Question Case Study: Inflammatory Bowel Disease  M.P., a 37-year-ol

Question Case Study: Inflammatory Bowel Disease  M.P., a 37-year-old mother of two school-aged children, is admitted for the fifth time in 11 months with acute ulcerative colitis. She complains of severe diarrhea (10-15 stools a day with blood and mucous) and intestinal cramping. She also complains of fatigue, anorexia, nausea & vomiting and says she has lost 8 lbs. in the past 11 months. She tearfully states she is “tired of this disease interfering with her life.” Physical exam reveals a temperature of 100°4 F (38°C), heart rate of 110 bpm, BP of 115/70 mmHg, weight of 109 lb., and abdominal tenderness over the colon upon palpation. Laboratory tests show an Hb/Hct of 9 g/dl & 26%, and a serum albumin level of 2.3 g/dl. Admitting orders from the gastroenterologist and general surgeon include: NPO except ice chips; I.V. fluid of D5LR at 150 mL/hr; up in chair Q.I.D. as tolerated; schedule esophagastoduodenoscopy (EGD) and colonoscopy; if begins vomiting insert NG tube and connect to low intermittent suction, irrigate NG tube prn.                       Describe the pathophysiologic changes that occur between ulcerative colitis and Crohn’s disease?   What additional assessment data needs to be obtained regarding M.P.’s altered nutrition/elimination need?  Interpret M.P.’s lab diagnostics Hb/Hct of 9 g/dl & 26%, and a serum albumin level of 2.3 g/dl. What concerns do you have about these results? Identify your two priority nursing diagnoses for M.P. at the time of admission.  M.P.’s medications include sulfasalzine (Azulfidine) and prednisone, although she states she has not taken any medication in the past 72 hours because of nausea and vomiting.     Discuss the pharmacokinetics & pharmacodynamics of sulfasalzine (Azulfidine) and prednisone in treating the disease.                         a. Sulfasalzine (Azulfidine)             b. Prednisone  What other classifications of drugs are currently being implemented or investigated for the management of Inflammatory Bowel Disease (IBD)? Frequently results in toxic megacolon   NCLEX-RN Questions: In planning care for the patient with Crohn’s disease, the nurse recognizes that a major difference between ulcerative colitis and Crohn’s disease is that Crohn’s disease: Causes fewer nutritional deficiencies than ulcerative colitisOften recurs after bowel resection surgery, whereas ulcerative colitis is curable with a colectomyIs manifested by rectal bleeding and anemia more frequently than is ulcerative colitis A patient with Crohn’s disease has a nursing diagnosis of imbalanced nutrition: less than body requirements related to decreased nutritional intake and decreased intestinal absorption. Assessment data that support this nursing diagnosis are:     a.   Hypotension and urine output below 30 mL/hr    b.   Frequent diarrhea stools    c.    Anorectal excoriation and pain    d.   Poor muscle tone and decreased serum albumin and transferrin levels  After instructing a client with diverticulosis about appropriate self-care activities, which of the following client comments indicate effective teaching? Select all that apply.             ____1. With careful attention to my diet, my diverticulosis can be cured.____2. Using a cathartic laxative weekly is okay to control bowel movements.____3. I should follow a diet that’s high in fiber.____4. It’s important for me to drink at least 2,000 mL of fluid every day.____5. I should exercise regularly.  Health Science Science Nursing NUR 112 Share QuestionEmailCopy link Comments (0)

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