Electrolyte imbalance hypoalbuminemia vitamin and trace metal deficiencies

Electrolyte imbalance hypoalbuminemia vitamin and

This preview shows page 14 - 18 out of 25 pages.

Anemia, leukocytosis. Electrolyte imbalance, hypoalbuminemia, vitamin and trace metal deficiencies. Guaiac- positive stool. Abnormal sigmoidoscopic, colonoscopic, and/or barium enema findings IBD Complications o Systemic o GI Hemorrhage Strictures Fistulas Colonic dilation Perforation o Anemia o Abscess and fistulas Care o Drug therapy Aminosalicylates Achieve and maintain remission Antimicrobials Corticosteroids Immunosuppressants Maintain remission Targeted/ biologic therapies o Surgery UC Prostatectomy is curative? Crohns Surgery is for complications o Nutritional therapy Supplemental iron Vitamin B12
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Zinc Calcium Potassium Sufficient calories/ protein Low residue Lactose free Low fat Nursing care o Imbalances Monitor IV Supplements I&O o Psychosocial Develop rapport Stress management Depression/ anxiety o Rest/ activity Fatigue Sleep disturbances Activity and rest o Acute flare up Clean Odor free Meticulous pericare No harsh soap Barrier creams Sitz baths Witch hazel o Education Rest Diet Perianal care Medications Stress management Dealing with chronic disease When to notify physician Comparison of Ulcerative Colitis and Crohn's Disease Characteristic Ulcerative Colitis Crohn's Disease Clinical Usual age at onset Teens to mid-30s. After 60 Teens to mid-30s. After 60 Diarrhea Common Common Abdominal pain Common, severe constant Common, cramping Fever (intermittent) During acute attacks Common Weight loss Rare Common, may be severe Rectal bleeding Common Sometimes
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Tenesmus Common Rare Malabsorption and nutritional deficiencies Minimal incidence Common Pathologic Location Usually starts in rectum and spreads in a continuous pattern up the colon Occurs anywhere along GI tract. Most frequent site is distal ileum. Small bowel involvement Minimal Common Distribution Continuous areas of inflammation Healthy tissue interspersed with areas of inflammation (skip lesions) Depth of involvement Mucosa Entire thickness of bowel wall (transmural) Cobblestoning of mucosa Rare Common Pseudopolyps Common Rare Complications Perianal abscess and fistulas Rare Common Strictures Occasional Common C. difficile infection Increased incidence and severity Increased incidence and severity Perforation Common (because of toxic megacolon) Common (because inflammation involves entire bowel wall) Toxic megacolon More common Rare Carcinoma Increased incidence of colorectal cancer after 10 yr of disease Increased incidence of small intestinal cancer Increased incidence of colorectal cancer but not as much as with ulcerative colitis Extraintestinal Complications of IBD Joints • Peripheral arthritis (colitic) • Ankylosing spondylitis • Sacroiliitis • Finger clubbing Skin • Erythema nodosum • Pyoderma gangrenosum Mouth • Aphthous ulcers Eye • Conjunctivitis • Uveitis • Episcleritis Other
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• Gallstones • Kidney stones • Liver disease: primary sclerosing cholangitis • Osteoporosis • Thromboembolism Interprofessional Care Inflammatory Bowel Disease Diagnostic Assessment
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