Care Of Clients With Problems In Oxygenation PDF

Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES Musculoskeletal Disorders Types of Arthritis  Gout Arthritis - Gout is a type of arthritis that causes inflammation, usually in one joint that begins s...

Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES Musculoskeletal Disorders Types of Arthritis  Gout Arthritis - Gout is a type of arthritis that causes inflammation, usually in one joint that begins suddenly. - Caused by the deposition of needle-like crystals of uric acid in a joint.  STAGE IV: CHRONIC GOUT - Also called as “TOPHACEOUS GOUT”. - The uric acid deposits can form nodules called “tophi”. Progressive joint damage develops. Stages of Gout  Asymptomatic Hyperuricemia  Acute Gout  Intercritical Gout  Chronic Gout  STAGE I: ASYMPTOMATIC HYPERURICEMIA - Uric acid is building up in the blood and starting to form crystals around joints Minimal joint pain, redness or MEDICATIONS swollen joints.  Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include over-the-counter options such as ibuprofen (Advil, Motrin IB, others). - NSAIDs carry risks of stomach pain, bleeding and ulcers.  Corticosteroid medications, such as prednisone, may control gout inflammation and pain. Side effects of corticosteroids may  STAGE II: ACUTE GOUT include mood changes, increased blood sugar - Sudden, unexpected nighttime attack of gout levels and elevated blood pressure. symptoms.  Colchicine - An anti-inflammatory drug that - The urate crystals are released into the joint fluid and effectively reduces gout pain. The drug's effectiveness cause inflammatory reaction. may be offset, however, by side effects such as nausea, - There is pain, redness and swelling of joint, called vomiting and diarrhea. GOUT FLARE. PREVENTION  Maintain the concentration of uric acid level within the normal range.  Drinking plenty of water.  Balance your weight with proper diet and exercise.  Avoid purine rich foods.  Reducing alcohol consumption  Avoid diuretic drugsJuvenile Idiopathic Arthritis Juvenile rheumatoid arthritis - occurs when the body's immune system attacks its  STAGE III: INTERCRITICAL GOUT own cells and tissues. - After a first gout flare, 75% of people will have a - It's not known why this happens, but both heredity and second within a year. environment seem to play a role. - Patient should begin longterm treatment. SYMPTOMS  Pain  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  Swelling  Stiffness  Fever, swollen lymph nodes and rash COMPLICATIONS  Eye Problems  Growth Problems  There are several different subtypes of juvenile  idiopathic arthritis, but the main ones are  systemic, oligoarticular and polyarticular. Types of Psoriatic Arthritis  Symmetric Psoriatic Arthritis BLOODTESTS - usually affects the same joints on both sides of the  Erythrocyte sedimentation rate (ESR). The body. Usually multiple pairs of joints, such as the right sedimentation rate is the speed at which your and left knees or right and left elbows, are affected. red blood cells settle to the bottom of a tube of blood.  C-reactive protein. This blood test also measures levels of general inflammation in the body but on a different scale than the ESR.  Antinuclear antibody. Antinuclear antibodies are proteins commonly produced by the immune systems of people with certain autoimmune diseases, including arthritis. Rheumatoid factor. This antibody is occasionally found in the blood of children who  Asymmetric arthritis have juvenile idiopathic arthritis and may mean - doesn’t typically affect the same joints on both sides of there's a higher risk of damage from arthritis. the body. IMAGING TESTS - Usually, it affects the fingers and toes first, which can  X-rays lead to an enlarged and “sausage-like” appearance.  (MRI) Magnetic Resonance Imaging - Sometimes a larger joint, like the knee, is also affected. MEDICATIONS  Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications, such as ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve), reduce pain and swelling.  Disease-modifying antirheumatic drugs (DMARDs). Doctors use these medications when NSAIDs alone fail to relieve symptoms of joint pain and swelling or  Distal Interphalangeal (DIP) Predominant if there is a high risk of damage in the future. Psoriatic Arthritis Biologic agents. Also known as biologic response -DIP affects the joints in the fingers and toes closest to modifiers, the nail; nail changes are common  this newer class of drugs includes tumor necrosis factor (TNF) blockers.  Corticosteroids. Medications such as prednisone may be used to control symptoms until another medication takes effect.  MANAGEMENT  Physical therapy  Nutritional support  Psychosocial support  Participate in moderate fitness, flexibility, and  strengthening exercises.  Spondylitis - refers to inflammation of the spinal column. Psoriatic Arthritis - Many people with psoriatic arthritis will have stiffness in - A type of inflammatory arthritis that affects some the neck, lower back, or spinal vertebrae, making motion people with psoriasis, a skin condition characterized by painful and difficult. red, scaly patches. - It can cause pain, stiffness, and swelling in the joints, and it may affect any joint in the body.  Arthritis mutilans  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES - is a severe, deforming, and destructive form of psoriatic arthritis. - It usually affects the small joints at the ends of the hands and feet Signs and Symptoms  Fatigue.  Morning Stiffness Signs and Symptoms  Joint Pain  Joint Pain and Swelling  Loss of Appetite  Morning Stiffness  Fever  Dactylitis  Numbness and Tingling  Skin Changes  Joint Stiffness  Nail Changes COMPLICATIONS  Back Pain  Osteoporosis  Fatigue  Rheumatoid nodules  Reduced Range of Motion  Lymphoma COMPLICATIONS  Dry eyes and mouth  Joint Damage and Deformity  Heart problems  Eye Problems  Lung disease  Cardiovascular Disease LAB TESTS  Metabolic Syndrome  Rheumatoid Factor (RF): This blood test detects  Gastrointestinal Problems the presence of RF antibodies, which are found MEDICATIONS in about 70-80% of people with RA.  Nonsteroidal Anti-Inflammatory Drugs  Anti-Citrullinated Protein Antibody (ACPA): This (NSAIDs): These over the-counter or test detects antibodies to citrullinated proteins, prescription medications (e.g., ibuprofen, which are more specific for RA than RF. naproxen) help reduce pain and inflammation.  Erythrocyte Sedimentation Rate (ESR) or C-  Disease-Modifying Antirheumatic Drugs Reactive Protein (CRP): These are markers of (DMARDs): These slow the progression of inflammation and can be elevated in RA, psoriatic arthritis and prevent joint damage. reflecting the level of inflammation in the body. Methotrexate, and leflunomide are commonly  Complete Blood Count (CBC): This test helps used DMARDs. assess anemia, which can be associated with MANAGEMENT RA, and overall blood health.IMAGING TESTS  Physical Therapy: Helps improve joint flexibility,  X-rays strength, and overall function.  Ultrasound  Lifestyle Modifications: Maintaining a healthy  Magnetic Resonance Imaging (MRI) weight reduces stress on joints and lowers  Arthocentesis inflammation. Smoking and excessive alcohol MEDICATION consumption can worsen psoriatic arthritis  Disease-Modifying Anti-Rheumatic Drugs symptoms and interfere with medications. (DMARDs): Methotrexate, sulfasalazine,  Stress Management: Stress can trigger flare- leflunomide. ups of both psoriasis and psoriatic arthritis.  Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):  Skin Care: Proper skin care is essential for Help reduce pain and inflammation (e.g., managing psoriasis, which often accompanies ibuprofen, psoriatic arthritis. naproxen).  Regular Monitoring and Check-ups: Regular  Corticosteroids: Used for short-term relief of check-ups to know early signs of psoriatic severe arthritis. inflammation (e.g., prednisone). Rheumatoid Arthritis MANAGEMENT - An autoimmune disorder in which the joint lining and  Exercise other tissues become inflamed.  Diet - RA is chronic, systemic, inflammatory disorder that  Stress Management primary invloves the joints.  Regular Monitoring  Ankylosing Spondylitis  axial spondyloarthritis  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  an inflammatory disease that, over time, can - Osteoarthritis (OA) is a common, chronic joint condition cause some of the bones in the spine, called that occurs when the protective cartilage cushioning vertebrae, to fuse. the ends of bones wears down over time. TYPES - It primarily affects the joints in the knees, hips, hands,  Axial Spondyloarthritis - condition is found on and spine, though it can occur in any joint. X-ray. Primary and Secondary  Nonradiographic Axial Spondyloarthritis-  Primary (Idiopathic) Osteoarthritis condition can't be seen on X-ray but is found - The term "idiopathic" means that there is no specific based on symptoms, blood tests and other disease or condition causing the osteoarthritis imaging tests. - it's often linked to age-related changes in joint SYMPTOMS structure.  back pain and stiffness in the lower back and  Secondary Osteoarthritis hips - It results from an identifiable underlying cause or  neck pain and fatigue known specific cause, condition. though genetic factors seem to be involved. In - Occurs as a result of an existing medical condition, particular, people who have a gene called joint injury, or abnormality. HLA-B27 are at a greatly increased risk of Types Based on Location developing ankylosing spondylitis. However,  Knee Osteoarthritis: The most common form, only some people with the gene develop the often linked to aging, obesity, or injury. condition  Hip Osteoarthritis: Causes pain and stiffness COMPLICATIONS in the hip joint, often leading to difficulty  Eye inflammation, called uveitis walking.  Compression fractures  Hand Osteoarthritis: Affects small joints in the  Heart problems fingers and base of the thumb, commonly seen IMAGING TESTS in older adults..  X-rays  Spinal Osteoarthritis: Affects the spine,  Magnetic resonance imaging (MRI) particularly the lower back (lumbar spine) or LAB TESTS neck (cervical spine), leading to pain and - There are no specific lab tests to identify ankylosing stiffness. spondylitis. Signs and Symptoms -Certain blood tests can check for markers of  JointPain inflammation, but many different health problems can  Stiffness cause inflammation.  Loss of Flexibility MEDICATIONS  Swelling and Tenderness  Nonsteroidal anti-inflammatory drugs  Grinding or Grating (NSAIDs) - such as naproxen sodium (Aleve)  Sensation (Crepitus) and ibuprofen (Advil, Motrin IB, others) — are  Bone Spurs (Osteophytes) the medicines health care providers most COMPLICATIONS commonly use to treat axial spondyloarthritis  Chronic Pain and nonradiographic axial spondyloarthritis.  Joint Deformity  Tumor Necrosis Factor (TNF) blocker or an  Loss of Joint Function and Mobility interleukin-17 (IL-17) inhibitor-these  Sleep Disturbances medicines are injected under the skin or  Increased Risk of Falls through an intravenous line.  Bone Fractures  Janus Kinase (JAK) inhibitors - taken by IMAGING TESTS mouth, these types of medicines can reactivate  X-rays untreated tuberculosis and make you more  Magnetic Resonance Imaging prone to infections.  (MRI) THERAPY  Physical Examination  Range-of-motion and stretching exercises LAB TEST Strengthening exercises for abdominal and back  Joint Fluid Analysis (Arthrocentesis) A muscles Proper sleeping and walking positions. needle is used to withdraw fluid from the SURGERY affected joint for laboratory analysis. - Most people with ankylosing spondylitis or - Joint fluid is examined for signs of inflammation, nonradiographic axial spondyloarthritis don't need infection, or the presence of crystals (as seen in gout). surgery. - It helps differentiate osteoarthritis from other types of -Surgery may be recommended if you have severe pain arthritis, such as rheumatoid arthritis or gout. or if a hip joint is so damaged that it needs to be SURGERY replaced.  Arthroscopy MANAGEMENT - A minimally invasive procedure used to replace hip and  Exercise knee joints.  Follow a diet plan that’s healthy for you - A small camera (arthroscope) is inserted into the joint  Firm Mattress and flat pillow through tiny incisions.  Heel cups or pads - Can be used to clean out loose cartilage, remove bone Osteoarthritis spurs, or repair damaged meniscus (in knee OA).  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  Osteotomy - A procedure that involves cutting and reshaping the bone to relieve pressure on the affected joint. - The bone is cut and realigned to redistribute weight and reduce stress on the damaged area. - It helps to realign the joint and reduce pain and damage, particularly in cases of knee OA. Post-operative Management  Have enough rest  Use prescribed pain relievers and anti inflammatories (NSAIDs) to manage pain and PREVALENCE inflammation. - Higher number of cases of Crohn's disease found in  Cold Therapy: Apply ice or a cold pack for 15-20 Western industrialized nations. minutes at a time, several times a day, to - Males and females are equally affected. reduce swelling and pain. - Smokers are three times more likely to develop  Increase the range of motion progressively to Crohn's disease. prevent joint stiffness. - Crohn’s disease tends to present initially in the teens  Monitor symptoms: Be mindful of any new pain and twenties. or discomfort, and adjust activity levels CAUSE accordingly. - The exact cause of Crohn's disease is unknown, but it MANAGEMENT is believed to result from a combination of factors:  Physical Therapy: Physical therapy helps  Genetics strengthen the muscles around the joints,  Autoimmune Disorder improve range of motion, and reduce pain.  Environmental Factors  Lifestyle Modifications: Maintaining a healthy CLASSIFICATION weight decreases the load on weight-bearing On the area of the GI tract which it affects: joints (e.g., knees, hips), alleviating pain and  Ileocolitis: Inflammation in your lower small slowing the progression of osteoarthritis. intestine and part of your large intestine.  Medications: Nonsteroidal Anti-inflammatory  Colitis: Inflammation in the lining of your large Drugs (NSAIDs): Ibuprofen (Advil, Motrin), intestine. Naproxen (Aleve) These reduce both pain and  Ileitis: Swelling and inflammation in your lower half inflammation. small intestine (ileum)  Acupuncture: Some studies show acupuncture can help reduce OA pain and improve function in some patients.  Patient Education and Support: Help patients actively participate in managing symptoms and improving outcomes. GI TRACT - The part of an organ system in humans and other animals that take in food, digest it, absorb nutrients and expel it out in the form of feces. CLASSIFICATION - On the area of the GI tract which it affects:  Gastroduodenal: - Inflammation and irritation that affects your stomach and the top of your small intestine (the duodenum).  Jejunoileitis: Patchy areas of inflammation in the upper half of your small intestine (the jejunum). INFLAMMATORY BOWEL DISEASE On the behavior of disease as it progresses: - Inflammatory bowel disease (IBD) refers to diseases  Stricturing- disease causes narrowing of the bowel that cause chronic inflammation in your which may lead to bowel obstruction or changes in gastrointestinal (GI) tract. the caliber of the feces. - It is a lifelong illness for which there’s no cure.  Penetrating- disease creates abnormal Two types: Crohn's Disease and Ulcerative Colitis. passsageways between the bowel and other CROHN'S DISEASE structures such as the skin. - Crohn’s disease is an idiopathic, chronic inflammatory  Inflammatory- disease causing inflammation process that can affect any part of the gastrointestinal without causing strictures or fistulae. tract from the mouth to the anus. - Most commonly, it causes inflammation in small and/or large intestines. PATHOPHYSIOLOGY  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES Symptoms of Chrons Disease  Abdominal Pain DIAGNOSIS  Chronic Diarrhea  Barium enema  Loss of Appetite and Weight Loss - In which barium is inserted into the rectum, fluoroscopy  Bloody Stool is used to image the bowel. They are useful for  Mouth Ulcers identifying anatomical abnormalities when strictures of  Fever and Fatigue the colon are too small for colonoscope to pass through.  Arthritis or Joint Pain  Capsule endoscopy  Rashes Is a procedure that uses a tiny wireless camera to take  Eye Inflammation pictures of the organs in the body that food and liquids  Skin Tags travel through.  Inflammation that may cause LABORATORY TEST  fistula to develop - Lab tests check a sample of fluid or tissue for microscopic signs of disease.  Blood test - A blood test checks your blood cell counts and blood chemistry for signs of Crohn’s. - A high white blood cell count may indicate inflammation or infection. Low levels of red blood cells indicate anemia, common with Crohn’s disease. - A protein your liver makes called the C-reactive protein (CRP) may be elevated if there’s active inflammation.  Stool test - This test checks a stool (poop) sample for bacteria or parasites. - It can rule out infections that cause chronic diarrhea. For example, a calprotectin fecal test measures inflammation in your intestines. TREATMENT  Antibiotics -- Metronidazole, ciprofloxacin, and other antibiotics may be used when infections occur, or to treat complications of Crohn's disease.  Aminosalicylates (5-ASAs)- - Given either orally or rectally, these drugs work to decrease inflammation in the lining of the intestines.  Corticosteroids (Steroids)- - Given orally, as an injection, rectally, or intravenously, DIAGNOSIS these medications help  Colonoscopy reduce inflammation by suppressing the immune system. - is the best for diagnosing Cohn's disease, as it allows  Immune modifiers (Immune modulators)- direct visualization of the colon and the terminal ileum, - Given orally or injected, these medications suppress identifying the pattern of disease involvement. the body's immune response so that it cannot cause  CT Scan AND MRI ongoing inflammation. - are useful for evaluating the small bowel with  Biologic therapies (Biologics)- enteroclysis. They are useful for looking for intra- - Given intravenously or injected, this class of drugs abdominal complications of Crohn's disease such as suppresses the immune system to reduce inflammation. abscesses, and fistulae. COMPLICATIONS 1. Intestinal complications Stricture Fistula Perforation Abscess Neoplasm 2. Systemic complications Arthritis Oxalate stones Ankylosing spondylitis  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  Sclerosing episcleritis despite the urge to do so. This is called - in which peripheral cornea is opacified by fibrosis tenesmus. and lipid deposition with neighboring scleritis may  Left-sided colitis occur particularly with herpes zoster scleritis. - Inflammation extends from the rectum up through the  Uveitis sigmoid and descending portions of the colon. - it is inflammation of the uvea, the middle layer of Symptoms include bloody diarrhea, abdominal cramping the eye between the retina and the sclera (white pain on the left side, and urgency to defecate. of the eye), and can lead to vision loss if left  Pancolitis untre.) - This type often affects the entire colon and causes  Sclerosing cholangitis bouts of bloody diarrhea that may be severe, abdominal - is a chronic liver disease characterized by a cramps and pain, fatigue, and significant weight loss. progressive course of cholestasis with PATHOPHYSIOLOGY inflammation and fibrosis of the intrahepatic and extrahepatic bile ducts.)  Erythema nodosum - it is initially managed by identifying and treating any underlying condition present. Simultaneously, treatment is directed toward the inflamed skin from the erythema nodosum. NURSING ASSESSMENT PHYSICAL ASSESSMENT  Monitor the Temperature  Weigh the patient.  Auscultate the bowel sounds.  Perform a rectal examination.  Record the physical assessment findings.  HEENT Musculoskeletal Integumentary  Assess the patient’s bowel movements  Inspect the stool color.  Check if the stool is bloody or mucoid in appearance. SYMPTOMS M I L D  Observe for bowel signs and symptoms  Diarrhea ULCERATIVE COLITIS  Increased bowel movements or episodes - Ulcerative colitis is a recurrent ulcerative &  of diarrhea (four or fewer episodes daily) inflammatory disease of the mucosal & submucosal  Urgent bowel movements layers of the colon & rectum.  Tenesmus - The peak incidence is between 30 & 50 years of age.  Mild abdominal cramping or tenderness - 10% to 15% of the patients develop carcinoma of the MODERATE TO SEVERE colon.  Frequent bowel movements  or episodes of diarrhea  Blood, mucus or pus in your  stool  Severe belly cramping  Fatigue  Weight loss  Nausea  Fever ETIOLOGY 0THER SYMPTOMS  Genetic Factors  Sudden urges to poop  Immune System Dysfunction  Not feeling hungry  Environmental Factors  Dehydration Other Factors  Eye pain when you look at a bright light - Defect in the repair of mucosal injury, which may  Canker sores develop into a chronic condition.  Anemia TYPES OF ULCERATIVE COLITIS  Feeling like you haven’t completely emptied your  Ulcerative proctitis colon after you use - Inflammation is confined to the area closest to the anus,  the bathroom. also called the rectum. Rectal bleeding may be the only  Not being able to hold your stool in sign of the disease. CAUSE .Proctosigmoiditis - The cause of ulcerative colitis is unknown. - Inflammation involves the rectum and sigmoid colon — People with this condition have problems with the lower end of the colon. their immune system. However, it is not clear if - Symptoms include bloody diarrhea, abdominal cramps immune problems cause this illness. and pain, and an inability to move the bowels - Stress and certain foods can trigger symptoms,  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES but they do not cause ulcerative colitis. - Has serious side effects such as risk of infection and DIAGNOSTIC EVALUATION the cardiovascular health.  Stool Examination – to rule out enteral pathogens Risk factor  Blood Count – hemoglobin and hematocrit may be - FDA advises people with a history of blood clots low due to bleeding; WBC may be increased. Using or heart problems to talk with a doctor about the risk of sample of blood, number of blood tests taking JAK inhibitors. including: * CBC  ULCERATIVE COLITIS DIET * Electrolyte - While food doesn’t appear to play a role in causing * Albumin ulcerative colitis, certain foods may cause more Laboratory Tests:OTHER DIAGNOSTIC TESTS symptoms when your disease is active. Imaging Tests: - Your doctor may suggest the following diet changes  Barium Enema depending on your symptoms  CT Scan  Avoid dairy – milk, yogurt, cheese and ice cream  MRI  Avoid fiber – raw fruits, and vegetables and whole OTHER DIAGNOSTIC TESTS grains. Endoscopic Tests:  Avoid nuts, seeds, corn, and popcorn.  Colonoscopy  Eat smaller meals – try eating five or six small  Sigmoidoscopy meals a day.  Upper Endoscopy (Upper GI Endoscopy or  Choose drinks carefully – drink lots of water  esophagogastroduodenoscopy) everyday.  Biopsy  Avoid alcohol, caffeine, and carbonated drinks. TREATMENT  Add vitamins and minerals – your doctor may - Treatment for ulcerative colitis can include medicines, suggest adding foods or supplements with: calcium, changes in diet, or surgery. The goal in treating folic acid, iron, vitamin B12, D , A, E, and K ulcerative colitis is to reduce the inflammation, hopefully SURGERY leading to remission. The two leading treatment options - Surgery may be recommended for patients who have are medication and surgery. stopped responding to their medication or if their - Approximately 70 percent of patients respond well to medication is no longer as effective as it once was. medication and go into remission. For those who did not Sometimes, people with ulcerative colitis need respond well to medication, surgery is an option. emergency surgery if they have a perforation in the MANAGEMENT MEDICATIONS colon or bleeding that will not stop.  Aminosalicylates ( or “5-ASA’s”) - There are two types of ulcerative colitis surgery first treatment for mild to moderate ulcerative colitis  PROCTOCOLECTOMY WITH ILEAL POUCH help to reduce inflammation ANAL ANASTOMOSIS (IPAA) used as a short-term treatment for flare-ups - most common procedure for ulcerative colitis  Corticosteroids commonly referred to as j-pouch surgery for moderate to severe ulcerative colitis help by quickly - this procedure doesn't require a permanent stoma. reducing inflammation in the digestive tract. - this procedure is frequently done in two operations. not a long-term solution because of their serious side In between the operations, you’d need a temporary effects ileostomy.  Immunosuppressants  PROCTOCOLECTOMY WITH ILEAL POUCH - Controls or suppresses the body’s immune system ANAL ANASTOMOSIS (IPAA) response so it cannot cause ongoing inflammation. - This procedure removes your colon and rectum but  Biologics leaves your anus intact. Then, the surgeon forms an - For moderate to severe ulcerative colitis Scientists and ileal pouch, a section of small intestine that attaches to drug manufacturers make these medications from your anus. specially engineered living cells, or antibodies. After - After 2–3 months, they will close the temporary stoma growing the cells in a laboratory, scientists extract in the abdomen and reroute the waste to the internal special proteins and use these to make each drug. pouch and out via the anus. - These proteins then operate by targeting a particular - Once you’ve healed, this section of your small intestine receptor on immune cells. acts as a new rectum that allows you to poop as you -Directly attack cells and proteins responsible for typically would. ulcerative colitis Alternative for people who do not respond to typical treatments such as 5-aminosalicylates or corticosteroids  Janus Kinase (JAK) inhibitors - moderate to severe ulcerative colitis helps block inflammation small molecules used in the treatment of ulcerative colitis. - These are oral medicines that can quickly work to get and maintain a remission in ulcerative colitis.  Tofacitinib (Brand name: Xeljanz) – the first JAK inhibitor that is FDA-approved.  Upadacitinib (Brand name: Rinvoq) – second JAK inhibitor that is FDA-approved.  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  Infection or pouch inflammation (pouchitis). Signs: Diarrhea, frequent bowel movements, stomach cramps and pain, fever, joint pain. Treatment: Antibiotics.  Blockage or bowel obstruction. Signs: Cramping, nausea, vomiting. Treatment: IV fluids and fasting, sometimes surgery.  Pouch failure. Signs: Fever, swelling, pain. Treatment: Surgery and permanent ileostomy. CARING FOR AN OSTOMY BAG NURSING ASSESSMENT - Empty your pouch when it is one-half full to prevent - Review nursing history for patterns of fatigue & over- leakage and bulges. work, tension, family problems that may exacerbate - This should be about one to three times every day. symptoms. - The bag needs to be changed every 4 to 7 days - Ask about the patient’s general symptoms Identify the risk factors - Assess food habits & use of any dietary or herbal supplements used as alternative therapies that may have a bearing on triggering symptoms (milk intake may be a problem). Many patient use vitamins, herbs & homeopathic - remedies without realizing the effect on bowel function. NURSING ASSESSMENT TOTAL PROCTOCOLECTOMY WITH END  Determine number & consistency of bowel ILEOSTOMY movements, - This proctocolectomy surgical procedure removes the  any rectal bleeding present. colon, rectum, and anus, and creates an end ileostomy  Interview about changes in bowel habits. so that waste can exit your body into an ostomy bag.  Regularly monitor for weight loss. The tip of the lower small intestine is brought through  Listen for bowel sounds. the stoma. An external bag, or pouch, is attached to  Perform an abdominal examination the stoma. This is called a permanent ileostomy.  Check for stool characteristics. NURSING DIAGNOSIS  Chronic pain related to disease process  Imbalanced Nutrition: less than body requirement related to diarrhea, nausea & vomiting  Deficient fluid volume related to diarrhea & loss of fluid & electrolytes  Risk for infection related to disease process, surgical procedures  Ineffective coping related to fatigue, felling of CONTINENT ILEOSTOMY (KOCK POUCH) helplessness, & = The least common surgery for UC is continent  lack of support system. ileostomy, also called the Kock pouch. NURSING INTERVENTION - an option for people who would like their ileostomy Promoting Comfort: converted to an internal pouch. It's also an option for  Apply a protective emollient such as petroleum jelly people who aren’t able to have IPAA. etc. - During the procedure a surgeon removes your colon  Report any evidence of sudden abdominal and rectum. He then uses your small intestine to create distention a holding place (reservoir) for waste that will be drained  Reduce physical activity from a valve in your abdomen.  Provide bathroom next to bed because urgency of - To drain the pouch, the patient inserts a catheter movement may be problem. through the valve into the internal reservoir.  Be aware of skin breakdown around anus. - This procedure isn’t not the preferred surgical  Cleanse the skin gently after each bowel movement. treatment for ulcerative patients. NURSING INTERVENTION Maintain fluid Balance:  Maintain accurate intake & output records Check weight daily  Monitor serum electrolytes, & report abnormalities.  Observe for decrease skin turgor, dry skin, oliguria, decreased temperature, weakness, increase hemoglobin, hematocrit, &  specific gravity, which all are signs of fluid loss leading to dehydration. NURSING INTERVENTION COMPLICATIONS Minimizing Infection & Complications:  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  Give antibacterial drugs as prescribed.  Alert patient to possible postoperative problems  Administer corticosteroids as prescribed. with skin care, aesthetic difficulties, & surgical  Administer prescribed therapy to correct existing revisions. anemia.  Encourage patient to share experiences with others  Observe for signs of colonic perforation & undergoing similar procedures. hemorrhage - SYSTEMICLUPUSERYTHEMATOSUS(SLE)  abdominal rigidity, distention, hypotension, - a chronic, multi-organ, autoimmune disease of tachycardia. connective tissue, which develops as a consequence of NURSING INTERVENTION complex disorders of the immune system and the cause Providing Supportive Care: remain unknown but three factors play a role  Recognise psychological needs of the patient. signs and symptoms  Hypersensitivity may be evident.  Malar / Butterfly rash (rash on cheeks and nose)  Acknowledge patient's complaints.  Alopecia  Encourage the patient to talk; listen & offer  Fatigue psychological support.  Arthritis  Answer questions about the permanent or  Anemia temporary ostomy, if appropriate.  Change of color in the fingers and toes - blue  Initiate patient education about living with chronic  purplish, white, or red - from cold and stress disease. (Raynaud’sphenomenon)  Include the patient as a part of the health care team to provide continuity of care.  Offer educational & emotional support to family members NURSING INTERVENTION Food Blockage:  Patient with a temporary or permanent ileostomy mus be alert for signs & symptoms of a food TREATMENT blockage.  Non-steroidal anti-inflammatory drugs (NSAIDs)  It is most likely to occur in the first 6 weeks  Corticosteroids postoperatively when the bowel is edematous.  Hydroxychloroquine  Symptoms may include watery stool with strong  Immunosuppressants odor, decreased or no stool output, abdominal discomfort, cramping or bloating, & stomach Celiac disease swelling. - is a serious autoimmune disease that occurs  Nausea & vomiting are late symptoms & requires in genetically predisposed people where the immediate attention. ingestion of gluten leads to damage in the NURSING INTERVENTION small intestine. Treatment includes: - Also called Gluten-Sensitive Enteropathy.  Avoiding solid foods & drinking clear liquids when - 1887: Dr. Samuel Gee writes the first modern symptoms medical description of celiac disease and occur. Patient with ileostomies must never take laxatives. hypothesizes it can be treated through diet. Gently massaging the abdomen around & pulling the knees to chest & rocking the body back & forth.  A warm shower or bath may help with relaxation. If the blockage lasts for more than 2 to 3 hours or if nausea/vomiting occurs, seek medical attention immediately NURSING INTERVENTION - It is best to instruct the patient how to prevent a food blockage by limiting certain foods the first few months after surgery PATHOPHYSIOLOGY - Chinese vegetables, skins & seeds, fatty meats, been Immune Response to Gluten hulls, Damage to the Intestinal Lining popcorn & other foods that do not digest well. Malabsorption Instruct the patient to avoid unhealthy foods, chew food Triggering factors well, drink plenty of fluids while eating, eat foods in small Genetic Predisposition amounts, & reintroduce problem foods slowly into the Signs and Symptoms diet. GASTROINTESTINAL Treatment includes:NURSING INTERVENTION  Stomach pain.  Teach patient about chronic aspect of ulcerative  Bloated stomach. colitis & each component of care prescribed.  Gas.  Encourage self-care in monitoring symptoms,  Constipation. seeking annual checkup, & maintaining health.  Diarrhea.  Fatty stools.  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES signs and symptoms feet, and abdomen IRON-DEFICIENCY ANEMIA Treatment  Weakness and fatigue.  Diet changes  Pallor (pale complexion).  Immunosuppressants  Cold hands.  Angiotensin-converting enzyme inhibitors  Brittle or concave nails.  (ACE Inhibitors)  Headaches.  Corticosteroids  Mouth sores.  Dialysis signs and symptoms  Diuretics MALNUTRITION Polyarteritis nodosa  Unintended weight loss. - 1866 - Kussmaul and Maier identified a condition that  Growth delays and failure to thrive in children. consisted of “focal inflammatory arterial nodules”  Muscle wasting or low muscle tone. - They termed this “periarteritis nodosa”  Dental enamel defects, such as pitting, mottled or - the name was change to “POLYARTERITIS NODOSA”  translucent-looking teeth. - It is systemic necrotising vasculitis of medium sized  Abnormal periods or difficulty getting pregnant. Vessels  Mood changes, most commonly irritability in signs and symptoms children  Fatigue  and depression in adults.  Weight loss and loss of appetite DIAGNOSTIC TEST  Fever  Serology Tests: Tissue Transglutaminase  Generalized weakness Antibodies (tTG IgA),Deamidated Gliadin Peptide  Arthralgia (DGP)Antibodies  Palpable purpura  Genetic Testing:HLA-DQ2 and HLA-DQ8  Livedo Reticularis  Endoscopy: Upper Endoscopy with Biopsy and  Raynaud Phenomenon Capsule Endoscop COMPLICATIONS TREATMENT  Aneurysm  Gluten free diet: Avoid gluten, Read labels, Cross-  Damage to tissues that cant receive oxygen and contaminants  nutrients  Nutritional support: Dietitian consultations,  Renal Failure Supplements  Gangrene  Monitoring and Follow up: Regular Check-Ups,  Heart Failure (Not common) Blood tests  Managing Symptoms and Complications: Medications, Bone health  Education and support: Patient education and Support groups MEDICATIONS Steroids:  Prednisolone  Budesonide (Entocort EC, Uceris) Immunosuppressants:  Azathioprine (Azasan, Imuran) Other Medications: Infliximab Glomerulonephritis - is inflammation of the tiny filters in the kidneys (glomeruli - “cleaning units of kidney”) - excess fluid and waste that glomeruli remove from the bloodstream exit the body as urine ASSESMENT OF DISEASE SEVERITY Mild Signs and Symptoms signs and symptoms  Constitutional symptom  Hypertension  Arthralgias  Pink or cola-colored urine  Anemia  Frothy (foamy urine) due to excess protein  Skin Lesions  Nocturia  Normal renal function - Fluid retention with swelling evident on face, hands,  Absence of significant multiorgan or life-threatening  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  manifestations.polyarteritis nodosa ASSESMENT OF DISEASE SEVERITY  Moderate to severe  Renal dysfunction  New or worsened hypertension  Multisystem involvement (e.g., GI, cardiac, nuerologic) or life  threatening manifestations Management  The primary treatment method is with oral glucocorticoids. Signs and symptoms  Immunosuppresive agents may also be needed for  Chest Pain patients  Fever  with moderate - to - severe disease.polyarteritis  Weakness nodosa  Fatigue Treatment Goals  Dyspnea  Achieve remission (absence of active disease)  Tachycardia  Resolve reversible symptoms  Pericardial Effusion  Prevent progression to severe disease  Pleuritic Pain Management Medication  Initial monotherapy with oral glucocorticoids.  Nonsteroidal Anti  Additional immunosuppressants may be added,  Inflammatory Drugs depending on response to treatment:  (NSAIDs) such as ibuprofen and indomethacin >Azathioprine  Colchicine >Methotrexane  Corticosteroids >Mycophenolate mefetil  (Prednisone)  If associated with HBV or HCV infection, antiviral  Operation therapy  Pericardiocentesis waranted. - A procedure in which a needle will be inserted Management through a chest wall into the pericardial sac to Moderate PAN drain excess fluid that may cause pressure on  Initial therapy: combination of glucocorticoids and the heart.  cyclophosphamide Graves disease  Maintenance theraphy with - Robert Graves, Irish doctor who first described the >Azathiprine condition in the 1800s. >Methotrexatepolyarteritis nodosa - An autoimmune disease in which your immune Management system attacks healthy tissue in your thyroid gland Moderate PAN for unknown reasons. It’s the most common cause  Hypertension Management of hyperthyroidism, a condition in which your >Ace inhibitors or angiotensin receptor blockers (ARBs) thyroid gland produces excessive thyroidhormone. are preferred. Signs and symptoms > If renal function worsens, switch to another General symptoms: antihypertensive class (e.g., calcium channel blockers)  Weight loss Management  Increased heart rate Moderate PAN  (tachycardia)  If associated with HBV or HCV infection, treatment  Excessive sweating. may also include  Nervousness, anxiety, and >Antiviral therapy  irritability. > Plasma exchange  Tremors (shaking hands or DRESSLER'SSyndrome  fingers). - Also known as Postmyocardial Infarction Syndrome.  Fatigue or muscle weakness. Associated to Pericarditis.  Increased sensitivity to heat. - It is an autoimmune inflammatory condition affecting  Diarrhea. the pericardium. Difficulty sleeping (insomnia). - Typically occurs after cardiac injury, such as Signs and symptoms myocardial infarction (heart attack) or heart surgery. (a Thyroid-Specific Symptoms: week to a month after the  Goiter: An enlarged thyroid gland, causing swelling incident) at the front of the neck.  Irregular menstrual cycles in women. Skin Symptoms:  Thickened, red skin on the  shins or tops of the feet (less  common) Signs and symptoms  Eye Symptoms:  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  Exophthalmos - Topical agents containing enzymes are applied to the  Eye irritation, dryness, or wound to break down necrotic tissue.  redness. - This is best for patients who cannot tolerate surgical  Double vision or light debridement and for wounds with less extensive  sensitivity. necrosis.  Swelling around the eyes. - It is a slower but more selective process.  Difficulty closing the  Autolytic debridement:  Eyelids - This method utilizes the b..o. dy’s own enzymes and moisture to naturally break down necrotic tissue. - A moisture-retentive dressing (e.g., hydrocolloids, hydrogels) is applied to the wound, allowing the wound fluids to stay in contact with the dead tissue.  Biological ( Maggot) debridement: - This method involves the u..s.e of sterile, medical- grade maggots (larvae) to selectively eat away dead tissue. - Maggots also secrete substances that kill bacteria and promote wound healing. - This is effective for patients with chronic wounds, especially when other debridement methods have failed or are contraindicated. Purpose  Promote wound healing  Prevent infection  Prepare wound bed for closure Medication  Reduce odor  Antithyroid Drugs  Improve the effectiveness of (Methimazole, Propylthiouracil)  topical treatments  Beta-blockers (Propranolol, Atenolol) Indications  Iodine Compounds (Potassium Iodide)  Necrotic tissue in the wound (e.g., eschar/slough)  Radioactive Iodine Therapy  Chronic non-healing wounds (e.g., diabetic foot  Corticosteroids (Prednisone) ulcers, pressure ulcers)  Thyroid Hormone Replacement  Infected wounds (Levothyroxine)operation  Traumatic wounds (injuries, burn or frostbite)  Total Thyroidectomy  Venous stasis ulcers  Subtotal Thyroidectomy  Deep burns  Lobectomy  Gangrene Debridement Nursing Responsibilities (Before the Procedure) - is a medical procedure used to removedead,  Assess the wound damage, or infected tissue from a wound to promote  Monitor patient’s Vital Signs healing.  Administer prescribed analgesics or local Types of debridement  anesthesia 1. Surgical (Sharp) debridement  Explain the procedure to the patient 2. Mechanica.. l. debridement  Gather supplies 3. Enzymatic (Chemical) debridement Nursing Responsibilities (During the Procedure) 4. Autolytic debridement  Assist the physician or surgeon 5. Biological ( Maggot) debridement  Monitor patient condition  Surgical (Sharp) debridement:  Control bleeding - A physician or specially trained nurse uses surgical  Maintain sterile environment instruments like a scalpel, scissors, or curette to cut Nursing Responsibilities (After the Procedure) away necrotic tissue.  Apply appropriate dressings as per protocol or - This is indicated for large wounds, infected wounds, or physician’s order wounds with extensive necrosis that require quick  Ensure the wound is kept clean and dry removal of dead.  Monitor for complications  Mechanical debridement :  Educate the patient on wound care at home - This method involves the use of external force to  Document the findings remove dead tissue.  Incision and drainage (I&D) is a medical procedure - Techniques include wet-to-dry  used to treat infections, especially when a pocket of dressings, hydrotherapy (whirlpool baths), or wound pus (called an abscess) forms under the skin. irrigation.  The doctor makes a small cut, or incision, to allow - This type of debridement is appropriate for wounds the pus or fluid to drain out. with moderate necrotic tissue, but it can be painful and may also remove healthy tissue.  Enzymatic (Chemical) debridement:  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  Wound Dressing  Post-Procedure Care  Follow-Up Procedure Patient preparation Gathering supplies Assisting the physician Nursing Responsibilities (Pre-procedure)  Maintaining a sterile environment  Monitoring the patient Purpose  Assisting the physician - The purpose of incision and drainage (I&D) is Nursing Responsibilities (During procedure) to treat infections, especially abscesses, by  Wound care removing pus or fluid that has built up in the  Patient monitoring affected area.  Pain management Why it's done:  Patient education  Relieve pain and pressure  Follow-up care  Prevent the spread of infection Excision  Speed up healing - is a surgical removal of a piece of tissue from the body. Indication - This procedure is commonly performed to remove - Removing the pus or infected fluid allows the abnormal tissue, such as a tumor or an area of infection. body's immune system to better fight off the infection and start healing the affected area. Some specific indications include:  Abscess formation  Boils or furuncles  Cysts  Dental abscesses  Infected wounds  Soft tissue infections Types  Simple I&D Purpose Use: For small, superficial abscesses. Removal of Tumors Procedure: A small incision is made over the Diagnosis abscess to allow pus or fluid to drain. Treatment of Abnormal Tissue - The area may be irrigated with saline, and gauze Symptom Relief or packing material might be used to help keep the Cosmetic ImprovementIndication wound open and promote drainage. Malignant Tumors  Complex I&D Benign Tumors Use: For larger or deeper abscesses or Skin lesions infections involving multiple pockets. Infections Procedure: More extensive incisions are made, and the Trauma abscess cavity may require debridement (removal of Diagnostic Purposes infected tissue). Standard procedures for removing tissue, such as - Packing or drains may be left in place for a cutting out tumors or lesions using traditional surgical longer period to ensure proper healing. tools. Used for a variety of conditions.  Perirectal I&D Surgical Excision (General) Use: For abscesses around the anus or Surgical Procedure in excision rectum. Simple Excision Procedure: This type of I&D often requires Wide Local Excision more care due to the sensitive location, and Radical Excision sometimes anesthesia or operating room Excisional Biopsy conditions are required.Types Mohs Surgery  Dental Abscess I&D Special Excision Procedures Use: For abscesses in the gums or around the - Advanced techniques like lasers, cryotherapy, or teeth. endoscopy that offer more precision or less Procedure: Incision is made in the gum, and invasiveness, tailored for specific cases or to minimize pus is drained, often followed by a course of damage and recovery time. Mohs Micrographic Surgery Antibiotics Laser Excision  Patient Preparation Cryosurgery  Skin Preparation Electrosurgery  Incision Endoscopic Excision  Drainage SpecialProcedures in Excision  Packing (if needed) Procedure  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES Nursing Responsibilities (Before procedure) Nursing Responsibilities Preoperative Assessment  Preparation of the Sterile Field Educate the patient  Sterilization of Equipment Preparation  Hand Hygiene and Sterile Technique Documentation  Donning Sterile Attire Nursing Responsibilities (During procedure)  Assisting the Surgical Team Assisting the surgeon  Monitoring the Sterile Field Monitor Patients Condition  Handling Specimens Nursing Responsibilities (Post procedure)  Patient Safety Recovery Monitoring Pcos Pain Management - Polycystic ovary syndrome (PCOS) is a common Wound Care Documentation hormonal condition that affects women of reproductive Medical asepsis age. It usually starts during adolescence, but symptoms - also known as “clean technique, ” refers to may fluctuate over time. practices and procedures designed to reduce the - PCOS can cause hormonal imbalances, irregular risk of infection by minimizing the presence of pathogenic microorganisms. periods, excess androgen levels and cysts in the ovaries. - It involves methods to prevent the spread of germs - Irregular periods, usually with a lack of ovulation, can and maintaining clean environment in healthcare make it difficult to become pregnant. PCOS is a leading settings. Purpose cause of infertility.  Prevent infection - PCOS is a chronic condition and cannot be cured.  Protect patients and healthcare workers However, some symptoms can be improved through  Promote healing  Reduce healthcare associated lifestyle changes, medications and fertility treatments.  infections (HAIs)Indication - The cause of PCOS is unknown but women with a  Routine Patient Care family history or type 2 diabetes are at higher risk.  Wound Care Signs and symptoms  Intravenous (IV) Therapy  Irregular Menstrual Cycles  Diagnostic and Therapeutic Procedures  Increased Hair Growth  Handling and Disposing of Contaminated Materials  Acne and Oily Skin  General Cleanliness  Weight Gain or Difficulty Losing Weight  Infection Control in High-Risk Areas DIAGNOSTIC METHODS Nursing responsibilities Physical Examination Hand Hygiene Pelvic Ultrasound Use of Personal Protective Equipment (PPE) Transvaginal Ultrasound Environmental Cleaning BHP Sterilization of Equipment - Benign prostatic hyperplasia, a noncancerous Aseptic technique enlargement of the prostate gland, is the most common Patient Education benign tumor found in men. Monitoring for infection - As is true for prostate cancer, BPH occurs more often Surgical asepsis in the West than in Eastern countries, such as Japan - also known as "sterile technique, " refers to practices and China, and it may be more common among black designed to create and maintain a completely sterile people. Not long ago, a study found a possible genetic environment. link for BPH in men younger than age 65 who have a - The goal is to prevent the introduction of any very enlarged prostate: Their male relatives were four microorganisms into areas that are normally sterile, such times more likely than other men to need BPH surgery as during surgeries or other invasive procedures. at some point in their lives, and their brothers had a Purpose sixfold increase in risk. - surgical asepsis is to create a sterile - BPH produces symptoms by obstructing the flow of environment to prevent infection during surgical urine through the urethra. Symptoms related to BPH are procedures. present in about one in four men by age 55, and in half - It involves meticulous techniques to of 75-year-old men. However, treatment is only eliminate all microorganisms from the surgical field, necessary if symptoms become bothersome. By age 80, ultimately protecting both the patient and some 20% to 30% of men experience healthcare staff. - BPH symptoms severe enough to require treatment. Indications Surgery was the only option until the recent approval of  Surgical procedure minimally invasive procedures that open the prostatic  Invasive procedure urethra, and drugs that can relieve symptoms either by  Wound care shrinking the prostate or by relaxing the prostate muscle  Labor and delivery tissue that constricts the urethra.  Sterile dressing changes Signs and symptoms  Diagnostic procedures   Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES  Frequent Urination  Often gets worse as time goes on  Difficulty Starting Urination (Hesitancy)  May feel worse when you are moving, taking deep  Weak or Interrupted Urine Stream breaths, being touched, and coughing or sneezing  Incomplete Bladder Emptying  May be felt all over your belly if your appendix  Painful Urination (Dysuria) bursts Diagnostic method  Other common symptoms include:  Digital Rectal Exam (DRE)  Upset stomach and vomiting  Prostate-Specific Antigen (PSA)  Loss of appetite  Blood Test  Fever and chills  Urinalysis  Trouble having a bowel movement (constipation)  Uroflowmetry (Urine Flow Test)  Diarrhea Appendicitis  Trouble passing gas - Appendicitis is a medical emergency. It happens when  Swollen belly your appendix becomes sore, swollen, and diseased. - The appendix is a thin tube that is joined to the large Diagnosis intestine. It sits in the lower right part of your belly Your healthcare provider will ask about your past (abdomen). - The health and do a physical exam. They may also order appendix is a working part of your immune system. The the following tests: immune system helps your body to fight disease. - The appendix can get infected and inflamed. If not  Blood tests. To check for signs of infection, such treated, it can burst (rupture). This is serious and can as having a high white blood cell count. lead to more infection and even death.  Urine tests. To see if you have a urinary tract What causes appendicitis? infection. - Appendicitis nearly always happens when the inside of You may also have some imaging tests, including: your appendix gets blocked by something.  Abdominal ultrasound (sonogram). This shows - This makes it swell up, and that makes the blockage internal organs as they work and checks how blood worse. The bacteria that live in your intestines start an is flowing through different blood vessels. infection. If you have appendicitis, there is a serious risk  CT scan. This computerized X-ray shows detailed that your appendix may burst. images of any part of the body, such as the bones, - This can happen as soon as 48 to 72 hours after you muscles, fat, and organs. start having symptoms.  MRI. This scan uses a large magnet and radio - Appendicitis may be caused by various infections, such waves to show different details than a CT scan. It is as viruses, bacteria, or parasites, in your digestive sometimes used to diagnose appendicitis, tract. especially in a pregnant woman, instead of CT scan. - it may happen when the tube that joins your appendix with your large intestine gets blocked or trapped by stool. Sometimes tumors can cause appendicitis Surgery - The appendix then becomes sore and swollen. The blood supply to the appendix stops as the swelling and  Traditional (open) surgery method. You are soreness get worse. All of the organs in your body need given anesthesia. A cut (incision) is made in the the right amount of blood flow to stay healthy. lower right-hand side of your belly. The surgeon - Without enough blood flow, the appendix starts to die. finds the appendix and takes it out. If the appendix The appendix will burst as its walls start to get holes. has burst, a small drain may be put in to drain out These holes let stool, mucus, bacteria, and other things pus and other fluids in the belly. The drain will be leak through and get inside your belly. - You may get taken out in a few days, when your surgeon feels peritonitis. This is a serious infection throughout the the infection has gone away. belly that happens when the appendix or other part of  Laparoscopic method. You are given anesthesia. the intestines or stomach has a hole and leaks out its This surgery uses several small cuts (incisions) and contents. a camera (laparoscope) to look inside your belly. Who is at risk for appendicitis? The surgical tools are placed through a few small Appendicitis is the most common cause of sudden cuts. The laparoscope is placed through another (acute) belly pain that requires surgery. - cut. A laparoscopy can often be done even if the It mostly happens in teens and young adults in their 20s, appendix has burst. but it can happen at any age. Having a family history of appendicitis may raise your risk, especially if you are a Can appendicitis be prevented? male. Common symptoms At this time, there is no known way to stop appendicitis from happening. Pain in the abdomen is the most common symptom. This pain: Peritonitis  May start around your belly button area and move - Peritonitis is a redness and swelling (inflammation) of to the lower right-hand side of your belly, or it may the tissue that lines your belly or abdomen. start in the lower right-hand side of your belly  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES - This tissue is called the peritoneum. includes bones, muscles, fat, and organs. They are more detailed than standard X-rays. - Peritonitis can be a serious, deadly disease.  MRI. This is an imaging test that uses a strong magnet, radio waves, and a computer. What causes peritonitis? Surgery Peritonitis is caused by an infection. Bacteria can enter the lining of your belly from a hole in your  If you are very ill, you may have surgery to find and gastrointestinal tract. This can happen if you have a hole remove what is causing the infection. in your colon or a burst appendix. How is peritonitis treated? Other causes are:  Get medical care immediately. Peritonitis can lead  A hole in your stomach, intestine, gallbladder, to serious health problems very quickly. You will be uterus, or bladder admitted to a hospital. You will be given IV  An infection during treatment for end-stage kidney (intravenous) infection-fighting medicines (renal) disease (peritoneal dialysis) (antibiotics). These will treat the infection.  An infection of fluid in the belly from end-stage liver  If you have organ failure, you may also be given disease (cirrhosis) other treatments.  Pelvic inflammatory disease in women  You will likely need emergency surgery to find and  Surgery (if bacteria enter your belly during surgery) remove what is causing the infection. This is done  Trauma (if bacteria enter your belly during trauma) when the infection may be caused by these and other conditions:  Redness and swelling (inflammation) of your What are symptoms of peritonitis? appendix (appendicitis)  An open sore in your stomach or intestine  Each person’s symptoms may vary. They may (perforated peptic ulcer) include:  Swelling in small pouches in your colon  Severe belly pain that gets worse with any motion (diverticulitis)  Nausea and vomiting  Fever  Sore or swollen belly What are possible complications of peritonitis?  Fluid in the belly  Not being able to have a bowel movement or pass  Peritonitis can cause severe health problems. It can gas be deadly if not treated right away.  Less urine than normal  Peritonitis can make fluid fill up in your belly. This  Thirst can cause severe fluid loss or dehydration.  Trouble breathing  If peritonitis isn’t treated, the infection can quickly  Low blood pressure and shock spread through your body. This can cause an  These symptoms may look like other health extreme response from your infection-fighting problems. Always see your healthcare provider to system (immune system) called sepsis. be sure.  Sepsis is a fast-moving, serious health problem. It happens when chemicals sent into your How is peritonitis diagnosed? bloodstream to fight the infection cause a widespread inflammatory response in your body This can slow blood flow, decrease oxygen getting  It’s important to find out right away if you have to your tissues, and hurt your organs. peritonitis. It can lead to severe health problems  Severe sepsis can cause your body to go into very quickly. shock. It can lead to organ failure and death.  Your healthcare provider will look at your past health. They will give you an exam. Peritonitis is often diagnosed by looking at a sample of the infected fluid taken from the belly. Other tests you may need are:  X-rays. These imaging tests make pictures of your body’s tissues, bones, and organs.  Blood, fluid, and urine tests. These tests are done to find out what is causing the infection.  CT scans. These imaging tests use X-rays and a computer to make pictures of the body. CT scans show detailed images of any part of the body. This  Lalamunan Karylle Irene A. / BSN3B CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION FLUID AND ELECTROLOYTES