MEDSURG | Lower GI

🔥 Med-Surg Crash Review: Lower GI Problems1️⃣ Acute Infectious DiarrheaMain cause: Infectious agents (bacteria/viruses/parasites), often from contaminated food/water 🌎🍲. Big danger: Severe dehydration + electrolyte loss → hypovolemia & metabolic acidosis. C. diff = HIGH priority (hospital-acquired, spore-forming).Nursing Must-KnowsAssess: I&O, electrolytes, H&H, skin turgor, VS, stool frequency.Intervene: IV fluids (NS/LR), oral electrolytes (Pedialyte).Infection control: Soap + water only, contact precautions, bleach cleaning.Avoid antidiarrheals ❌ (except certain traveler’s diarrhea). Red Flags: Sunken eyes, hypotension, tachycardia.2️⃣ Acute Abdominal Pain & PeritonitisOften caused by inflammation, perforation, obstruction, or bleeding. Peritonitis = life-threatening!Priority Signs 🚨Shock: Low BP, tachycardia, cool skin, ↓ urine.Peritonitis: Board-like rigidity, rebound tenderness, fever.Nursing ActionsABCs + high-flow O₂Two large-bore IVs + rapid fluidsNPOPain control after MD evalPrepare for imaging or surgeryQuick Cue: Don’t apply heat to the abdomen (may worsen inflammation).3️⃣ Inflammatory Bowel Disease (UC & Crohn’s)Chronic, autoimmune, inflammatory flares.UC vs Crohn’s 🔍UC: Continuous colon inflammation → bleeding risk + toxic megacolonCrohn’s: “Skip lesions,” transmural → fistulas, strictures, malabsorptionMedications5-ASAs: reduce inflammation (best for UC)Steroids: for flares onlyImmunomodulators/Biologics: maintain remission; test for TB/Hep B/C firstNursing FocusMonitor stool, H&H, electrolytesNPO + IV fluids during severe flaresSkin care for diarrheaDiet: high-calorie, high-protein, low-residueB12 deficiency common in Crohn’sEmergency: Toxic megacolon → fever, tachycardia, abdominal distention.4️⃣ Bowel Obstruction (SBO & LBO)Contents can’t pass → fluid backs up → massive fluid loss → hypovolemic shock ⚡Mechanical vs Paralytic IleusMechanical: adhesions, tumors, herniasNon-mechanical: post-op, inflammation, meds (opioids)Priority SignsStrangulation: sudden severe pain, fever, rigiditySBO: rapid vomiting (bile/projectile) → metabolic alkalosisLBO: distention, constipation → metabolic acidosis