Nursing Care Plan for Crohn's Disease


Crohn's disease is an autoimmune disease characterized by inflammation of any part of the digestive tract starts from mouth to anus. Crohn's disease typically affects the ileum, the lower part of the small intestine. This condition occurs when the immune system reacts abnormally, attack bacteria, food, and other substances improperly, which causes the accumulation of white blood cells in the lining of the intestine.

Cause of Crohn 's disease is unknown. The study focused on three possible causes, namely :
1. Immune system dysfunction
2. Infection
3. Food

Although not found the presence of autoantibodies, regional enteritis is thought to be a hypersensitivity reaction or may be caused by an unknown infectious agent. These theories put forward because of the granulomatous lesions similar to lesions found in fungi and pulmonary tuberculosis. There are some interesting similarities between regional enteritis and ulcerative colitis. Both are inflammatory diseases, although the lesions is different. Both of these diseases have manifestations outside the digestive tract ; uveitis, arthritis and skin lesions were identical.

Crohn's disease that attacks the digestive system can cause a variety of complications, one of which is certainly disorders of the gut or digestive system. Crohn 's disease can cause a thickening or swelling of the intestinal wall, and this can cause blockage in the intestines. Finally, disturbed digestive system, intestines can not absorb nutrients from food, such as protein, vitamins, calories, and minerals.

Other complications that may arise as a result of Crohn 's disease is osteoporosis, anemia can cause fatigue, impaired liver function, cancer of the colon, toxic megacolon, kidney stone disease, or arthritis.

The main symptoms are diarrhea, abdominal pain, and weight loss . Often obtained malaise, loss of appetite, nausea, vomiting, and there may be subfebrile fever. Occur suddenly, can resemble obstruction and appendicitis. At regional enteritis, the onset of symptoms is usually hidden, with persistent abdominal pain and diarrhea that does not go away with defecation. Diarrhea occurred in 90 % of patients. Scar tissue and granuloma formation affects the ability of the intestine to transport the products of digestion upper intestine, through the lumen constriction, resulting in a cramping abdominal pain. Because the intestinal peristaltic stimulated by food, cramping pain occurs after eating. To avoid this cramping pain, patients tend to limit food intake, reducing the amount and types of food so that the normal nutritional needs are not met. The result is weight loss, malnutrition, and anemia secondary. In addition, the formation of ulcers in the lining membrane of the intestine and the place of inflammation, discharge will produce a constant irritant to the colon that are drawn from the thin intestine, swollen, which causes chronic diarrhea. Nutritional deficiencies may occur due to impaired absorption. The result is that the individual be thin because of inadequate food intake and fluid lost continuously. In some patients, inflamed bowel can be perforated and anal abscess formation, and intra-abdominal. Fever and leukocytosis. Abscesses, fistulas, and fissures are common. Clinical course and symptoms vary. In some patients there were periods of remission and exacerbation, while others follow the weight causes illness. Symptoms extends throughout the gastrointestinal tract and generally include joint problems (arthritis), skin lesions (erythema nodosum), ocular disorders (conjunctivitis), and oral ulcers.


Nursing Diagnosis for Crohn's Disease

1. Pain related to irritable initestinal, abdominal cramps and surgical response.
2. Fluid and Electrolyte imbalances related to discharge of excessive vomiting.
3. Imbalanced Nutrition Less Than Body Requirements related to the inadequate nutritional intake secondary to pain, stomach and intestinal inconveniences.
4. Risk for infection related to post- surgical wound.
5. Anxiety related to the prognosis of the disease and surgical plan.

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