Inflammatory Bowel Disease Case Study (45 min)
Included In This Lesson
Study Tools For Inflammatory Bowel Disease Case Study (45 min)
Outline
Ms. Hale is a 19 year old female who presents to the Emergency Department (ED) reporting bloody diarrhea. She reports that she has been told she has Irritable Bowel Syndrome (IBS) in the past, and sometimes has bloody stools, but this is the first time she’s seen this much blood
What further history questions would you ask Ms. Hale?
Ms. Hale reports she has 5-10 bowel movements daily, she has had 3 already this morning. She reports she’s used to that, especially if she eats greasy foods. She says “I had just accepted that I would never poop normally, but I’ve never seen that amount of blood before. It was crazy!”. She reports a weight loss of 10 lbs in the last 4 months.
What additional nursing assessments need to be performed?
What diagnostic tests would you expect the provider to order? Why?
Ms. Hale’s vital signs are stable. The provider found frank blood on a digital rectal exam. Ms. Hale received a colonoscopy, which showed a bleeding ulcer in her transverse colon, which was cauterized, but no other signs of bleeding. The provider believes this may have been an isolated incident due to irritation caused by the patients greasy food diet and IBS. He orders for her to be discharged home.
What discharge instructions should be included for Ms. Hale?
Ms. Hale returns to the ED 2 days later complaining of bright red blood in her stools – two yesterday and five already today. She reports severe lower abdominal pain, nausea and vomiting.
What further diagnostic testing should be done at this time?
The nurse notes open sores in Ms. Hale’s mouth and Ms. Hale also begins reporting epigastric pain.
An endoscopy, repeat colonoscopy, and CT scan show severe thickening of the mucosa in the small and large intestine, with some ulcerations in the duodenum and ileocecal junction, in addition to the previous one seen in the transverse colon.
What do you believe might be the issue for Ms. Hale?
Is Ms. Hale presenting with signs of Ulcerative Colitis or Crohn’s Disease? Explain.
A Gastroenterology specialist officially diagnoses Ms. Hale with Inflammatory Bowel Disease, and explains that these symptoms can sometimes be misdiagnosed until they become severe. Specifically, he diagnoses her with Crohn’s Disease and explains how it affects the entire GI tract. He will write for new medications and discharge her home tomorrow, as long as she is stable.
What medications would you expect Ms. Hale to be discharged with? Why?
Rina’s NCLEX Study Plan
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Circulatory System
- Cardiac Disorders
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Basics of NCLEX
- Test Taking Strategies
- Respiratory Disorders
- Hematologic Disorders
- EENT Disorders
- Basics of Chemistry
- Adult
- Medication Administration
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Anxiety Disorders
- Renal Disorders
- Prenatal Concepts
- Vascular Disorders
- Gastrointestinal Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Immunological Disorders
- Sexually Transmitted Infections
- Upper GI Disorders
- Microbiology
- Labor and Delivery
- Communication
- Proteins
- Newborn Care
- Hematologic System
- Urinary Disorders
- Eating Disorders
- Musculoskeletal Disorders
- Bipolar Disorders
- Terminology
- Pregnancy Risks
- Concepts of Population Health
- Factors Influencing Community Health
- Postpartum Complications
- Prioritization
- Psychotic Disorders
- Basics of Human Biology
- Neurologic and Cognitive Disorders
- Labor Complications
- Writing
- Statistics
- Community Health Overview
- Dosage Calculations
- Musculoskeletal Trauma
- Neurological Trauma
- Note Taking
- Cardiovascular Disorders
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Cognitive Disorders
- Depressive Disorders
- Developmental Considerations
- Shock
- Documentation and Communication
- Legal and Ethical Issues
- EENT Disorders
- Fundamentals of Emergency Nursing
- Emotions and Motivation
- Renal and Urinary Disorders
- Digestive System
- Integumentary Disorders
- Intraoperative Nursing
- Fetal Development
- Basics of Mathematics
- Prenatal and Neonatal Growth and Development
- Childhood Growth and Development
- Preoperative Nursing
- Postoperative Nursing
- Neurological Emergencies
- Understanding Society
- Somatoform Disorders
- Reading
- Emergency Care of the Neurological Patient
- Infectious Respiratory Disorder
- Metabolism
- Oncologic Disorders
- Developmental Theories
- Basics of Sociology
- Emergency Care of the Trauma Patient
- Med Term Basic
- Med Term Whole
- Suffixes
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Newborn Complications
- Male Reproductive Disorders
- Adulthood Growth and Development
- Perioperative Nursing Roles
- Concepts of Pharmacology
- Endocrine System
- Postpartum Care
- Trauma-Stress Disorders
- Psychological Disorders
- State of Consciousness
- Shock
- Skeletal System
- Learning Pharmacology
- Hematologic Disorders
- Prefixes
- Delegation
- Tissues and Glands
- Personality Disorders
- Basic
- Musculoskeletal Disorders
- Disorders of Thermoregulation
- Integumentary Important Points
- Reproductive System
- Psychological Emergencies
- Growth & Development
- Intelligence and Language
- Pediatric
- Sensory System