Small Bowel Ingestion: A Case Study

The 78-year-old female client came into the emergency room (ER) with intractable nausea and vomiting over the previous 24 hours. She also presented with leukocytosis of approximately 14,000 cells/uL, mild hyponatremia and hypokalemia, and mild distention. The client was otherwise asymptomatic. An abdominal X-ray was able to identify and locate an adhesive related obstruction in her small intestine, resulting in a diagnosis of a Small Bowel Obstruction (SBO) (Lewis, Bucher, Heitkemper, & Harding, 2017). A SBO is a disruption in the progression of chyme in the gastrointestinal (GI) system (McCance, Huether, Brashers, & Rote, 2014). When it is an adhesive related SBO, fibrin is what is responsible for attaching a segment

HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

The second system we will cover is the Gastrointestional System. All medications in this system were used based upon the manufacturers intended use as referenced by Davis’s Drug Guide. The first medication she was put on relating to the GI system is polyethylene glycol which was used to draw water into the lumen of the GI tract and aid in the evacuation of the GI tract without causing electrolyte imbalance. The teaching that was given to her for this medication was to take the medication until gone even if she is feeling better, avoid alcohol and products that contain aspirin or NSAIDs and to avoid foods that may cause an increase in GI irritation. She was also told to report any black and tarry stools, diarrhea or abdominal pain immediately. The second medication she was put on relating to the GI system was furosemide which was used to prevent edema and encourage excretion of sodium and water (Valerand, 2013). We informed her that she should not double the doses, and that if she started to get a rash, muscle weakness, cramps, nausea, diaainess, numbness or tingling she needed to contact the physician immediately. The final

A week after initial admission, the patient is on the medical surgical floor recovering from his transverse colostomy five days ago. At 1200 vital signs are as follows, temperature 99.1; pulse 96; respirations 18; blood pressure 141/69; pulse ox is 94% on 1L NC in AM. The patient appears acutely ill and lays in bed with his eyes closed even when family comes into the room to check on him. He is alert and oriented to person, but not place or situation. He appears lethargic and is slow to respond to questioning, this appears to be due to recent administration of pain medication. Pupils are equal round and reactive to light and grips are week bilaterally in hands. Abdomen is firm, distended, and non-tender. Colostomy site appears to be

Patient History: my patient is a 79 y/o female. She weighs 71.7 kg and is 165.1 cm tall. She has a history of colon carcinoma and hypertension. She has had a previous cholecystectomy, appendectomy, and removal of a uterine polyp. She has no history of bleeding disorders. She was a smoker, but quit 30 years ago. She smoked a half pack per day for 10 years; rare alcohol use. She is status post right-hemicolectomy. She is allergic to penicillin.

increasingly dependent upon Jim to maintain and coordinate her care. Early in their relationship, several of Lynn’s doctors and surgeons encouraged Jim to learn as much as he possibly could about Lynn’s condition. They knew, as a scientist living with Lynn and focused on only one patient, through time and necessity, Jim was going to become an “expert in Lynn.” Because of a high-output end-jejunostomy, Lynn required intravenous (IV) support for many years, some of the time infusing IV nutrition (i.e., total parenteral nutrition [TPN]) and some of the time infusing IV hydration with added magnesium. From 2003 to 2006, a customized care plan was painstakingly developed and personalized for her needs. Over time, Lynn was

A recent meta-analysis (Zhu, 2016) showed that SICUS had a sensitivity and aspecificity of 88% and 86%, respectively, for assessment of CD. the authors defined it as a reliable method in ascertaining the small bowel disease. In addition, they affirmed that in the evaluation of the surgical patient the negative SICUS excludes a recurrence. According to that statement, in our series all anastomotic recurrence was correctly identified.

The dose-response curve in the presence of antagonist shows it effect on the ileum smooth muscle contraction which increases rapidly after 5 minutes exposure to atropine at a constant concentration of 3 x 10-7 M. The dose-response curve in the absence of antagonist shows it effect on the ileum smooth muscle contraction which increases rapidly on 3 minutes exposure to acetylcholine with the interval of 20 seconds between all doses at the concentration of 1 x 10-8 M to 1 x 10-4 M for every 3-2 doses. Also, as shown in figure 1, dose-response curve in the absence of antagonist has a higher contraction than the dose response curve in the presence of antagonist.

Patients suffering from Crohn’s disease have a risk of developing obstruction, fistulae, abscess formation, and chronic blood loss (McCance, Huether, Brashers, & Rote, 2014).  These patients are also at greater risk for developing intestinal carcinoma. In our case study, our patient shows classical manifestations of a small bowel obstruction.  Obstruction in Crohn’s disease can occur due to chronic inflammation and remodeling of the mucosal lining, leading to the formation of scar tissue. Obstruction of the small bowel will lead to abdominal distention, vomiting of bilious material, and increase temperature. These symptoms are present in our patient.  If medications are unsuccessful at relieving the patient’s symptoms, surgery may be necessary.

1. Date of birth:____________(MM/DD/YY); 2. Height (m): (i)___________ (ii) ___________ Average __________ 3. Weight (kg): (i)___________ (ii) ___________ Average ___________ BMI (kg/m2) ________ 4.

The gastrointestinal tract contains the esophagus, stomach, small intestine, and the large intestine. Each of these have a specific job/function to do, and when parts of the GI system don’t work as they should GI disorders can arise. Stress can be defined as “a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances” (Merriam-Webster Dictionary).

A gastric emptying study is a procedure that speeds up the process from which food and other waste leaves your stomach and enters into your small intestine using radioactive chemicals. It helps people who have slow emptying stomachs. It can give you side effects such as nausea, stomach pain, vomiting, and diarrhea. To perform a gastric emptying study, nuclear medicine physicians monitor the pace at which the patient’s stomach empties. You have to lie on a table for at least an hour while your stomach is being scanned. The physicians then give the patients the appropriate medicine. The nuclear medicine, and the radioactivity of the elements on the periodic table that the physicians give the patients helps with the scanning process, and helps

The barium is then released from the bag and begins to flow slowly into your colon. As the barium begins to fill your bowel you will feel some pain and pressure, and an urgency to have a bowel movement. The doctor will watch the barium as it moves through your intestine on a TV screen, using a special “live x-ray” called fluoroscopy. You will be asked to turn to different positions, and the table may be tilted slightly to help the barium flow through your colon and to take x-rays from different directions. Sometimes a slightly different version of the test may be done. It is called a double contrast barium enema. If a double contrast study is being done, the barium will be drained out, and then air will be injected into your colon. As you can imagine with the air contrast study, the amount of cramping and pain increases, due to the expansion of the bowel with air. After all of the films are taken the enema tube is removed, and you are taken to the restroom to expel the remaining barium and air. One or two films may be taken afterwards, to check how much barium is remaining in your bowel. The entire test takes anywhere from thirty minutes to one hour. After the exam you may resume a regular diet, and be sure to drink plenty of liquids to replace those you have lost and to help flush the remaining barium out of your system.