Inflammatory Bowel Disease: Crohn's Disease/UC

What age range is crohns disease usually seen in?

14-40 years old

What is Crohn's disease?

A chronic inflammatory bowel disease that affects the lining of the digestive tract.

What causes the anemia with UC?

Blood loss and diarrhea

What is ulcerative colitis?

Chronic ulcerative disease and inflammatory disease of the mucosal and submucosal layers of the colon and rectum that is characterized by unpredictable periods of remission and exacerbation with bouts of abdominal cramps and bloody or purulent stool.

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of? Crohn's disease Ulcerative colitis Irritable bowel syndrome Diverticulitis

Crohn's disease

Which of the following is accurate regarding regional enteritis? Fistulas are common Severe diarrhea Severe bleeding No narrowing of the colon

Fistulas are common

A client is recently diagnosed with Crohn's disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response? Ciprofloxacin Methotrexate Azathioprine Sulfasalazine

Sulfasalazine

What is toxic megacolon?

Too much inflammation where it inhibits the contraction (peristalsis) o the large intestine

What is the depth of the lesions for crohns disease?

Transmural (Through the wall of the bowel)

A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a: fissure. fistula. hemorrhoid. pilonidal cyst.

fissure

What is another name for crohns disease?

regional enteritis

What are the risk factors of UC?

- Predisposed genetically - Altered immune response - Altered response to gut organisms

Where are lesions most commonly found for Crohns disease?

Distal ileum and ascending colon.

What is anemia caused by as a result of crohns disease?

Due to chronically low food intake.

How do the lesions of ulcerative colitis pregress?

From the rectum/sigmoid colon upward. Dont enter the rest of the GI tract.

A client with Crohn's disease is losing weight. For which reason will the nurse anticipate the client being prescribed parenteral nutrition? Insufficient oral intake Impaired ability to absorb food Unwilling to ingest nutrients orally Prolonged preoperative nutritional needs

Impaired ability to absorb food

Where are the lesions of ulcerative colitis found?

Large intestine

What diet education would you give to patient that have UC and Crohns?

Low fiber and high protein

Does Crohn's have blood stool?

No

Which is a true statement regarding regional enteritis (Crohn's disease)? It has a progressive disease pattern. It is characterized by pain in the lower left abdominal quadrant. The clusters of ulcers take on a cobblestone appearance. The lesions are in continuous contact with one another.

The clusters of ulcers take on a cobblestone appearance.

Which symptom characterizes regional enteritis? Transmural thickening Diffuse involvement Severe diarrhea Rectal bleeding

Transmural thickening

What causes exacerbations of crohns disease?

food, stress, poor quality of sleep or amount of sleep, and environmental toxins or chemicals.

What are some common complication for both UC and Crohns

- Anorexia - wt loss - abd. pain - Incr. risk of osteoporosis and fracture - problems with joints (arthritis)

What labs moght be done for crohns disease?

- CBC - BMP - ESR (Marker of inflammation) - C-Reactive protein (Inflammation marker) - Albumin and protein levels

What tests should be done for UC?

- CBC - BMP - ESR blood tests (Inflammation marker) - C-Reactive Protein (Inflammation marker)

The nurse is comparing Crohn's disease (regional enteritis) with ulcerative colitis. Which of the following describes Crohn's disease? Fistulas are rare Diarrhea is more severe Bleeding is common and severe Its course is prolonged and variable

Its course is prolonged and variable

How can crohns disease lead to obstructions?

Narrowing of intestine wall due to inflammation can lead to blockage.

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client? inflammatory bowel disease (IBD) colorectal cancer diverticulitis liver failure

inflammatory bowel disease (IBD)

What are the life threatening complications of UC?

- Colon cancer - Toxic megacolon

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition? Small-bowel disease Ulcerative colitis Disorders of the colon Intestinal malabsorption

Ulcerative colitis

What medications will you see with UC patients

- Corticosteroids - Amino Salicylates - Immunomodulators - Antibiotics

What meds might someone with crohns disease get?

- Corticosteroids - Amino Salicylates - Immunomodulators (Boost immune system) - Antibiotics (Tx or prevent)

What are the signs of toxic megacolon?

- Fever - Vomiting - abd. pain - distension - increased HR - Hypoactive bowels

What are some possible risk factors for crohns disease?

- Genetic factors - Autoimmune response - Altered response to gut organisms

What are the assessments you would do for crohns disease?

- Head to toe (Focus on GI) - Cardiovascular (For effects of anemia) - General assessment of nutrition - Focus assessment of psychological care concerns (Stress)

What assessments should you do with UC?

- Head-to-toe (Focus on Gi) - Cardiovascular to see effects of anemia - general nutrition assessment - Focused psychological care concerns

What are some life threatening complicaitons of crohns disease?

- Increase risk of colorectal cancer - Strictutures/obstructions

What are the clinical manifestations for crohns disease?

- Mild if any bleeding - Steatorrhea (Fat in stool) - Malnutrition - RLQ pain (Relieved by defication) - Wt loss - Anemia - dehydration - Mouth ulcers

What is the tx for toxic megacolon?

- NG tube - Corticosteroids - Antibiotics - Fluids - electrolytes - surgery

What are the interventions for crohns disease?

- Parenteral feedings (PICC line) - Hydration (Fluids & Electrolytes) - Iron for anemia (IV or oral) - Surgery (Wont cure)

What are the interventions you will see with UC?

- Parenteral feedings (PICC line) - Hydration (Electrolyte replacement) - Give blood for anemia - Surgery (Colectomy) Can actually cure disease process.

What are the clinical manifestations of UC?

- Severe bleeding - Severe diarrhea with pus/blood (6+days) - LLQ pain - Electrolyte imbalance/dehydration - Anemia/fatigue