N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide ©2017 Achieve Test Prep Page 157 of 204 • Diarrhea with milk, spicy/fatty foods, or gluten • Anemia • Dehydration • Electrolyte imbalance The most common symptoms of Crohn’s disease are intermittent diarrhea with abdominal pain. Nursing assessment for Crohn’s disease: • Full abdominal assessment: inspection for distention, auscultation/bowel sounds, and percussion and palpation for tenderness • Dietary and nutritional assessment: intolerances to foods, weight changes, and eating habits • Inquire if patient has a history of food intolerances, history of autoimmune disease, and gather a family history • Review laboratory data: o CBC with differential o Serum chemistry panel o X-ray/small bowel and barium enema o Colonoscopy with biopsy o Sigmoidoscopy Nursing diagnosis for Crohn’s disease: • Altered nutrition with less than body requirements due to decreased absorption, diarrhea, and intake • Altered gastrointestinal tissue perfusion related to bowel inflammation • Diarrhea related to irritated and inflamed bowel tissue • Body image disturbance related to chronic illness and possible ostomy • Knowledge deficit related to disease process, lifestyle changes, and treatment plan Nursing interventions for Crohn’s disease: • Monitor frequently for changes in vital signs, weight, and dietary intake; frequently assess abdomen for pain, distention, or increased/decreased bowel sounds • Give medications for diarrhea per MD order: loperimide (Imodium), atropine/diphenoxylate (Lomotil), corticosteroids , and vitamin supplements Signs and symptoms of Crohn’s disease: • Fever • Weight loss • Fatigue • Malnutrition • Abdominal pain • Abdominal tenderness