SEMINAR ( Inflammatory Bowel Disease ) Done by:

content : Introduction Scenario Last of nursing diagnosis Nursing care plan Evidence base practice Summary & conclusion References

Introduction chronic inflammatory GI disorders ( Crohn’s disease and Ulcerative colitis ) . Unknown Cause triggering factors : Food additives /Tobacco/ smoking /Use of NSAID and other .

Right lower abdominal pain Left lower abdominal pain Steatorrhea Crohn’s Disease Ulcerative Colitis acute or chronic inflammation of the layers of GI tract wall (distal ileum to ascending colon) inflammatory disease of mucosal and sub-mucosal layers of colon and rectum Right lower abdominal pain Left lower abdominal pain Steatorrhea Bleeding Diarrhea Less severe Diarrhea 10-20 times Dehydration

Scenario

Last of nursing diagnosis Diarrhea R/T inflammatory process Acute pain R/T increased peristalsis & GI inflammation Imbalanced nutrition R/T diet restriction and malabsorption Deficient fluid volume R/T nausea and diarrhea Anxiety R/T change in health status Risk for impaired skin integrity R/T diarrhea

Nursing care plan Actual Nursing Diagnosis : Diarrhea R/T inflammatory process AMB Frequent, and often severe, watery stools and Increased bowel sounds Outcomes: Pt report reduction in frequency of stools, return to more normal stool consistency and avoid contributing factors within one week.

Nursing Interventions :  Observe and record stool frequency, characteristics, amount, and precipitating factors.  Identify foods and fluids that precipitate diarrhea, e.g., raw vegetables and fruits, whole-grain cereals, condiments, carbonated drinks, milk products.  Promote bed rest, provide bedside commode.  Restart oral fluid intake gradually. Offer clear liquids hourly; avoid cold fluids.

Actual Nursing Diagnosis : Imbalanced nutrition less than body requirements R/T diet restriction and malabsorption AMB pt look thin has weight 61 kg and pt feel weak . Outcomes : Pt will gain weight 2 kg within one month and absence of signs of malnutrition.

Nursing Interventions :  Weigh daily and check for BS Provide oral hygiene. Avoid foods that might cause abdominal cramping (e.g., milk products, foods high in fiber or fat, alcohol) Provide clear liquids progressing to bland, low residue; then high-protein, high-calorie, caffeine-free, non-spicy, and low-fiber as indicated. Record intake and out put.

Potential Nursing Diagnosis : Risk for impaired skin integrity R/T diarrhea Outcomes : Pt skin remain intact .

Nursing Interventions : Inspect skin daily . Clean and dry the area after defecation . Irritated area over bony prominences must given immediate attention . Avoid tight cloth and change the cloth to relieve pressure and contamination of microorganisms .

Evidence base practice

Summary & conclusion

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