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The N.E.T. A&P Review

Written by kimmel52

The student who is studying for the NURSING ENTRANCE TEST, THE HESI OR THE TEAS-ATT, will have to take an exam on anatomy and physiology. Preparing for this section is not easy. It is very difficult to remember every piece of information from two semesters of anatomy and physiology. At the Nurses Learning Center, students are able to study A&P in a logical fashion that pulls all of their knowledge together and applies the concepts that they have learned in real life situations.
An example of how to study anatomy and physiology is by looking at the bowel and intestinal tract through types of infections and aliments that can occur. This is one of the best ways to study for THE NURSING ENTRANCE TEST. Below is an explanation of how ulcerative colitis begins and its signs and symptoms. Keep in mind while reading the passage what you have learned from anatomy and physiology, and try to see how the endocrine system and the digestive system come into play.

Ulcerative colitis usually appears with chronic symptoms from mild to severe. These symptoms include but are not limited to bloody diarrhea, abdominal pain and cramping, fever, malaise, anorexia, tachycardia and dehydration.

With the milder form of the disease, diarrhea and abdominal pain may be mild, unless there is a perforation in which the pain becomes much worse. In the moderate disease an individual may have up to five stools per day. In the severe form of the disease, an individual can have up to ten or more stools per day. Ulcerative colitis is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers form where inflammation has killed the cells that usually line the colon, then bleed and produce pus. Inflammation in the colon also causes the colon to empty frequently, causing diarrhea

When the inflammation occurs in the rectum and lower part of the colon it is called ulcerative proctitis. If the entire colon is affected it is called pancolitis. If only the left side of the colon is affected it is called limited or distal colitis. Ulcerative colitis can occur in people of any age, but it usually starts between the ages of 15 and 30, and less frequently between 50 and 70 years of age. It affects men and women equally and appears to run in families, with reports of up to 20 percent of people with ulcerative colitis having a family member or relative with ulcerative colitis or Crohn’s disease. A higher incidence of ulcerative colitis is seen in Whites and people of Jewish descent.

With any disease there are complications that can arise. With ulcerative colitis the complications include hemorrhage, stricture, perforation, dilation and paralysis of the colon and colonic dilation. The skin and joints can also be affected. Skin lesions such as erythema nodosum and pyoderma gangrenosum are among the most frequently seen. Some of the diagnostic studies used include; CBC (helps to determine if there is anemia present from blood loss); WBC ( diagnosis of infection); serum electrolytes ( helps to determine if the individual is dehydrated, from diarrhea and vomiting); stool for occult blood (identifies any parasites and if there is blood in the stool.); a double contrast barium enema can identify ulcerations and perforations; hypoalbuminemia or serum albumin level(indicates if there is protein loss); sigmoidoscopy.

The goals of treatment are to rest the bowel, control and or reduce inflammation and reduce infection. Malnutrition must be corrected and fluids replenished. The individual needs to learn how to reduce the stress in their life, adhere to a strict medication regime and if necessary, seek hospitalization. The principal drug that is used in the treatment of ulcerative colitis is the drug Azulfidine. This drug works well in cases where the symptoms are moderate to mild. During the active cycle of the disease, the drug 5 ASA and 4 ASA are given as retention enemas. Corticosteroids have been implicated in helping to relieve the swelling and irritation thus helping to rest the bowel. Sometimes immunosuppressive drugs are given when all other therapies have failed. When drug therapy is no longer an option, then surgical intervention is a choice. Such surgical procedures include; total proctocolectomy with a permanent ileostomy; total proctocolectomy with continent iliesotomy (Kock pouch) and 3; total colectomy with rectal mucosal stripping and ileoanal reservoir.

Nutritional therapy is just as important as medication therapy. Certain foods can exacerbate symptoms and cause unwanted abdominal pain and cramping. A dietary consult is a good step in the right direction in helping to control symptoms of ulcerative colitis. Foods that can cause gastric acidity should be avoided, such as greasy foods, fried foods, and nuts or fruits with seeds. Everyone has a different digestive system in relationship to what foods they can or cannot eat. However, by avoiding those foods that can produce lots of gas and acid may indeed prevent discomfort for the individual. Some of these foods may include the following; canned tomatoes, cantaloupe with seeds, grapes, nuts, dried fruit, deep fried foods and medium rare meat servings.

Nursing care for the patient with ulcerative colitis include keeping the patient hydrated, and comfortable. It is important for the nurse to attend to the patient’s level of coping, since nervousness can cause flare ups of symptoms. Engage the patient in open ended conversation and attempt to explore how the patient sees them. Try to understand what the patient is going through and let the patient know that you care and are there for whatever needs that they may have. Help to educate the patient on nutrition and how to handle the stress in their life. Restricting the physical activity of the individual will also help in healing the bowel. This may be hard for the patient who is still youthful and engages in much physical activity and sports. The entire person must be treated. When making a nursing care plan the nurse must take into consideration what the needs of the person are as a whole.

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