1. Nursing Management: Lower Gastrointestinal Problems
Chapter 43 Overview
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2. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Diarrhea
Etiology and Pathophysiology
Clinical Manifestations
Diagnostic Studies
Collaborative Care
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3. Nursing Management: Acute Infectious Diarrhea
Nursing Assessment
Nursing Diagnoses
Planning
Nursing Implementation
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Fecal Incontinence
Etiology and Pathophysiology
Diagnostic Studies and Collaborative Care
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5. Nursing Management: Fecal Incontinence
Nursing Assessment
Nursing Diagnoses
Planning
Nursing Implementation
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Constipation
Etiology and Pathophysiology
Clinical Manifestations
Diagnostic Studies and Collaborative Care
Nutritional therapy
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7. Nursing Management: Constipation
Nursing Assessment
Nursing Diagnoses
Planning
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8. Nursing Management: Constipation
Nursing Implementation
Acute intervention
Preoperative care
Postoperative care
Ambulatory and home care
Evaluation
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Acute Abdominal Pain
Etiology and Pathophysiology
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Acute Abdominal Pain
Fig Signs and symptoms of colorectal cancer by location of primary.
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Acute Abdominal Pain
Fig Etiology of acute abdominal pain and pathophysiologic sequelae.
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Acute Abdominal Pain
Clinical Manifestations
Diagnostic Studies and Collaborative Care
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13. Nursing Management: Acute Abdominal Pain
Nursing Assessment
Nursing Diagnoses
Planning
Nursing Implementation
Acute intervention
Preoperative care
Postoperative care
Ambulatory and home care
Evaluation
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14. Chronic Abdominal Pain
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15. Irritable Bowel Syndrome
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16. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Abdominal Trauma
Etiology and Pathophysiology
Clinical Manifestations
Diagnostic Studies
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17. Nursing and Collaborative Management: Abdominal Trauma
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18. Inflammatory Disorders
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19. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Appendicitis
Etiology and Pathophysiology
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Appendicitis
Fig In appendicitis the blood supply of the appendix is impaired by inflammation and bacterial
infection in the wall of the appendix, which may result in gangrene.
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21. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Appendicitis
Etiology and Pathophysiology
Clinical Manifestations
Diagnostic Studies and Collaborative Care
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22. Nursing Management: Appendicitis
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Peritonitis
Etiology and Pathophysiology
Clinical Manifestations
Diagnostic Studies
Collaborative Care
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24. Nursing Management: Peritonitis
Nursing Assessment
Nursing Diagnoses
Planning
Nursing Implementation
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Gastroenteritis
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26. Nursing Management: Gastroenteritis
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27. Inflammatory Bowel Disease
Etiology and Pathophysiology
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28. Inflammatory Bowel Disease
Fig Comparison of distribution patterns of Crohn’s disease and ulcerative
colitis, as well as different conformations of ulcers and wall thickenings.
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29. Inflammatory Bowel Disease
Clinical Manifestations
Complications
Diagnostic Studies
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30. Inflammatory Bowel Disease
Collaborative Care
Drug therapy
Surgical therapy
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31. Inflammatory Bowel Disease
Table Indications for Surgical Therapy for Inflammatory Bowel Disease.
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32. Inflammatory Bowel Disease
Collaborative Care, continued
Surgical therapy
Total colectomy and ileoanal reservoir
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33. Inflammatory Bowel Disease
Fig Ileoanal reservoir. A, Formation of a reservoir. B, Posterior suture lines completed.
C, J-shaped configuration for ileoanal reservoir. D, S-shaped configuration for ileoanal reservoir.
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34. Inflammatory Bowel Disease
Collaborative Care
Surgical therapy, continued
Total proctocolectomy with permanent ileostomy
Total proctocolectomy with continent ileostomy
Postoperative care
Nutritional therapy
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35. Nursing Management: Inflammatory Bowel Disease
Nursing Assessment
Nursing Diagnoses
Planning
Nursing Implementation
Evaluation
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36. Gerontologic Considerations: Inflammatory Bowel Disease
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37. Intestinal Obstruction
Types of Intestinal Obstruction
Mechanical
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38. Intestinal Obstruction
Fig Bowel obstructions. A, Adhesions. B, Strangulated inguinal hernia. C, Ileocecal
intussusception. D, Intussusception from polyps. E, Mesenteric occlusion. F, Neoplasm.
G, Volvulus of the sigmoid colon.
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39. Intestinal Obstruction
Types of Intestinal Obstruction, continued
Nonmechanical
Etiology and Pathophysiology
Clinical Manifestations
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40. Intestinal Obstruction
Table Clinical Manifestations of Small and Large Intestinal Obstructions.
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41. Intestinal Obstruction
Diagnostic Studies
Collaborative Care
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42. Nursing Management: Intestinal Obstruction
Nursing Assessment
Nursing Diagnoses
Planning
Nursing Implementation
Care of nasogastric tube
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43. Polyps of the Large Intestine
Types of Polyps
Diagnostic Studies and Collaborative Care
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44. Polyps of the Large Intestine
Fig Endoscopic image of pedunculated polyp in descending colon.
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45. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Colorectal Cancer
Fig Incidence of colorectal cancer. Approximately one half of all colon cancers
occur in the rectosigmoid area. Percentages are listed for males (M) and females (F).
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Colorectal Cancer
Etiology and Pathophysiology
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Colorectal Cancer
Table Risk Factors for Colorectal Cancer.
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48. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Colorectal Cancer
Fig A, Carcinoma of the cecum. The fungating carcinoma projects into the lumen but has
not caused obstruction. B, Carcinoma of the descending colon. This circumferential tumor has
heaped-up edges and an ulcerated central portion. The arrows identify separate mucosal polyps.
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49. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Colorectal Cancer
Clinical Manifestations
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Colorectal Cancer
Fig Signs and symptoms of colorectal cancer by location of primary.
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51. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Colorectal Cancer
Diagnostic Studies
Collaborative Care
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52. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Colorectal Cancer
Table Classification System Used to Stage Colorectal Cancer.
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53. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Colorectal Cancer
Collaborative Care, continued
Surgical therapy
Chemotherapy and biologic and targeted therapy
Radiation therapy
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54. Nursing Management: Colorectal Cancer
Nursing Assessment
Nursing Diagnoses
Planning
Nursing Implementation
Health promotion
Acute intervention
Preoperative care
Postoperative care
Ambulatory and home care
Evaluation
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Ostomy Surgery
Types
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Ostomy Surgery
Fig Types of ostomies.
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Ostomy Surgery
Types, continued
End stoma
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Ostomy Surgery
Fig Sigmoid colostomy. Distal bowel is oversewn and left in place to create Hartmann’s pouch.
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Ostomy Surgery
Types, continued
Loop stoma
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Ostomy Surgery
Fig Loop colostomy.
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Ostomy Surgery
Types, continued
Double-barrel stoma
Kock pouch
Ileoanal reservoir
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62. Nursing Management: Ostomy Surgery
Preoperative Care
Postoperative Care
Colostomy Care
Colostomy irrigations
Ileostomy Care
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63. Nursing Management: Ostomy Surgery
Adaptation to an Ostomy
Sexual Function After Ostomy Surgery
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64. Diverticulosis and Diverticulitis
Fig Diverticula are outpouchings of the colon. When they become inflamed,
the condition is diverticulitis. The inflammatory process can spread to the
surrounding area in the intestine.
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65. Diverticulosis and Diverticulitis
Fig In diverticular disease, the outpouches (arrows) of mucosa appear as slitlike
openings from the mucosal surface of the open bowel.
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66. Diverticulosis and Diverticulitis
Etiology and Pathophysiology
Clinical Manifestations and Complications
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67. Diverticulosis and Diverticulitis
Fig Complications of diverticulitis.
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68. Diverticulosis and Diverticulitis
Diagnostic Studies
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69. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Nursing and Collaborative Management: Diverticulosis and Diverticulitis
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Hernias
Types
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71. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Hernias
Fig A, Types of hernias.
Fig B, Indirect inguinal hernia.
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Hernias
Clinical Manifestations
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73. Nursing and Collaborative Management: Hernias
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74. Malabsorption Syndrome
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75. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Celiac Disease
Etiology and Pathophysiology
Clinical Manifestations
Diagnostic Studies and Collaborative Care
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Lactase Deficiency
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Short Bowel Syndrome
Clinical Manifestations
Collaborative Care
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78. Gastrointestinal Stromal Tumors
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Anorectal Problems
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Hemorrhoids
Fig Anatomic structures of the rectum and anus with
external and internal hemorrhoids.
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Hemorrhoids
Fig Thrombosed external hemorrhoids.
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Hemorrhoids
Etiology and Pathophysiology
Clinical Manifestations
Diagnostic Studies and Collaborative Care
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83. Nursing Management: Hemorrhoids
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84. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Anal Fissure
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Anorectal Abscess
Fig Common sites of anorectal abscesses and fistula formation.
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Anal Fistula
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Pilonidal Sinus
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