Research Crohn's disease and discuss the incidence of the disease, the cause, the symptoms, and the treatment
Crohn's disease is approximately equal in frequency among males and females. Ethnic and geographic distribution is widespread but there is evidence that it is more frequent among Jews.1 The cause is not clear. One thought is that the repeated impact of emotional stress may give rise to dysfunction of the small intestine, with subsequent structural changes.1 There appears to be a high family incidence.2
The disease usually begins in the teens or twenties with over 10 percent appearing before age 15; 50 percent beginning in the third decade; and over 90 percent before age 40 . Symptoms include a vague, cramping abdominal pain that may be localized to the perium-bilical area or to the right lower quadrant, depending on what part of the intestines is affected. It often occurs one or two hours after meals, may be preceded by audible bowel sound (borborygmi), and is relieved by defecation or vomiting.
Because of anorexia, nausea, or the fear of abdominal cramps, intake is decreased. The aims of therapy should be to suppress active inflammatory disease, conserve the small bowel with medical treatment, and reserve surgery for the complications of fistulae and abscess. Adreno-cortical steroids alone or in combination with antibiotics produce symptomatic improvement in the majority of patients treated during the first few years of their disease. Initially, Crohn's has been treated with prednisone, 40 to 60 mg per day and sulfasalazine, 3 to 4 g p.o. per day if there is no clear evidence of an abscess. Today there are other approaches that are being used. A drug called Remicade is being used to treat Crohn's disease. It induces and maintains remission of moderate to severe clinical Crohn's disease unresponsive to conventional therapy. A second drug, mercaptopurine (commonly called 6-MP), was originally intended to be used to treat certain forms of leukemia, but it also affects the immune system so that in some conditions where the immune system is overly active, such as Crohn's disease, it is being used, believed by some to be the most potent drug for Crohn's disease.
If there are deep fissures in involved bowel, antibiotics such as tetracycline are added.3 Surgery is employed for the complications of Crohn's disease in the fibrotic stage for: (1) obstruction, (2) abscess, and (3) fistula.4
You might also like to view...
A researcher gains support of the medical staff, the nursing staff, and the nurse manager of a cardiothoracic ICU within a prestigious private hospital, aligned with a teaching institution
A research proposal, concerning ambulation patterns after bypass surgery, is approved by the Human Subjects Committee. Federal funding is obtained. Just before data collection is to begin, the hospital is sold to a large university with a medical school, the nurse manager is replaced with a manger from another hospital in the corporation, and there is a 30% staff turnover. Choose the factors that are real concerns and could impact feasibility. (Select all that apply.) a. Most of the newly hired nurses are BSNs and newly graduated. b. The new manager grudgingly allows the research to proceed but makes it clear that she will not support subsequent research until the unit is more stable. c. Fewer patients come to this hospital now for bypass surgery, going instead to its sister hospital across town. d. Two of the research assistants, who were already trained, take jobs elsewhere. e. Staff nurses dislike the new manager and miss the old one.
Which stage in the policy process is exemplified by the activities of identifying the health problem and/or using a goal-oriented approach?
A) Policy adoption B) Policy evaluation C) Policy formulation D) Policy implementation Ans: C
Following a surgical procedure, an older Chinese woman refuses to perform the range of motion and breathing exercises requested, in addition is hesitant to complete her hygienic care and grooming. The nurse recognizes that this is most likely related to:
1. Dependence on health care providers for care 2. Reliance upon family members to assist with care 3. Lack of personal motivation to participate in self-care 4. Reluctance to cooperate with traditional Western medical treatment
A nurse knows that a blood culture specimen must be drawn if it is suspected that the patient has
1. Hemoconcentration. 2. Lymphostasis. 3. Septicemia. 4. Tortuous veins.