Ulcerative "Cool"itis
UC S/Sx
bloody diarrhea, fever during acute phase, rectal bleeding
Best diet for crohn's?
Low residue, high cal, high protein.
Cholelithiasis vs Cholecystitis
Cholelithiasis- gallstones
Cholecystitis- inflammation of the gallbladder that may be caused by the stones or something else
Flare up Tx for Crohn's
#1. NPO
#2. corticosteroids
(solumedrol or prednisone) check BG
#3. Prevent peritonitis
(give metronidazole, but watch for c-diff)
Where is UC located?
back half of large intestine
Oops! We resected the colon too much due to flair ups, and now the cecum can't be reconnected! What is this?
Short Gut Syndrome
Cholecystitis labs
WBC
High bilirubin if obstruction present
High liver enzymes if obstruction present
High amylase/lipase if pancreas involved
What must you take w/ solumedrol or prednisone?
calcium supplement
Treat it!
Ulcerative colitis
Total colectomy w/ IPAA
temporary ileostomy
Second surgery will be the take down of the ileostomy
Where is Crohn's located?
Small intestine
Cholecystitis diagnostic tests
Ultrasound- least invasive and 1st test
ERCP- invasive, scoops some stones out with a basket, can take a bile sample at same time
Labs
3 categories(steps) of UC and Crohn's drugs
1. immunomodulators
2. biological therapies
3. aminosalicylates
Aminosalicylates: Sulfasalazine
What do you take it with?
What odd side effect are you warning people about?
Folic Acid and water
turns your pee orange
S/Sx of Crohn's
diarrhea, fever, weight loss, vit-b12 deficiency, inflamed cobblestone of mucosa, fistulas
Laparoscopic cholecystectomy discharge education
- pretty chill, can return to work w/i one week
- you can shower
- remove band aid if present
- call HCP if s/sx of infection
Methotrexate- which category is it?
DO NOT TAKE WITH _____?
immunomodulators
DO NOT TAKE W/ corticosteroids.
Potassium wasting diuretic
Furosemide
Treat it!
Crohn's
bowel rest, meds, reduce stress, correct malnutrition, treat infection, control inflammation
Risk factors for cholelithiasis and cholecystitis
- women
- 40+
- birthing multiple crotch goblins
- pregnancy
- estrogen therapy
- sedentary
- fat
Infliximab and Adalimumab
What category are they?
What side effect do you immediately call the doctor about?
Biologic therapies
Call HCP about fever RIGHT AWAY!!!