Ulcerative Colitis (UC) & Chron’s Disease II

Complication

Nursing Care

Pharmacology

Fluid & E+ • Strict I & O monitoring • 2 Liters of water daily + more with diarrhea • Hypokalemia low potassium: 3.5 or less • Daily multivitamins containing Calcium

Diet • High: Protein & Calories • Low: Fiber • Keep food journal • Small frequent meals

NCLEX TIP

Common NCLEX QuestionClient with ulcerative colitis ... interventions? Select all that apply.

Discuss plans to decreaseclient’s stress

1.

Give analgesics as prescribed2.

Limit fluids to 500 ml per day3.

Increase protein foodswith meals

4.

Monitor Input & Outputclosely

5.

Recommend high fiber andlow calorie diet

6.

PeritonitisReport to HCP!

NCLEX TIP

• Fever (over 100.3F) • Rebound tenderness• “Rigid” or “board-like abdomen” • Increasing Pain, tenderness • Restless• Fast HR & RR (tachycardia / tachypnea)

Surgery

Most clients get a colostomy or ileostomy after a bowel resection, where we cut out the part of the bowel causing the problem.

Colon Small Intestine

Sulfasalazine “STOPS bodyattacking itself”

Steroids “Sooth the Swelling” • PredniSONE

Antidiarrheal: • Loperamide “Low bowel movements” • Dicyclomine “Dry Cycle”

SULFASALAZINE

STEROIDS

ImodiumLoperamide

2 Liters

K3.5 or less

Saunders

• “I should increase the fiber in my diet”

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction?

Pain - administer analgesics AVOID Alcohol Reduce Caffeine (coffee, tea) PsychoSocial

• Stress reduction • Encourage clients to discussion feelings

ANALGESICS

Toxic megacolon

1

Med Surg: GI - Gastrointestinal

Bowel rupture from a toxic megacolon, which can lead to peritonitis (deadly infection in the peritoneal cavity).