Question

PN 200 Fundamentals of Nursing II Concept Map: Crohn Disease Carley Downs is a 32-year-old with a 14-year history of Chron Disease who presents with a three-day history of diarrhea and steady abdominal pain. She has been referred by her family physician to the GI clinic. The clinical course of her disease has included obstruction due to small intestine stricture and chronic steroid dependency with disease relapse when trying to taper her steroids. Endocrine tests reveal that she has developed adrenal insufficiency as a result of her steroid use and a DEXA scan that has demonstrated significant demineralization of the bone. B/P 165/95, P 69, R 15, afebrile, Ht 61 inches, Wt 154

Answer 1

Crohn's disease

Nursing Diagnosis

• Impaired bowel pattern related to inflammatory process as evidenced by diarrhea

Intervention

• Monitor the general condition of the patient, to know the basic status and plan for care
• Administer antidiarrhoeal to prevent frequent stools
• Administer IV fluids to 0reveby fluid volume deficit
• Maintain intake and output chart to identify any changes in the renal system

Positive outcomes

• The patient will have normal bowel pattern

Negative outcomes

• The patient may exhibit dehydration due to diarrhea of untreated

Evaluation

• Decrease in the number bowel movements

Nursing diagnosis

Acute pain (abdomen) related in inflammatory changes in the intestine as evidence by pain score,verbalisation

Intervention

• Assess the level of pain,baseline to plan for care
• Administer analgesics, antacids as per order to relieve pain
• Stop steroids because this can irritate the intestinal lining and cause pain

Positive outcomes

• The pain level decreased completely

Negative outcomes

• Patient may experience complications due to abdominal pain

Evaluation

The patient exhibits no pain and able to do daily activities