C.W., a 36-year-old woman, was admitted several days ago with a diagnosis
of recurrent inflammatory bowel disease (IBD) and possible small bowel
obstruction (SBO). C.W. is married, and her husband and 11-year-old son are
supportive, but she has no extended family in-state. She has had IBD for 15
years and has been taking mesalamine (Asacol) for 15 years and
prednisone 40 mg/day for the past 5 years. She is very thin; at 5 feet 2
inches she weighs 86 pounds and has lost 40 pounds over the past 10
years. She has an average of 5 to 10 loose stools per day. C.W.'s life has
gradually become dominated by her disease (anorexia; lactase deficiency;
profound fatigue; frequent nausea and diarrhea; frequent hospitalizations
for dehydration; and recurring, crippling abdominal pain that often strikes
unexpectedly). The pain is incapacitating and relieved only by a small dose
of diazepam (Valium), oral electrolyte solution (Pedialyte), and total bed
rest. She confides in you that sexual activity is difficult: “It always causes
diarrhea, nausea, and lots of pain. It's difficult for both of us.” She is so
weak she cannot stand without help. You indicate complete bed rest on the
nursing care plan.
1. Identify at least six priority problems for CW
-incapacitating pain
-sexual dysfunction
-malnutrition
-weight loss
-she is at risk for skin breakdown
-risk for depression
-profound fatigue
-frequent hospitalizations could impact her finances, she has no other
family in the state other than her husband and 11y/o son so if she is
hospitalized it effects them also.
-dehydration.
2. Considering C.W.'s weakness, chronic diarrhea, and lower-than-desired
body weight,
what nursing interventions need to be implemented to minimize skin
breakdown? Name
at least six.
-ambulatory care
-frequent skin checks, especially over boney areas
-meticulous perineal care
-position patient differently q 2 hours
-barrier cream over boney areas
-IV fluids due to dehydration, poor skin turgor means risk for tears
-try to keep patient at optimal nutrition
3. What is the mechanism of action of the mesalamine (Asacol) in relation to
the IBD?
This study source was downloaded by 100000817935606 from CourseHero.com on 02-01-2022 07:24:40 GMT -06:00
https://www.coursehero.com/file/57551662/case-study-donedocx/
of recurrent inflammatory bowel disease (IBD) and possible small bowel
obstruction (SBO). C.W. is married, and her husband and 11-year-old son are
supportive, but she has no extended family in-state. She has had IBD for 15
years and has been taking mesalamine (Asacol) for 15 years and
prednisone 40 mg/day for the past 5 years. She is very thin; at 5 feet 2
inches she weighs 86 pounds and has lost 40 pounds over the past 10
years. She has an average of 5 to 10 loose stools per day. C.W.'s life has
gradually become dominated by her disease (anorexia; lactase deficiency;
profound fatigue; frequent nausea and diarrhea; frequent hospitalizations
for dehydration; and recurring, crippling abdominal pain that often strikes
unexpectedly). The pain is incapacitating and relieved only by a small dose
of diazepam (Valium), oral electrolyte solution (Pedialyte), and total bed
rest. She confides in you that sexual activity is difficult: “It always causes
diarrhea, nausea, and lots of pain. It's difficult for both of us.” She is so
weak she cannot stand without help. You indicate complete bed rest on the
nursing care plan.
1. Identify at least six priority problems for CW
-incapacitating pain
-sexual dysfunction
-malnutrition
-weight loss
-she is at risk for skin breakdown
-risk for depression
-profound fatigue
-frequent hospitalizations could impact her finances, she has no other
family in the state other than her husband and 11y/o son so if she is
hospitalized it effects them also.
-dehydration.
2. Considering C.W.'s weakness, chronic diarrhea, and lower-than-desired
body weight,
what nursing interventions need to be implemented to minimize skin
breakdown? Name
at least six.
-ambulatory care
-frequent skin checks, especially over boney areas
-meticulous perineal care
-position patient differently q 2 hours
-barrier cream over boney areas
-IV fluids due to dehydration, poor skin turgor means risk for tears
-try to keep patient at optimal nutrition
3. What is the mechanism of action of the mesalamine (Asacol) in relation to
the IBD?
This study source was downloaded by 100000817935606 from CourseHero.com on 02-01-2022 07:24:40 GMT -06:00
https://www.coursehero.com/file/57551662/case-study-donedocx/
