IBO &
Diverticulitis
Diverticulitis
The most common cause of small bowel obstruction
What are Adhesions from previous abdominal surgery?
Rationale: Postoperative adhesions cause fibrous bands that constrict the bowel lumen.
Difficulty starting urination (hesitancy)
What is a common initial symptom of BPH?
Rationale: The enlarged prostate compresses the urethra, impeding urine flow.
Dyspnea and pulmonary crackles
What is a classic symptom of left-sided heart failure?
Rationale:Blood backs up into the lungs, causing fluid accumulation.
Intermittent claudication
What is a hallmark symptom of peripheral arterial disease (PAD)?
Rationale: Muscle pain occurs with exertion due to decreased blood flow, relieved by rest.
Dangerous electrolyte imbalance commonly seen with intestinal bowel obstruction
What is hypokalemia?
Rationale: Hypokalemia (low potassium) is common in bowel obstruction due to vomiting and NG suction and can cause dangerous arrhythmias. This requires immediate correction.
The hallmark sign of a mechanical bowel obstruction
What are high-pitched bowel sounds followed by absence of bowel sounds?
Rationale: Bowel attempts to overcome obstruction initially (hyperactive sounds) before peristalsis stops.
Why should patients taking tamsulosin be instructed to rise slowly?
What is the risk of orthostatic hypotension?
Rationale: Alpha-blockers dilate blood vessels, which can cause sudden drops in BP when standing.
BNP (B-type natriuretic peptide)
Lab value that helps diagnose congestive heart failure (CHF)?
Rationale: BNP is released when the ventricles are overstretched from fluid overload.
This is the most significant modifiable risk factor for atherosclerosis
What is smoking?
Rationale:Smoking damages endothelium and accelerates plaque formation.
This class of drugs reduce blood volume and have proven cardiovascular benefit
What are thiazide diuretics (hydrochlorothiazide; HCTZ)?
Rationale: Mild diuresis lowers BP effectively with few adverse effects.
A low fiber diet during exacerbation, high-fiber diet once inflammation resolves
What is dietary teaching that should be given to a patient recovering from diverticulitis?
Rationale: Fiber helps prevent constipation and formation of new diverticula, but avoided during acute inflammation.
Medication class that is commonly used to relax smooth muscle in BPH
What are Alpha-adrenergic blockers (e.g., tamsulosin)?
Rationale: These reduce urethral resistance by relaxing smooth muscle in the bladder neck and prostate.
This is limited in patients with heart failure to prevent fluid retention
What is sodium?
Rationale: Sodium promotes water retention, worsening edema and pulmonary congestion.
The reason that patients with PVD/PAD should avoid elevating legs above the heart
Because it decreases arterial perfusion to the extremities?
Rationale: Gravity assists blood flow to ischemic tissues; elevation worsens ischemia.
Infusion of this electrolyte must be infused slowly IV to prevent toxicity, and deep tendon reflexes must be monitored to ensure the electrolyte inmbalance is not overcorrected
What is magnesium?
Rationale: Magnesium sulfate must be infused slowly IV to prevent toxicity, and deep tendon reflexes must be monitored because loss of reflexes may indicate hypermagnesemia.
Abdominal distention, cramping pain, vomiting, and absence of flatus or stool
What are the classic clinical manifestations of an intestinal bowel obstruction?
Rationale: These signs result from accumulation of intestinal contents and gas above the obstruction. Peristalsis increases to overcome the blockage (causing cramping), and obstruction prevents passage of stool and gas. Vomiting may occur as intestinal contents
This class of drugs is used in the treatment of BPH to prevent the conversion of testosterone and to decrease prostate size.
What is 5-alpha-reductase inhibitors (Finasteride)?
This drug class is used in heart failure because it reduces afterload and preload by preventing angiotensin II formation
What are ACE inhibitors?
Rationale: ACE inhibitors cause vasodilation and reduced fluid volume, easing cardiac workload.
Thun, shiny skin, weak peripheral pulses, and hair loss on lower extremities.
What are signs of chronic arterial insufficiency?
Rationale: These are classic signs of advanced PVD.
When infusing this IV fluid, serum sodium levels should be monitored closely and the nurse should assess for neurological changes
What is hypertonic saline (3% NaCl)?
Rationale: Hypertonic saline must be administered slowly and cautiously to prevent central pontine myelinolysis. Analyzing patient response and monitoring labs and neurological status is crucial for safe treatment.
What is the reason laxatives and enemas contraindicated in acute diverticulitis
Because they increase colonic pressure and may cause perforation?
Rationale: Straining or stimulation of the bowel can rupture inflamed diverticula.
Hydronephrosis and kidney damage
What is the major complication of untreated chronic urinary retention?
Rationale: Prolonged backflow of urine causes renal pressure and eventual damage.
This condition of the heart can cause reduced cardiac output and ischemia which may lead to chest pain and syncope on exertion
What is aortic stenosis?
Ankle-brachial index (ABI)
What is the noninvasive test commonly used to diagnose PAD?
Rationale: This test compares BP in ankle vs. arm; <0.9 indicates PAD.
The major electrolyte imbalance risk with potassium-sparing diuretics (e.g., spironolactone)
What is hyperkalemia?
Rationale: These drugs block aldosterone, leading to potassium retention.