NU 460 Inflammatory Bowel Disease With Small Bowel Obstruction

NU 460 Inflammatory Bowel Disease With Small Bowel Obstruction 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.