Disorders of the Gastrointestinal System, 2nd Edition
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precancerous or cancerous, the frequen- cy of colonoscopy screenings will gener- ally be increased for the remainder of the patient’s life (Enders, 2020). | NURSING CONSIDERATION Patients receiving radiation therapy for intestinal cancer or for treatment of cancers of the cervix or uterus need to be taught to be alert to the signs and symptoms of proctitis. Proctitis, a con- dition in which the lining tissue of the inner rectum becomes inflamed, can occur at any time during the treatment process or even years after radiation therapy has concluded. Pain, blood, or mucus in the stool and a sensation of rectal fullness may indicate proctitis (Friedman & Hong, 2021). ABDOMINAL TRAUMA Abdominal trauma can occur in many ways and for various reasons—from car crashes, blunt force trauma, punctures or stab wounds, gunshots, and sexual abuse. There is no one treatment for all types of abdominal trauma. To manage abdominal trauma, nurs- es should be prepared to (Offner et al., 2022): ● Assess for immediate life-threatening concerns, focusing on the airway, hemodynamic stability, and prevention of additional injury, such as preventing a foreign object from causing additional damage. IV catheters, urinary catheters, nasogastric tubes, and other equipment may be used to achieve this. ● Once the patient is stabilized enough
This is often done with a CT scan, ultrasound, or abdominal x-rays. ● Manage pain. ● Provide emotional support and education to the patient and their family. ● Monitor closely for changes in condition, especially if the patient was stabbed or injured with a dirty object. In addition, with blunt force abdominal trauma, bleeding may not be immediately evident, so ongoing hemodynamic stability assessment is key. ● Do not remove any penetrating object. Object removal should be done in a controlled setting, usually an operating room, in case the object has injured a vessel and prevents the vessel wall from fully collapsing by providing internal pressure to the area. Anorectal abscesses and fistulas An anorectal abscess is an infection of a cavity in the soft tissue near the rectum or anus. Pus collects in the localized area of inflammation. Inflammation may cause a fistula (an abnormal opening) in the anal lining that can create a channel be- tween the rectum and/or perirectal area. The development of an abscess may start when the lining of the anal canal or rec- tum is torn or suffers an abrasion and sub- sequent infection, or it may occur without an infection present (Hebra, 2022). Additional causes of abscesses result- ing from trauma of the anal canal and rec- tal tissue include (Vogel, 2021): ● Trauma or injury during childbirth. ● Radiation and chemotherapy. ● GI disorders such as perforated diverticular disease.
to undergo imaging or testing, they should be prepped for this.
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