Inflammatory Bowel Disease: chronic inflammation of the GI tract characterized by periods of
remission interspersed with periods of exacerbation
1. Crohn's disease
2. Ulcerative colitis (UC) based on clinical manifestations
Assessment:
Abdominal pain, diarrhea, fever, malabsorption and nutrition deficiency, rectal bleeding, weight
loss,
h HR, i BP
In elderly, dx can be difficult since IBD can be confused with CDI, diverticulitis or colitis
Risk Factors:
Family history
Diet, smoking, and stress increase susceptibility
NSAIDs, antibiotics, and oral contraceptives increase risk
Obesity-high intake of refined sugar, total fats, polyunsaturated fatty acid & omega 6 fatty
acids
Cystic fibrosis (genetic syndromes)
Cirrhosis & multiple sclerosis
Dx: CBC
Stool culture
Double contrast barium enema, transabdominal ultrasound, CT, MRI
Colonoscopy
Planning:
Have fewer and less severe acute exacerbations
Maintain normal fluid and electrolyte balance
Free from pain or discomfort
Adhere to medical regimens
Maintain nutrition balance
Have improved quality of life
Interventions:
During the acute phase, focus attention on hemodynamic stability, pain control, fluid and
electrolyte balance, and nutrition support
Maintain accurate I&Os
Monitor number and appearance of stools
Assess for presence of blood in stools and emesis
Give IV fluids, electrolytes, analgesics, and anti-inflammatory drugs as prescribed
Monitor serum electrolytes, CBC, vital signs and being alert for changes to diarrhea and
dehydration
If pt has orthostatic hypotension, teach patient to change positions slowly
Meticulous perineal skin care using plain water no harsh soap w/ moisturizing skin barrier
cream to prevent skin breakdown
Dibucaine, witch hazel, sitz baths and other compresses or ointments may reduce perianal
irritation and pain
Calculate adequacy of daily caloric intake
Obtain daily weight
Assess abdomen, including bowel sounds as needed
remission interspersed with periods of exacerbation
1. Crohn's disease
2. Ulcerative colitis (UC) based on clinical manifestations
Assessment:
Abdominal pain, diarrhea, fever, malabsorption and nutrition deficiency, rectal bleeding, weight
loss,
h HR, i BP
In elderly, dx can be difficult since IBD can be confused with CDI, diverticulitis or colitis
Risk Factors:
Family history
Diet, smoking, and stress increase susceptibility
NSAIDs, antibiotics, and oral contraceptives increase risk
Obesity-high intake of refined sugar, total fats, polyunsaturated fatty acid & omega 6 fatty
acids
Cystic fibrosis (genetic syndromes)
Cirrhosis & multiple sclerosis
Dx: CBC
Stool culture
Double contrast barium enema, transabdominal ultrasound, CT, MRI
Colonoscopy
Planning:
Have fewer and less severe acute exacerbations
Maintain normal fluid and electrolyte balance
Free from pain or discomfort
Adhere to medical regimens
Maintain nutrition balance
Have improved quality of life
Interventions:
During the acute phase, focus attention on hemodynamic stability, pain control, fluid and
electrolyte balance, and nutrition support
Maintain accurate I&Os
Monitor number and appearance of stools
Assess for presence of blood in stools and emesis
Give IV fluids, electrolytes, analgesics, and anti-inflammatory drugs as prescribed
Monitor serum electrolytes, CBC, vital signs and being alert for changes to diarrhea and
dehydration
If pt has orthostatic hypotension, teach patient to change positions slowly
Meticulous perineal skin care using plain water no harsh soap w/ moisturizing skin barrier
cream to prevent skin breakdown
Dibucaine, witch hazel, sitz baths and other compresses or ointments may reduce perianal
irritation and pain
Calculate adequacy of daily caloric intake
Obtain daily weight
Assess abdomen, including bowel sounds as needed
