Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide Crohn’s disease can go through periods of attacks and remissions. The disease is most common between the ages of 20-40 and carries complications, such as fistulas, malabsorption of nutrients, peritonitis, intestinal obstruction, chronic diarrhea, perianal abscess, and anal fissure. The condition is treated with dietary management, lifestyle changes, medication, and possibly surgery. Signs and symptoms of Crohn’s disease: • Fever • Weight loss • Fatigue • Malnutrition • Abdominal pain • Abdominal tenderness • 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

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