Crohns vs Ulcerative colitis

Create a case study.

1. Provide a patient profile (i.e. gender, age, why patient is seeking care)
2. Provide subjective data
3. Provide objective data
4. Create at least 4 discussion questions with answers
Create one test question related to your topic

A 19 year old female presents to the ED with complaints of abdominal pain and bloody diarrhea
up to 15 times a day. She also reports fatigue and loss of appetite. The patient recalls that she
has experienced these symptoms before, but that eventually they went away. The nurse takes
her vital signs and obtained these results: Temperature-100.2, BP-124/70, Pulse-82, and
Respirations-16. The patient reports a pain level of 8 out of 10. Is the patient experiencing
Crohns disease or Ulcerative Colitis? What led you to this conclusion?

Discussion questions:

1. Which lab value might be elevated for this patient?

Answer: erythrocyte sedimentation rate (ESR) elevated indicating presence of inflammation,
blood counts would be low signifying anemia if pt. Was losing large amounts of blood in the
stool

2. Why would the patient be experiencing hematochezia?

Answer: The patient has small ulcers and abscesses in their colon and rectum that flare up.

3. Does this patient have to be concerned about fistulas?

Answer: No; fistulas are rare with ulcerative colitis because inflammation does not extend
through all bowel wall layers. Ulcerative colitis only affects the lining of the colon.

4. Due to the level of damage to the patients intestine related to her disease, the physician
schedules an ileoanal anastomosis (J- Pouch) surgery. The nurse knows that this procedure:

A. Removes the colon and rectum which allows a pouch to be created that will attach to the
ileum. This will allow stool to pass from the small intestine to the anus.

B. Removes the colon and rectum and creates a permanent ileostomy.

C. Removes the colon and creates a temporary colostomy.

D. Removes the rectum which allows a pouch to be created from the colon. This will allow stool
to pass from the colon to the anus.
Answer: A. A J-pouch surgery (ileoanal anastomosis) removes the colon and rectum
which allows a pouch to be created that will attach to the ileum. This will allow stool to
pass from the small intestine to the anus.

The patient returns from a successful surgery and is back on your floor. In your nursing
care you make it a priority to do the following:

- Monitor Stools
- Monitor fluids and electrolytes
- Intervene with pain control
- Provide stress management techniques related to emotions about the care and
acceptance of the ileal pouch
- Incourage smoking cessation if the patient is a current smoker
- Monitor psychosocial effects from the procedure such as: depression, isolation
and dealing with unpredictable bowel movements
- Provide skin care
- Encourage proper rest and nutrition
Of these tasks, which would you prioritize?