N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Nursing assessment for ulcerative colitis: • Full abdominal assessment: inspection, auscultation, percussion, and palpation • Take a thorough history, including the duration of abdominal pain and diarrhea, how many stools per day, and if the patient has a milk intolerance or allergy • Take vital signs: temperature, pulse, respirations, and blood pressure; watch for an increase in respiratory rate • Take a thorough diet history: meal patterns and diet; alcohol, nicotine, and caffeine use • Inquire if patient suffers from loss of appetite (anorexia), tenesmus, nausea, vomiting, and weight loss • Review laboratory reports: o CBC with differential: Look for signs of anemia or thrombocytosis from inflammation o Electrolytes o Serum iron o Liver panel for plasma protein: May be decreased o Stools for occult blood Stool culture for dysentery o Barium enema: If patient has ulcerative colitis they should avoid laxatives, which can perforate the colon; use liquid diet prep instead and a tap water enema the day of the exam o Sigmoidoscopy Nursing diagnosis for ulcerative colitis: • Diarrhea related to inflammation and irritation in bowel • Altered nutrition with less than body requirements related to decreased nutrient intake or diarrhea • Altered gastrointestinal tissue perfusion related to bowel inflammation • Ineffective coping skills related to the psychological processes • Knowledge deficit related to the disease process, lifestyle changes, and treatment plan Nursing interventions for ulcerative colitis: • Monitor number of bowel movements each day; check stools for blood; measure liquid stools • Promote bowel rest and keep patient NPO during acute phase; TPN may need to be used if prolonged • Replace lost fluids with IV fluids if patient is dehydrated; monitor electrolytes • Offer a high protein, low-residue diet; supplement with vitamins and iron ©2017 Achieve Test Prep Page 163 of 204