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Ulcerative Colitis PowerPoint Presentation

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Description : Ulcerative colitis is an inflammatory bowel diseases that causes long lasting inflammation and ulcers in the digestive tract. Ulcerative colitis affects the innermost lining of the colon and rectum.

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Published on : Sep 20, 2021 | Views : 4181 | Downloads : 11

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Ulcerative Colitis
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Ulcerative colitis is an inflammatory bowel diseases that causes long lasting inflammation and ulcers in the digestive tract. Ulcerative colitis affects the innermost lining of the colon and rectum Definition
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Ulcerative Colitis Inflammation Colon A type of inflammatory bowel disease that causes inflammation with ulcers in the inner lining of the COLON and RECTUM
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Etiology
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Pathophysiology Flare up  inflammation on the lining of the intestine  Kills cells of the lining forms ulcers  Bleeding  release blood/pus malfunction of the colon
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Clinical Manifestations Frequent loose bowel movements with or without blood:- Blood or mucus in stool is never normal in a bowel movement. While it may be due a relatively simple cause like hemorrhoids, it is important to make certain that the bleeding is not due to inflammatory bowel disease, tumor or another potentially like life-threatening cause. Diarrhea:-The inflammation makes the colon empty frequently causing diarrhea. Ulcers form in places where the inflammation has killed the cells lining the colon. The ulcers bleed and produce pus and mucus.Diarrhea lasting more than three days Lower abdominal discomfort or cramps:- Bowel movements are the hallmark of the disease. This range from infrequent and mild to persistent and severe. It is a colicky lower abdominal pain and cramps are a painful & involuntary muscular contraction. Weight loss,nausea,poor growth in children:-Long-term inflammation in the colon can cause digestive problems that may bring on symptom like this. With continuing diarrhea. Fever, lethargy, and loss of appetite:- Diarrhea with fever Tenesmus:-Painful spasm of the anal sphincter along with the urgent desire to defecate without the significant production of faeces.
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Dehydration such as dry mouth, excess thirst, little or no urination. Anemia:- Due to bleeding with bowel movements Because inflammatory bowel disease may be caused by a defect in the immune response system, other body organs may be involved, including for example: Vision problems or eye pain:-Uveitis Joint problems:- Migratory polyarthritis Neck or lower back pain:- Sacroilitis, Ankylosing spondilitis Skin rashes:- Erythema nodosum Liver and bile duct disease:- Hepatic involvement Kidney problems
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Both medications and surgery have been used to treat ulcerative colitis. However, surgery is reserved for those with severe inflammation and life-threatening complications. There is no medication that can cure ulcerative colitis. Medication treatment for ulcerative colitis. Since ulcerative colitis cannot be cured by medication, the goals of treatment with medication are to Induce remissions Maintain remissions Minimize side effects of treatment Improve the quality of life Minimize risk of cancer. Medical Treatment
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Azulfidine, Asacol, Pentasa, Dipentum, Colazal, and Rowasa all contain 5-ASA compounds which are topical anti-inflammatory ingredients. These medications are effective in inducing remission among patients with mild to moderate ulcerative colitis. They also are safe and effective in maintaining remission. Rowasa enemas are safe and effective in treating ulcerative proctitis and proctosigmoiditis. In ulcerative colitis patients with moderate to severe disease and in patients who fail to respond to 5-ASA compounds, systemic (oral) corticosteroids can be used. Systemic corticosteroids (prednisone, prednisolone, cortisone, etc.) are potent and fast-acting anti-inflammatory agents for treating Crohn's ileitis, ileocolitis, and ulcerative colitis. Systemic corticosteroids are not effective in maintaining remission in patients with ulcerative colitis. Serious side effects can result from prolonged corticosteroid treatment. Immunomodulators used for treating severe ulcerative colitis include azathioprine/6-MP, methotrexate, and cyclosporine. Infliximab (Remicade) may be beneficial in controlling moderate to severe ulcerative colitis and in decreasing the need for urgent removal of the colon.
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Surgery for ulcerative colitis Surgery for ulcerative colitis usually involves removing the entire colon and the rectum. Removal of the colon and rectum is the only permanent cure for ulcerative colitis. This procedure also eliminates the risk of developing colon cancer. Surgery in ulcerative colitis is reserved for the following patients: 1) Patients with fulminant colitis and toxic megacolon who are not responding readily to medications. 2) Patients with long standing pancolitis or left-sided colitis who are at risk of developing colon cancers. Removal of the colon is important when changes are detected in the colon lining. 3) Patients who have had years of severe colitis which has responded poorly to medications Standard surgery involves the removal of the entire colon, including the rectum. A small opening is made in the abdominal wall and the end of the small intestine is attached to the skin of the abdomen to form an ileostomy. Stool collects in a bag that is attached over the ileostomy. Recent improvements in the construction of ileostomies have allowed for continent ileostomies. A continent ileostomy is a pouch created from the intestine. The pouch serves as a reservoir similar to a rectum, and is emptied on a regular basis with a small tube. Patients with continent ileostomies do not need to wear collecting bags. More recently, a surgery has been developed which allows stool to be passed normally through the anus. In an ileo-anal anastomosis, the large intestine is removed and the small intestine is attached just above the anus.
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Discuss dietary modifications related to nutritional status and presence of ileostomy. Provide referral to dietitian for diet planning and teaching. Teach importance of maintaining a high fluid intake and manifestations of dehydration. Teach techniques to reduce stress. Teach food blockage management. Administer total parenteral nutrition as ordered. Administer anti-inflammatory medications as ordered. Provide intravenous therapy. Nursing management of ulcerative colitis
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For those with severe ulcerative colitis and patients with ostomy: Teach to empty and change ostomy pouch of choice. Teach stoma and peristomal skin assessment with each pouch change. Refer to local United Ostomy Association. Provide list of local medical suppliers for ostomy appliances. Continuation
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To put a care plan we will take an example – 42 years old ,Mrs. Sam had Ulcerative colitis for 18 years has been treated with medications. Over the past 4 moths she has been having abdominal pain and cramping and frequent bloody diarrhea stools. During the same time she has lost 9 kg. Nursing Care Plan
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Subjective – Have lost 9kg , Abdominal cramping and pain. Frequent bloody diarrhea Objective- Several reddened lesion are noted on her lower legs. Temperature 36.6 C, Pulse 72, Respiratory rate 20, BP 104/72 Skin was cool and pale Assessment
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Diarrhea related to inflammation of the bowel as evidenced bypatients verbalized. abdominal pain and cramping . Deficient fluid volume related to abdominal fluid loss as evidenced by pale skin and cool skin. Acute pain related to prolonged diarrhea as evidenced by cramping abdominal pain as patient verbalized. Imbalanced nutrition related to altered absorption of nutrients as evidenced by weight loss. Diagnosis
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Diarrhea Report reduction of frequency of stools, return to normal stool consistency. Deficient fluid volume Maintain adequate fluid volumes as evidenced by good skin turgor, stable vital signs. Planning
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3) Acute pain Report pain is relieved. Appear relaxed and able to rest . 4) Imbalanced nutrition Progressive gaining weight Planning cont;
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1) diarrhea Ascertain onset and pattern of diarrhea . To assess etiology . Observe and record stool frequency and characteristics Helps differentiate individual disease and asses the situation 2) Deficient fluid volume Observe for excessively dry skin and mucous membranes, decreased skin turgor, slowed capillary refill. Indicates excessive fluid loss or resultant dehydration. Interventions & Rationale
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Patient verbalized that pain relieved. Patient verbalized that the diarrhea stops. Evaluation
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References [online]. https://nurseslabs.com/7-inflammatory-bowel-disease-nursing-care-plans/6/ CROHN'S & COLITIS FOUNDATION (2017). Crohn's & Colitis Foundation. [online]. http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/ MAYO CLINIC (2018). Mayo Clinic. [online]. Last updated 8 March. https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326 NURSESLABS (2017). Nurseslabs.co. [online]. https://nurseslabs.com/7-inflammatory-bowel-disease-nursing-care-plans/6/ WEBMD (2017). WebMD. [online]. https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/default.htm Nursing File. (2018). Nursing Interventions for Ulcerative Colitis. [online] Available at: http://nursingfile.com/nursing-care-plan/nursing-interventions/nursing-interventions-for-ulcerative-colitis.html [Accessed 1 Apr. 2018]. Anon, (n.d.). UpToDate. [online] Available at: https://www.uptodate.com/contents/management-of-severe-ulcerative-coliti Anon, (n.d.). Ulcerative colitis: management | Guidance and guidelines | NICE. [online] Available at: https://www.nice.org.uk/guidance/cg166/chapter/1-Recommendations.s-in-adults
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