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17190275
IBD-Crohn's Disease
Descrição
Mapa Mental sobre IBD-Crohn's Disease, criado por Thi Thanh Tuyen Pham em 08-03-2019.
Sem etiquetas
english for healthcare providers
Mapa Mental por
Thi Thanh Tuyen Pham
, atualizado more than 1 year ago
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Criado por
Thi Thanh Tuyen Pham
aproximadamente 5 anos atrás
23
0
0
Resumo de Recurso
IBD-Crohn's Disease
PATHOPHYSIOLOGY
(Mazal, 2014)
unknown cause
progressive, systemic autoimmune disorder
abnormal inflammation of any parts of GI tract
Discontinuous, “skip” lesions
(Hart & Ng, 2015)
varied mucosal ulcerations
burrow gut wall
fistula
narrowed lumen
obstruction
cobble stone apperance
DIAGNOTIC TESTS
(Gajendran et al., 2018)
Laboratories studies
Serology
CBC (anemia), C-reactive protein (CRP)
erythrocyte sedimentation rate (ESR)
monitor response to treatment
Stool studies
Imaging
confirm disease location and intestinal complications.
endoscopy
obtain tissue ->pathological evaluation
CT, MRI, contrast radiography
COLLABORATIVE CARE
Nutritional therapy
(Crohn’s and Colitis Canada, 2016, 2017)
No special diet →customized to fit pt.
a well-balanced diet
Enteral feeding
insert NG tube or stomach tube
primary therapy
secondary treatment: malnutrition
Total parenteral nutrition (TPN)
when oral & enteral feeding is inadequate
supplements
Calcium citrate, Iron, Vitamins D, and B12, Folic acid,
(Karakashian & Schub, 2018)
eliminate certain foods (e.g., bulky grains, hot spices, alcohol, milk products)
prevent worsening diarrhea, cramping
NURSING INTERVENTIONS
Total parenteral nutrition (TPN)
( General Surgery North York General Hospital, 2013)
extended bowel rest
during exacerbation; pre-operation.
NOT compatible with any other solutions
be administered by itself
NOT obtain blood samples from same port as TPN infusions.
Do not abruptly discontinue
HYPOGLYCEMIA RISK
(Robertson, 2014; General Surgery North York General Hospital, 2013)
RISKS
Administration-related
Pneumothorax; Fluid excess/ pulmonary edema.
Monitor VS closely
sepsis, embolism, catheter occlusion
Formulation-related
nutritional imbalance; electrolyte imbalance
hypoglycemia, hyperglycemia
monitor blood glucose
Patient teaching
Ostomy care
(Crohn’s and Colitis Canada, 2017)
examine stoma daily
healthy stoma
moist, dark pink to red
skin around stoma
no redness or sores
Empty pouch when 1/3 full
Change pouch & skin barrier
if irritated->change skin barrier right away
regularly: at least 1-2X/week
not limited to sport and work
if physician says "all clear"
normal to experience diarrhea or constipation
Diarrhea → avoid foods make feces more watery
Constipated→ drinking fruit juices
Diet
(Crohn’s and Colitis Canada, 2017)
In remission
eating a well-balanced diet
no need to avoid any particular kind of food
During flare-up
modify diet, avoid aggravating gut
avoid trigger foods
Avoid Alcohol, Sugar, Fructose, Caffeine, Greasy food
Eat smaller meals, q2-3h
Avoid drinking a lot of fluid during a meal
Reduce fat intake
Overall goals (Cope, 2015)
induce & maintain remission
prevent complications
Anexos de mídia
Examine Stoma Daily (binary/octet-stream)
H9991314 002 Pi (binary/octet-stream)
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