Thomas is in his early 20s and he has been diagnosed with Crohn's disease. He is elated and upset at the same time. He is glad he finally has a diagnosis to his bowel issues but has no idea of what this disorder is
The physician simply gave him the findings and diagnosis from all his tests and left without answering any questions. You are the nurse left to discharge him from the clinic, and he is full of questions and very upset at the doctor for leaving so abruptly.
a. What teaching will you give Thomas about his disorder?
b. What is assessed at follow-up?
c. What are the signs and symptoms presented?
d. What type of diet or medication regimen will he need?
e. What is the treatment?
Students' answers should include the following:
a. Definition of Crohn's disease, also known as regional enteritis
Who usually is prone to this disorder such as young adults, smokers, and Whites of European or Jewish ancestry
Inflamed areas or skip lesions occur in bowel with cobblestone appearance
Deep ulcerations in edematous tissue and chronic inflammation through all layers of the bowel, especially the submucosal layer
Terminal portion of the ileum usually is most affected in the bowel region.
Fistulas may form.
Perianal and perilabial fistulas are the most common.
Inflammation may extend to other organs.
May lead to scarring and strictures or obstructions of lumen
b. Follow-up care includes monitoring for scarring, strictures, and obstructions.
c. S/s include abdominal pain, distension, and lower abdominal tenderness, especially on the right side.
Pain with eating, fatigue, and chronic diarrhea
Also may lead to arthritis, skin lesions, uveitis, conjunctivitis, and iritis
Assessment may reveal abdominal mass.
Lab results show anemia, serum protein and albumin levels are low, WBC is elevated, erythrocyte sedimentation rate is elevated, with occult blood and WBCs in stool.
d. High-fiber diet, vitamins, iron, and antidiarrheals; may need blood,
steroids, and antibiotics
e. Supportive treatment; surgical management for obstructions
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