Inflammatory Bowel Disease (IBD) FINAL

Question 1

Ulceration/inflammation in sigmoid colon and rectum

Answer 1

Ulcerative Colitis

Question 2

Autoimmune; inflammation anywhere in the GI

Answer 2

Crohn’s Disease

Question 3

-Frequent stools, cramps, exacerbations/remissions
-LLQ pain, high pitched bowel sounds
-Edema & inflammation in the large intestine
-Narrowed colon, partial obstruction
-10-20 liquid stools, bloody mucous
-Tenesmus: urge to go to the bathroom but can’t
-Hemorrhage
-Nutritional deficiencies especially Vit D deficiency

These are S/Sx of what?

Answer 3

Ulcerative Colitis

Question 4

-Frequent stools, cramps, exacerbations
-RLQ pain
-Commonly terminal ileum
-5-6 soft stools, non bloody
-Fistulas, nutritional deficiencies, weight loss
-Anemia
-Inflammation, malabsorption
-Steatorrhea: increase in fat secretion

These are S/Sx of what?

Answer 4

Crohn’s Disease

Question 5

Complications of Ulcerative Colitis

Answer 5

-Perforation and peritonitis with toxic megacolon due to perforation of the bowel. Massive dilation of the colon occurs and the client is at risk for perforation.
-Increased risk for cancer after 10 yrs.

Question 6

Complications of Crohn’s Disease

Answer 6

-Perirectal and intra abdominal fistulas; fissures and rectal abscesses
-Perforation and peritonitis
-Nutritional deficiencies, especially of fat-soluble vitamins

Question 7

Meds

Answer 7

-5 aminosalicylic acid: sulfonamides (yellows body fluids)
-Non 5 aminosalicylic acid: mesalamine
-Prednisone for exacerbations
-Immunosuppressants
-Immunomodulators
-Antidiarrheals (use w/ caution due to megacolon)

Question 8

Nursing interventions

Answer 8

-Monitor for fluid and electrolyte imbalances
-Monitor for colon cancer (colonoscopy)
-DIET: High protein, high calorie, low fiber, and small frequent meals with b12 and iron supplementation.
-No caffeine or alcohol
-Stress management in Crohn’s disease

Question 9

Nurse safety priority

Ileostomy stoma is usually placed in the RLQ of the abdomen below the belt line. It should not be prolapsed or retracted into the abdomen wall. Assess the stoma frequently after stoma placement.

Answer 9

Recognize that it should be pinkish to cherry red to ensure an adequate blood supply. If the stoma looks pale, bluish or dark, respond by reporting it to PCP