IBD (Class) Flashcards
Describe characteristics of regional enteritis r/t:
1) Location of lesions
2) Bleeding
3) Perianal involvement
4) Fistulas
5) Rectal involvement
6) Diarrhea
7) Abdominal mass
1) Ileum, ascending colon (usually)
2) Not usually
3) Common
4) Common
5) About 20%
6) Less severe
7) Common
Table 39-4 page 1155 in Paul
Describe characteristics of ulcerative colitis r/t:
1) Location of lesions
2) Bleeding
3) Perianal involvement
4) Fistulas
5) Rectal involvement
6) Diarrhea
7) Abdominal mass
1) Rectum, descending colon
2) Common - severe
3) Rare
4) Rare
5) Almost 100%
6) Severe
7) Rare
Table 39-4 page 1155 in Paul
How do Crohn’s and UC differ in terms of course and pathology (in terms of lesions)
UC ——
Course: Exacerbations + remissions
Patho: mucosal ulcerations
Crohns ——–
Course: Prolonged, variable
PAtho: transmural thickening progressing to deep, penetrating granulomas (in late stage)
Symptoms of regional enteritis?
RLQ pain Diarrhea Steatorrhea (excess fat in faeces) Abdominal cramping after meals Anorexia Weight loss Malnutrition Extra intestinal manifestations: arthritis/joint disorders, skin lesions, conjunctivitis & oral ulcers
Symptoms of UC?
Diarrhea LLQ pain Rectal bleeding Intermittent tenesmus Anorexia Weight loss Dehydration Vomiting Also see p. 1156 in Paul
What is tenesmus?
a continual or recurrent inclination to evacuate the bowels, caused by disorder of the rectum or other illness.
Assessments for IBD?
Pain PQRST/LOTARP
Presence of diarrhea, fecal urgency, straining at stool (tenesmus)
Bowel patterns, presence of blood, pus, fat, or mucous
N&V
Anorexia or weight loss
Family hx of IBD
Dietary patterns (alcohol, nicotine, caffeine), food intolerances, especially lactose
Sleep disturbances from diarrhea/pain at night
GI assessment
Diagnostics and Lab results review (nutritional focus)
Nursing diagnoses r/t IBD?
Diarrhea r/t inflammatory process
Acute pain r/t increased peristalsis and GI inflammation
Deficient fluid volume r/t anorexia, nausea, and diarrhea
Imbalanced nutrition (less than body req’ts) r/t dietary restrictions, nausea, and malabsorption
Activity intolerance r/t fatigue
Ineffective coping r/t repeated episodes of diarrhea
Risk for impaired skin integrity d/t malnutrition and diarrhea
Risk for ineffective therapeutic regimen management r/t insufficient knowledge concerning the process and management of the disease
Potential for loss of intimacy needs r/t disease processes/effects
Collaborative problems r/t IBD?
Many relate to possible complications
Electrolyte imbalance Cardiac dysrhythmias r/t electrolyte depletion GI bleeding with fluid volume loss Perforation of the bowel Small bowel obstruction Malnutrition Fistula + abscess formation Increased risk for colon cancer Retinitis, iritis, erythema nodosum Depression
What are the goals/plan of nursing care for individuals with IBD?
Maintain normal elimination patterns Relieve pain Maintain fluid intake Maintain optimal nutrition Promote rest Reduce anxiety Enhance coping Prevent skin breakdown Monitor and manage potential complications Promote independence and home care, support intimacy needs
What sort of teaching do pts with IBD need?
Diet-Nutritional Therapy
Medications and side effects
Lifestyle changes, improving quality of life, counseling, SW, RD, connect with support groups
Goals of medical interventions r’t IBD?
Reduce inflammation
Suppress inappropriate immune responses
Rest the bowel
Correct fluid + electrolyte imbalance
Outline reason/patho for SBO as complication of IBD?
Inflm and scarring –> narrowing of intestinal lumen d/t swelling
+ dec intake
+ opioid use
The mucosa of the ileum thickens and becomes edematous, thereby narrowing the passageway in the bowel, or obstructing it.
Outline reason/patho for fluid/electrolyte imbalance as complication of IBD?
d/t diarrhea + vom
Limited intake
Outline reason/patho for malnutrition as complication of IBD?
Dec intake - may avoid foods b/c cause discomofrt
Diarrhea (reduces absorption)
Dec absorption d/t ulcers (dec in functional surface area)
