Chapter 57

Care of Patients with Inflammatory

Intestinal Disorders

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 Concepts
 The priority concepts in this chapter are
 IMMUNITY
 ELIMINATION
• IMMUNITY EXEMPLAR IS PERITONITIS
• ELIMINATION EXEMPLAR IS ULCERATIVE COLITIS
 The interrelated concepts in this chapter are
 NUTRITION
 COMFORT

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Immunity Concept Exemplar: Peritonitis

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 Interprofessional Collaborative Care
  Assessment: Noticing
 Cardinal Signs of peritonitis: abdominal pain,
tenderness, and distension
 Laboratory Assessment: WBC counts are often
elevated to 20,000/

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 Analysis: Interpreting
 The priority collaborative problems for patients
with peritonitis include
 Potential for Infection due to peritonitis.
 Potential for fluid volume shift due to fluid moving into
interstitial or peritoneal space.
 Acute pain due to peritonitis.

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 Planning and Implementation:
Responding
 Decrease Potential for Infection
 Restore Fluid Volume Balance
 Manage Pain
 Care Coordination and Transition Management
 Evaluation: Reflecting

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 Group Activity for
Inflammatory Disorders

1. Priority concern(s)
2. Common signs and symptoms
3. Treatment options
4. Include interprofessional health care team
5. Potential complications
6. Implications for older adults

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 Group Activity for
Inflammatory Disorders (Cont.)
 Individualized questions
 Appendicitis
• Signs/symptoms before and after rupture
 Peritonitis
• Teaching plan for surgical patient
 Gastroenteritis
• Medications used
 Ulcerative colitis
• Profile of “typical” patient; dietary teaching plan
 Crohn’s disease
• Teaching plan

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 Group Activity for
Inflammatory Disorders (Cont.)
 Diverticulosis versus diverticulitis
• Compare/contrast
 Anorectal abscess, anal fissure, anal fistula
• Key differentiations
 Food poisoning
• Teaching plan regarding organisms

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McBurney’s Point
(Appendicitis)

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Elimination Exemplar:
Ulcerative Colitis

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 Analysis: Interpreting
 The priority collaborative problems for patients
with ulcerative colitis include
 diarrhea due to inflammation of the bowel mucosa.
 acute pain or chronic noncancer pain due to
inflammation and ulceration of the bowel mucosa and
skin irritation.
 potential for lower GI bleeding and resulting anemia
due to UC.

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 Planning and Implementation:
Responding
 Decrease diarrhea
 Drug Therapy
 Nutrition Therapy
 Surgical Management
 Minimize Pain
 Monitor for Lower GI Bleeding
 Care Coordination and Transition Management

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Crohn’s Disease

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Diverticula

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Anorectal Fissure

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Fistulas

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Anal Fistula

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Skin Barriers

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