Nursing Care of Ulcerative Colitis
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Posted: Saturday, March 14, 2009
by Nancy Nurse
NET Education, Inc.
Ulcerative colitis usually appears with chronic symptoms from mild to severe. These symptoms include but are not limited to bloody diarrhea, abdominal pain and cramping, fever, malaise, anorexia, tachycardia and dehydration.
With the milder form of the disease, diarrhea and abdominal pain may be mild, unless there is a perforation in which the pain becomes much worse. In the moderate disease an individual may have up to five stools per day. In the severe form of the disease, an individual can have up to ten or more stools per day.
The goals of treatment are to rest the bowel, control and or reduce inflammation and reduce infection. Malnutrition must be corrected and fluids replenished. The individual needs to learn how to reduce the stress in their life, adhere to a strict medication regime and if necessary, seek hospitalization. The principal drug that is used in the treatment of ulcerative colitis is the drug Azulfidine. This drug works well in cases where the symptoms are moderate to mild. During the active cycle of the disease, the drug 5 ASA and 4 ASA are given as retention enemas. Corticosteroids have been implicated in helping to relieve the swelling and irritation thus helping to rest the bowel. Sometimes immunosuppressive drugs are given when all other therapies have failed. When drug therapy is no longer an option, then surgical intervention is a choice. Such surgical procedures include; total proctocolectomy with a permanent ileostomy; total proctocolectomy with continent iliesotomy (Kock pouch) and 3; total colectomy with rectal mucosal stripping and ileoanal reservoir.
Nutritional therapy is just as important as medication therapy. Certain foods can exacerbate symptoms and cause unwanted abdominal pain and cramping. A dietary consult is a good step in the right direction in helping to control symptoms of ulcerative colitis. Foods that can cause gastric acidity should be avoided, such as greasy foods, fried foods, and nuts or fruits with seeds. Everyone has a different digestive system in relationship to what foods they can or cannot eat. However, avoiding those foods that can produce lots of gas and acid may indeed prevent discomfort for the individual. Some of these foods may include the following; canned tomatoes, cantaloupe with seeds, grapes, nuts, dried fruit, deep fried foods and medium rare meat servings.
Nursing care for the patient with ulcerative colitis includes keeping the patient hydrated, and comfortable. It is important for the nurse to attend to the patient's level of coping, since nervousness can cause flare ups of symptoms. Engage the patient in open ended conversation and attempt to explore how the patient sees them. Try to understand what the patient is going through and let the patient know that you care and are there for whatever needs that they may have. Help to educate the patient on nutrition and how to handle the stress in their life. Restricting the physical activity of the individual will also help in healing the bowel. This may be hard for the patient who is still youthful and engages in much physical activity and sports. The entire person must be treated. When making a nursing care plan the nurse must take into consideration what the needs of the person are as a whole.
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