in
tape
→
.
:
-
-
-
"" "^" " """" "" " " "" """
4) ✗ driving until approved
5) wear glasses /eye shield /eye patch
6) shield from UV rays
(
pink eye )
prevention
prolonged drug therapy
contraction
anticholinergic) paralyzes
""
numb
eye
-
2) ✗ activities
eye
-
,
-
°
→
excessive
clb
[
DX rubbing /pressing eye
" ""
into 'N of
inform 'N of outer
7) cantankerous
-
→
.
usually
-
,
goal
*
mostly palliative
5) SIabnisnm.rs
>
surgical
↳
"
"
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-
drooping eyelid
abx
night
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3) cycloplegia
→
moist compress
ointment
c¥¥¥LiE
-
@
-
Abnormalities 4 Abbreviations
-
perception
color
-
glasses
h¥¥¥nm
,
vision decline
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E) intraocular lens implant
2)
diabetes alcoholism )
.
dilates pupil
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2) NSAID drops ↓ inform 'N
-
"
lie
:
surgery
→
surgical
c) corrective
contacts
meds
diseases
sls
:
mostly age-related
earlier
:
3) glaring effects
4) vision worsens
5) opaque lens
irregular corneal curvature
light rays bent unequally
Corrective
1) Non
it
injury
1) gradual
2) abnormal
-
that 's
develop
2) certain
120°
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nearsightedness
2) Imerina farsightedness
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typically
4)¥xkgeaEcn
of lens
opacity
diabetics
-
blind
visual
visual
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:
to
w/
even
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contacts, meds,
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vision
some
that can't be
vision
impaired
:
vision
progressive
Risk
1)
vision
Pop
:
Diabetics
i > Non
-
-
loss
-
:
proliferative
most
;) Proliferative
common
-
cap micro aneurysms
retinal
hard exudates
.
-
-
swelling
2) Hypertensive
-
↑ BP
creates
Pts
-
new
blood vessel
hemorrhages
:
retinal
blood
vessel
blockage
growth
phototaxis
ritual
4) Retinal
Detachment
retina from the epithelium
accumulation b/w the 2 layers
Cause
•
i)
myopia
ocular
SIS
trauma
:
of retinal detachment
hx
1) floaters
flashes
2) retinal
:
(photopsia)
iiD painless
blurryin
field) ring
visual
detachment
ID
like
curtain
a
/veil
Types
•
1)
Diagnostics
1)
2)
3)
open
-
2)
angle
-
.
£
dlt trabecular
meshwork
primary
-
(Not important for
surgery
scleral
prod 'N
.
99 humor outflow
is ↓
ultrasound
↳
aq
:
primary
-
1) slit lamp
2) ophthalmoscope
Tx
of
(inflow) > rate of
absorption [outflow)
down
coming
↑ IOP
=
↳ rate
D same sls as tear
iD area of dark vision
sudden onset
vision [cobweb
,
☒
cause
•
tear
'
3)
AMP
fluid
/surgery
/personal
family
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•
&
vitreous humor shrinks)
( ble
severe
iv)
/holes) d/t
break C.tears
aging
)
ii
)
"
%
buckle
-
vision
5)
cases
Nursing
-
pt
.
2) eye drop
'D
ii
Age
↳ most
-
Types
1) Non
-
of irreversible
cause
affects
>
lights
3) photophobia
/pressure
2)
(
Dry)
cells
atrophy
↳
-
meshwork
-
↑
-
form
untreated
rapid
dry
→
iD
blindness
Risk
Factors
lead
)
V
1) age
2) genetics
.
Tino , B carotene
-
Tx
2)
-
-
-
9
•
,
darkened vision
spots
Cscotomas )
doesn't
doesn't
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notice
not
until both
,
lutein]
blood
destroy
leave blind
very few pts
Nursing
(slows
.
1)
[for
trabecular
-
-
vessels
considerations :
✗
avoid
lights
constricts pupil
↓
}↓
IOP
aq
humor
.
prod
[Diamond
meds
restrictions
strenuous
✗
sudden
✗
bending
4) wear
inhibitors
→
9
:
sunlight
eye
return
for
wet AMD)
.
Cdlt ↑
IOP )
activityto 's
position
or
cover
straining
as
directed
physician 's
appt
.
considerations
Nursing
determine
of
1)
spot
eligible
avoid
3) activity
D 's
eyes affected
anhydrase
aceta 2- Olamide
2) take prescribed
5)
vision loss)
(Maugeri)
ranibitumab (Lucent's)
Dpregabtanib
carbonic
Patient Ed
-
:
Meds
2)
,
blind
3) vision distortion
photodynamic therapy
↳
:
1) blurred
3) cigarette smoking
4) HTN
5) Nut factors (Vit GE
☒
•
/
S J
-
iv) B- blockers
to wet
-
•
.
of
circulation
Hyperosmotics
adrenergic agonists
Alpha
onset
can
systemic
3) Meds
1) Miotics
,
☒
4 contraction
open outflow
to
Irish trabecular meshwork
part
fluid percolates out through missing iris absorbed
into
blood vessels
macula
,
severe
-
↳
fragile leaky
-
spas
needs
abnormal
↳
light for tasks
gradual, progressive
painless vision loss
-
EMERGENCY !
:
(wet)
Exudative
near
difficulty
reading
mind
-
EYE
vision
redness
2) Iridectomy surgery
↳
of
removal of
most common
close vision affected
blurred vision
-
vision loss
°
Exudative
-
Tx
1) later trabeculoplasty
↳ later cantus
scarring
boy/
slightly
-
central
☒
:
↳ macular
-
Degeneration
Macular
H.A.is
intravitreal bubble
3) pain meds
4)
activity restrictions
5) can't drive
inflammatory
common
usually
☒
dlt
to face down
dilators
Related
-
or
,
7)
.es
-
process
aging pupil
dilation
4) blurred
5) ocular
b) NIV
meds
i ) abx
ii) anti
occurrence
colored halos around
bubble
have
may
d /t
lens )
bulging
1) severe pain frontal
"
Interventions
1) positioning
Cd It
acute
prolonged
vitrectomy
intra vitreal
↓
< closure
-
of
vision loss
tunnel
pain
no
-
obstruction
cause
gradual
-
us
closure
primary angle
's outflow
-
later photo coagulation
4) cryotherapy (cold therapy )
☒
optic
's
of diseases that can damage
eye
result in vision loss 4 blindness
group
nerve
:
1) retinal
☒
w/
separation of
↳
Glaucoma
↳
sunlight
15
days)
or
halogen
3) bevacizumab (Arnstein)
4) afriberce.pt/Ey1ea)
2) how
3) how
4)
does
is
client
direct
tone
impairment
length
?
impairment affect normal functioning
contact
eyevoice
of
5) sighted
b) explain
coping
-
?
when
speaking
in
a
guide technique
environmental sound, smells etc
,
.
normal
.
Lab
14
:
HGB
12
:
0-8
Eosinophils
I /
Lymphocytes
20-40 /
-
Colonoscopy
2.0
Pratte
↓
"
"
Hot acid secretion
Maalox
sodium
smoking
overeating
* no
,
wall
SYMRT
-_
uncommon
quick
*
NSAIDs , stress,
,
Mylanta
*
Do Not take
-
-
-
-
-
-
-
-
abscess
lining
-
cause
=
-
unknown
potentially
[
-
environ .G
have ups followed
remission
-
-
sepsis
↑
rashes
✗
diet
genetics)
by
-
kidney
cancer
✓ low fiber
(popcorn
✓ cooked foods
digest
stones
✗
✗
✗
veggies]
fatty
-
-
-
anal fissures
loss
weight
fatty stools
starts in
cure
-
_
✓ lots of H2O
-
-
dairy
allergens
-
meds
toxic
ileoanal anastomosis
↓
mega colon
peritonitis
diarrhea , abd
.
pain
loss , fever
,
,
→
rupture
haustra
tissue
scar
psudopolyps
weight loss
anemia
inform 'N of
Sls
weight loss
cramping
4
dehydration
joints eyes skin
,
,
,
:
-
fatigue
of intestinal
colectomy w/ ileostomy
liver
(wheat, fish)
weight
migrates up
:
✓high protein
spicy
-818
=
lining
colon
Ct pouch )
complications
-
:
rectum 4
affects inner
→
-
-
colitis
large intestine 4
affects
_
:
abd pain CRLQ)
ulcers in mouth
(Flagg)
-
high fiber
raw
✗
eye problems
cramping
Tetracycline
other
wall
-
:
✗ hard to
obstruction
diarrhea
w/
or
risk of colon
, nuts,
arthritis
.
-
fistula
s
fissure
Sls
-
:
gallbladder &
""
)
(
Ulcerative
-
_
→
h✓°MY
Biaxin
w/
inform 'N daubers
causes
-
of intestine
malnourishment
strictures
"" "
meds
BOTH
_
9
before
V2 hrs
Amoxacillin
-
-
Pylori
other meds
surgery helps w/ Qoldu
complications
.
Metronidazole
short term
Not take
H
from acid
sulcrafateccarafate)
relief
* do
.
-
kills
4
Magnesium hydroxide
affects whole GI tract
scattered patches (cobblestone)
affects entire
Antibiotics
meal
,
(?) I
ulcers
give
bicarbonate
calcium carbonate
Aluminum hydroxide
cimetidine
effects
for
give
Fanrutidine (Pepsi d)
* side
stomach
lines
12hr after
meals
(Zanu )
Ranitidino
fx
HCl
protects
give
→
MMM
ulcers
Crohn 's
.
scan
"
neutralizes
@ bedtime or
30min before meals
before
bone
tidine
prevents
ulcers
Crush
cure
get
Protestant
Mucosal
Antacid
Antagonist
antagonist
no
up
CT
visual of colon
Gastritis , GERD , PUD , hiatal hernia
FOR
-
.
-
to
rectum
3.0
"
Go diff infection
* more effective than HZR
-
camera
for
colon
.
HZR
acid secretion
term use
-
"
Esomeprazole (Nexium)
-
contrast into
=
.
3.0-4.0
Pantoprazole (protonic)
-
=
1.5 -2.0
.
↑ risk of
enema
.
Omeprazolecpriloseo)
long
9
'
2-8-1
A. fib
30min
givemeals
*
fiber
gastritis
diverticulosis
diverticulitis ,UC, Crohn
II -15sec
PPI
Do Not
→
,
'
Prosthetic valve
prevents
-
fiber
barium
/mm }
.
Basophils
z
low
PUD
→
.
.
PT
*
/
0.5
DVT
↓ Hot
.
pylori
.
high
47 't
Thousand
1-4.1
Monocytes
"
-
55-70-1
Bands
>
37
5-10
Neutrophils
0
It
.
:
WBC
-1891dL
-1691dL
42-521
:
Hot
§
M IS C
value
-
-
-
diarrhea GPUs {
pain CLLQ)
bloody
Abd
.
-
fever
electrolytesbalance
-
mucous)
IBD
v8
inflammatory Bond
diseases
group
disorders
of L
die
to
inflammation
NC
t
Crohn's
pathos known
anti inflammatory
meds
steroids
IBS
irritable
bowel
syndrome
defined by specific
signs symptoms
diagnosis clinically
patro
unknown
anxiety of
get