Crohn's disease

Question 1

Definition

Answer 1

Type of inflammatory bowel disorder that causes inflammation and ulcer formation in the GI tract

This can be found in both the small and large intestines, most likely the ileum & start of colon.

Affects all layers of the bowel.

The cause is unknown: faulty immune system, may be triggered by environment & genes

Question 2

Complications

Answer 2

“Abscessing Fistulas May Form Sepsis”

• Abscess: pockets of infection w/ in intestinal wall
• Fistulas: ulcer/abscess forms deep in intestinal wall creating an opening “channel/passage” between intestine to intestine, intestine to organ or intestine to skin’s surface.
• Malnourishments: small intestines inflamed
• Fissure: tears in the GI lining… mainly anal
• Stricture -> obstructions *common complication

Question 3

Clinical manifestations

Answer 3

Abdominal pain (right lower side)

Ulcer (mouth & GI tract)

Diarrhea (may have pus, blood or mucous)

Loss weight and malnourishments, electrolyte issues

Fissure (anal) that bleeds

Bloating

Question 4

Nursing interventions

Answer 4

Goals: help patient understand diet, medications, diet, surgery

• smoking cessation
• Severe cases… bowel rest w/ TPN per MD order ‘
• Daily weights
• Monitoring intake & output
• GI assessment: frequent. BM, description, bowel sounds

Diet

• Flare-ups or preventing one: no high fiber, dairy, spicy, fatty, allergen types, hard to digest
• Consume low fiber, high protein

Question 5

Medications: ordered based on severity of disease and combination of med used for moderate to severe

Answer 5

5- Aminosalicylates:
- Prevent flare-ups & maintain remission e.g.. sulfasalzine

Corticosteroids

• Not for long term… reduces inflammation e.g., prednisone
• Increased blood sugar, increased risk for infection, osteoporosis, thinning skin

Immunosuppressants

• Used when other meds not working or pt needs to be off steroids or may be used w/ steroids
• Suppressors: Azathioprine (Imuran)… lowers immune response and risk infection/cancer, no live cancer
• Biologic types: Infliximab or Adalimumab… check for TB (increase risk or reactive latent infection)… increased risk for cancer

Antibiotics