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Crohn’s Disease ELIZABETH ALVAREZ, ANDREA REYNA, KENT SCHMIDT, MELINDA TORRES, DALE V. TRINIDAD, & KEN WESTRA

Crohn’s disease dvt

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Crohns Disease

Crohns DiseaseElizabeth Alvarez, Andrea Reyna, Kent Schmidt, Melinda Torres, Dale V. Trinidad, & Ken Westra

A Description of Crohns DiseaseCrohns disease is a classification of inflammatory bowel disease (IBD). Times of remission are mixed among times of exacerbation. Research has yet to identify a definitive cause for Crohns disease, and a multitude of factors may contribute to this autoimmune reaction. No cure exist at this time.

Clinical Manifestationsdiarrheabloody stoolsweight lossabdominal pain

feverfatiguerectal bleeding (in some cases)

Potential Complicationsperineal abscessfistulasfat malabsorptionanemiacancer of the small intestineperipheral arthritisankylosing spondylitissacroiliitisfinger clubbingerythema nodosum

pyoderma gangrenosumaphthous ulcersconjunctivitisuveitisepiscleritisgallstoneskidney stonesprimary sclerosing cholangitisosteoporosisthromboembolism

Diagnosticshistory & physical examinationCBC, ESRserum chemistriesoccult blood stoolstool infectioncapsule endoscopy

double-contrast barium enemasmall bowel seriestransabdominal ultrasoundCTMRIsigmoidoscopy/colonoscopy with biopsyBarium enema is not employed in acute exacerbations.

Collaborative Therapyhigh-calorie, high-vitamin, high-protein, low-residue, lactose-free dietaminosalicylates*antimicrobialscorticosteroidsimmunosuppressantsimmunomodulatorselemental diet or parenteral nutritionphysical & emotional restcounseling or support groupsurgery**The goals of care are to rest the bowel, control the inflammation, fight infection, reestablish proper nutrition, relieve stress, address symptoms, and improve the quality of living for the client.*The use of sulfasalazine to cytokine inflammatory processes may discolor the skin and urine yellowish orange. This medication may also alter photosensitivity. Use caution in sun exposure and UV radiation. **Surgery is typically relegated to removing strictures, obstructions, arresting bleeding, and managing fistulas.

DiagnosesDiarrhea related to bowel inflammation and intestinal hyperactivityImbalanced nutrition: less than body requirements related to decreased absorption and increased nutrient loss through diarrheaIneffective coping related to chronic disease, lifestyle changes, inadequate confidence in ability to cope

Acute phase implementationhemodynamic stabilitypain controlfluid & electrolyte balancenutritional support

Implementation continuing into recovery & dischargeI&Onumber & appearance of stoolencourage client to talk about self-care strategiesteach strategies for managing stressencourage the client to quit smokingassist the client in accepting the chronicity of Crohns disease

Education regarding goalsimportance of rest and diet managementperianal caredrug action & side effectssymptoms of recurrencewhen to seek medical careuse of diversional activities to reduce stress

Expected outcomesThe client will:experience a decrease in the number of diarrhea episodesmaintain body weight within a normal rangebe free from pain & discomfortdemonstrate the use of effective coping strategies

For further information contact the Crohns and Colitis Foundation of America, www.ccfa.org.

ReferenceSchmelzer, M. (2014). Lower gastrointestinal problems. In S. L. Lewis, S. R. Dirksen, M. M. Heitkemper, L. Bucher, and M. M. Harding (Eds.), Medical-Surgical Nursing, (pp. 961-1005). St. Louis, MO: Elsevier.