Question

In: Nursing

Mrs. Sullivan is a 54 year old female patient that is being admitted to your medical floor from the emergency room. Mrs. Sullivan has a history of Crohn’s disease and is having a major flare up of this disease.

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would do.

1. Mrs. Sullivan is a 54 year old female patient that is being admitted to your medical floor from the emergency room. Mrs. Sullivan has a history of Crohn’s disease and is having a major flare up of this disease. She reports that she is having approximately 20 loose bloody stool per day. She came to the emergency room with dizziness and the sudden confusion. She was brought in by her adult son. She is having moderate abdominal pain that is intermittent. She has been incontinent of a small amount of tea colored urine that is foul smelling.

Labwork:

WBC: 20.1

RBC: 10.2

Hb: 6.5

Pt: 214

BUN: 34

Cr: 2.5

Vital signs:

BP: 78/40

P: 220

R:16

T:101.5

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would do.

2. Mr. Jones is a 65 year old overweight male that is complaining of signs of fatigue and thirst. A non healing wound persists on his left ankle. His bloodwork reveals the following results:

FBS 404

WBC 12.2

Expert Solution

Crohn's disease is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus. With symptoms of abdominal pain diarrhea( bloody in case of severe), fever, skin rashes, tiredness.

The causes of this disease is unknown, some suspect that the cause is due to certain bacteria.

Disease can cause ulsers in small intestine, colon. Associated sign of this include reddish, tender nodules, Inflammation in joints and liver.

The diagnosis is made by baroum enema, colonoscopy.

When she admitted to hospital nurse should supply intravenous nutrition or total parenteral nutrition ( TPN).

She should advice patient liquid diet and low fiber diet.

Supplementation of calcium, folate and vit B12 is helpful when malabsorption of these nutrients is apparent.

The use of anti -diarrheal agents(diphenoxylate and atropine, loperamide) and antispasmodic also can help to relieve symptoms of cramps and diarrhea.

Treatment: Should fallow some vaccination schedules. They should receive a single dose of Tdap,then Td boosterevery 10 years. Influenza vaccine annually, 2 doses of hepatitis A and 3 doses of hepatitis B.

Since there is no cure for disease, the goals of treatment is to minimize side effects.

Anti- inflammatory agents such as 5-ASA compounds and corticosteroids, topical antibiotics, immunomodulators are medications used to treat Crohn's disease.

Nightingale answered 2 years ago

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