N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide • Monitor for s/s dehydration and give fluids if necessary; monitor intake and output • If patient cannot tolerate oral intake, administer TPN per MDorder • Monitor electrolytes if diarrhea is severe; watch potassium levels; symptoms of hypokalemia are cardiac arrhythmia’s and muscle weakness • Teach patient about diet: low fiber (lower intake of whole grains and vegetables), low caffeine, and few carbonated beverages • Keep room free of bowel movement: use air freshener and empty commode or bedpan after use • During the acute phase of illness, encourage bed rest to lower the need forcalories • Prepare for surgical intervention (ileostomy, colectomy, and colostomy); the surgeon will make an opening for the bowel to drain out into an appliance; teaching how to empty and change an appliance will need to be done • Give emotional support and encourage patient to discuss feelings • Encourage patients to reduce stress levels and physical activity during acute episodes • Refer to community support groups or an ostomy nurse Expected outcomes for Crohn’s disease: • Patient maintains adequate nutrition and stable weight • Verbalizes reduction in diarrhea and abdominal pain • Patient demonstrates compliance with dietary modifications • Maintains adequate fluid and electrolyte balance • Verbalizes understanding of disease, lifestyle modifications, and treatment plan Diverticular Disorders Diverticulitis is the development of “finger-like” projections in the intestinal wall. These are called diverticulum and are actual herniations of the mucous membrane going through the smooth muscle. They can occur anywhere in the gastrointestinal tract, but most commonly occur in the sigmoid colon area. When there are many diverticulum, it is called diverticulosis. With this condition, there symptoms and inflammation are few. The cause of diverticular disorders is unknown. A contributing factor may be a low dietary intake of fiber, since dietary fiber makes stools easier to pass. When the patient does not eat enough fiber, they tend to pass harder stools and this elevates the lumen pressure. Retained stool causes bacterial growth, infection, and inflammation, which spreads and causes the bowel to perforate, develop edema, and abscess if left untreated. This disease is most common in people ages 40-80 years old, and if untreated, complications develop including bleeding, peritonitis, abscess, and perforation of the bowel. Perforation requires emergency surgical intervention. The main treatments for this disorder are increased fiber in the diet, laxatives, and bowel rest during the acute phase. ©2017 Achieve Test Prep Page 158 of 204