ULCERATIVE COLITIS

Prepared by: Section E2- Albarracin

What is ulcerative colitis?- Is a chronic

inflammatory bowel disease that causes ongoing inflammation and ulcers (open sores) in the innermost layers of the large intestine (colon) and rectum.

What is ulcerative colitis?

- The ulcers bleed and produce pus and mucus, and the inflammation causes the colon to empty frequently, causing diarrhea.

What is ulcerative colitis?

- Ulcerative colitis is almost similar to Crohn's disease, another inflammatory bowel disease.

Ulcerative Colitis VS Crohn’s Ds.

Ulcerative Colitis VS Crohn’s Ds.

Ulcerative Colitis VS Crohn’s Ds.Feature Ulcerative Colitis Crohn’s DiseaseINCIDENCE

Age of Onset

Family History

Gender of prevalence

Cancer risk

Any age; 10-40 years

Less common

Equal in men and women

Increased

Any age; 10-30 years

More common

Equal in men and women

Increased

Ulcerative Colitis VS Crohn’s Ds.Feature Ulcerative Colitis Crohn’s Disease

PATHOPHYSIOLOGYLocation of lesion

Inflammation and ulceration

Granulomas

Friable mucosa

Fistuale and abscesses

Strictures and possible obstruction

Colon and rectum, no “skip” lesions

Mucosal layer involved

Rare

Common

Rare

Rare

All of GI tract: mouth to anus, “skip” lesions commonEntire intestinal wall involvedCommon

Less common

Common

Common

Ulcerative Colitis VS Crohn’s Ds.Feature Ulcerative Colitis Crohn’s DiseaseCLINICAL MANIFESTATION

Abdominal pain

Diarrhea

Bloody stools

Abdominal mass

Small intestinal malabsorption

Steatorrhea

Potential for malignancy

Clinical course

Occasional

Common

Common

Rare

Rare

Rare

Common

Remission and exacerbation

Common

Common

Less common

Common

Common

Common

Common

Remission and exacerbation

PATHOPHYSIOLOGY

Identify the rationale for each of the orders.

NPO status except for oral medications

Colitis interferes with its ability to absorb water from the intestinal contents and allows leakage of important electrolytes, such as potassium and chloride, into your stool. Thus, would cause further problems in bowel movement or exacerbation of diarrhea would occur.

Identify the rationale for each of the orders.

Sulfasalazine 2g po qid

It works to reduce the inflammation in the colon caused by ulcerative colitis and then as a maintenance therapy to maintain remission.

Identify the rationale for each of the orders.

D5W in 0.9% Nacl with 40 mEq KCL at 125 ml/hr

People with IBD (ulcerative colitis or Crohn's disease) often have trouble absorbing nutrients from their intestine, and may have low levels of potassium and other important nutrients.

Identify the rationale for each of the orders.

Solumedrol 100mg IV q 6

Corticosteroids affect metabolism in various ways and modify the immune system. Corticosteroids also block inflammation and are used in a wide variety of inflammatory diseases affecting many organs.

Common Laboratory Findings

• Bloody diarrhea• Cellular mucosal breakdown• Diarrhea and vomiting• Toxic megacolon

Nursing Diagnosis

Diarrhea related to inflamed intestinal mucosaAltered nutrition: less than body requirements related to malabsorptionAltered comfort: acute pain related to inflamed mucosaDeficient fluid volume related to anorexia, nausea, diarrheaRisk for impaired skin integrity related to malnutrition and diarrheaActivity intolerance related to fatigueAnxiety related to impending surgeryIneffective coping related to repeated episodes of diarrhea

Collaborative problems:

Electrolyte imbalance

Cardiac dysrhythmias related to

electrolyte depletion

GI bleeding w/ fluid volume loss

Perforation of the bowel

Sources:

Ardizzone S. Ulcerative colitis. Orphanet encyclopedia. September 2003: (Ebook)

Black, J. and Jane Hokanson Hawks. (2004). Medical-Surgical Nursing: Clinical management for positive outcomes. 7th ed. Singapore: Elsevier Pte. Ltd.

Kozier, B. et. Al. (2008). Fundamentals of nursing, 8th ed. Singapore: Pearson Education South Asia Pte. Ltd.

Lewis, S. et. Al. (2007). Medical surgical nursing: Assessment & management of clinical problems, 7th ed. St. Louis, Missouri: Mosby Inc.

Smeltzer, S. (2008). Brunner & Suddarth’s textbook of medical-surgical nursing, 11th ed. Philadelphia: Lippincott Williams & Wilkins.

Ulcerative colitis. http://www.livestrong.com/article/484043-colitis-low-potassium/#ixzz1S31mPbc5

Ulcerative colitis. http://www.umm.edu/altmed/articles/ulcerative-colitis-000166.htm

Thank you for listening!!!