| Patho of Crohn’s disease: fibrosis thickness of the bowel, caused by stenosis (narrowing) which results in obstruction.
Involves any part of the GI tract and can extend to all layers of the intestinal wall. |
Clinical S&S: nutrient deficiencies, wt loss, bloody diarrhea, sm or lg intestinal obstruction, RLQ colicky pain, cramping & tenderness. (table 42-19) |
Dx Test: see table 42-16 pg 946
(Crohn’s disease) |
| Treatment Plan & Medication Regimen: corticosteroids, immune boosters, alleviate stress, antidiarrheal meds, opioids, nutritional supplements, dietary modifications, maybe surgery to repair any perforation or to fix the obstruction or fistula.
Nursing Considerations: |
Nursing Care: hand washing; therapeutic communication; emotional support R/T foul smelling diarrhea; administer medications as ordered; provide teaching of diet modifications; provide resources as needed; discuss pain management before the pain becomes severe; |
Expected Changes in the Elderly:
Older adults are prone to adverse effects of corticosteroids, immunosuppressants and biologic therapy have a higher risk of infection and malignancy, those with diminished cardiac and renal function are vulnerable to volume depletion secondary to the diarrhea |
| How to assess for worsening or improvements: presence of a fistula from bladder, anus or vagina; fluid imbalance; presence of a perineal abscess – indicates worsening of the illness.
Nutritional balance, wt gain or maintaining wt consistency, decrease or resolution of RLQ pain, formed stool – indications of improvement. |
| How to keep this client safe: teach foods to avoid, confirm environmental safety while inpatient, provide educational resources for optimal wellness; monitor for hypotension and or lightheadedness secondary to diarrhea, etc. |
| Patho of ______________________: |
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Nursing Considerations: |
Nursing Care: |
Expected Changes in the Elderly: |
| How to assess for worsening or improvements: |
| How to keep this client safe: |
| Patho of ______________________: |
Clinical S&S: |
Dx Test: |
| Treatment Plan & Medication Regimen:
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Nursing Care: |
Expected Changes in the Elderly: |
| How to assess for worsening or improvements: |
| How to keep this client safe: |
