Topic 7: IBD Ulcerative Colitis & Chrons

Question 1

Inflammatory bowel disease

Answer 1

autoimmune disease; chronic inflammation of the GI tract characterized by periods of remission interspersed with periods of exacerbation

Question 2

Ulcerative colitis

Answer 2

usually limited to the colon

Question 3

Crohn’s

Answer 3

can involve any segment of the GI tract

Question 4

Clinical Manifestations UC

Answer 4

· Teens to mid-30s. After 60
· Severe/constant abdominal pain
· Diarrhea (10-20 STOOLS A DAY)
· Fever during acute attacks
· Rectal bleeding
· Tenesmus (cramping rectal pain)
· Pseudopolyps

Question 5

Clinical Manifestations Crohn’s

Answer 5

· Teens to mid-30s. After 60
· Cramping abdominal pain
· Diarrhea
· Fever
· Malabsorption and nutritional deficiencies
· Weight loss may be severe
Cobblestoning of mucosa

Question 6

diagnostic studies for UC and crohns

Answer 6

· CBC, erythrocyte sedimentation rate
· Serum chemistries
· Testing of stool for occult blood and infection
· Capsule endoscopy
· Radiologic studies with barium contrast
· Sigmoidoscopy and/or colonoscopy with biopsy
Colonoscopy

Question 7

when testing stool and occult blood, what is being looked for

Answer 7

looking for blood, pus, and mucous

Question 8

acute care

Answer 8

· Focus on hemodynamic stability, pain control, fluid and electrolyte balance, and nutritional support.
· I&Os
· Monitor number and appearance of stools
· Assess presence of blood in stools and emesis
· Give IV fluids, electrolytes, analgesics, and anti-inflammatory drugs
· Monitor electrolytes, CBC, and VS
· Help patient stay clean, dry, and free of odor until the diarrhea is under control
· Perianal skin care using plain water (no harsh soap) and barrier creams
· Assess abdomen, including bowel sound

Question 9

nutritional therapy for acute exacerbations

Answer 9

liquid enteral feedings are preferred
o High in calories and nutrients
o Lactose-free
o Easily absorbed

Question 10

when it is acceptable to eat non liquid enteral feedings, what does diet therapy look like

Answer 10

· Regular foods are reintroduced gradually
· Lower the intake amount of fiber

Question 11

patient teaching for IBD

Answer 11

· Importance of rest and diet management
· Perianal care
· Drug action and side effects
· Symptoms of recurrence of disease
· When to seek medical care
· Ways to reduce stress
Quit smoking

Question 12

medications for IBD

Answer 12

Aminosalicylates (5-aminto salicylic acid)
Antimicrobials
Corticosteroids
Immunosuppressants
Biologic and targeted therapy (TNF and Integrin receptor antagonists)

Question 13

corticosteroids

Answer 13

· Decrease inflammation
· Used to achieve remission
· Helpful for acute flare-ups

Question 14

immunosuppressants

Answer 14

· Suppress immune response
· Maintain remission after corticosteroid induction therapy
· Require regular CBC monitoring