Instructions: Choose An Illness Or Disease We Covered In Cla

Instructionschoosean Illnessdisease We Covered In Class From The Foll

Choose an illness/disease we covered in class from the following systems; Neurological, Respiratory, Sensory Perception, Skin, Cardiac, GU, or GI. You will be completing a head-to-toe assessment on the patient along with a focused assessment related to the specific system affected by the illness/disease process. Identify the following:

Introduction: begin with the patient scenario (case study) that includes the patient’s past medical history, and the subjective and objective data that correlate with the disease (use your textbook as a refresher on what to include in a Physical and nutritional assessment). Summarize the pathophysiology of the disorder and relate the clinical manifestations of each back to the pathophysiology.

Evaluate the GI disease including patient history, clinical manifestations, and diagnostic test results. Identify the treatment, discuss the patient’s anticipated nutrition needs, and identify alternative forms of feeding or dietary changes. Patient teaching to include the disease, the treatment plan, and how to evaluate the effectiveness of the teaching. Review nursing diagnoses common to patients with your group’s chosen GI disease, determine the priority of the problems, and discuss interventions appropriate for each diagnosis. Create three questions (with answers available after students respond) for the class to respond to at the end of your presentation specific to the disorder.

The content will need to be presented in some form (PowerPoint, etc.) AND you will need to perform the patient scenario. Choose which team members will role play, such as the patient, nurse, MD, UAP, etc. Must include a title slide, an introduction to the topic, and group member names. Reference page with a minimum of 3 references in APA format. The remaining 25 points will be divided for: spelling and grammar, presentation length, look of the presentation including creative ways to engage peers, which are essential. Required three sources at minimum and will need to be in APA format. See Rubric for point breakdown.

Paper For Above instruction

The chosen disease for this assessment is Crohn's Disease, a chronic inflammatory bowel disease affecting the gastrointestinal (GI) tract. This condition exemplifies a complex interaction of immune dysregulation, genetics, and environmental factors, leading to transmural inflammation of the GI tract. The illness primarily involves the ileum and colon but can affect any part of the GI tract from the mouth to the anus. The following paper discusses the clinical scenario, pathophysiology, assessment, treatment, nutritional considerations, patient education, nursing diagnoses, and interventions related to Crohn's Disease.

Patient Scenario

Mr. John Doe, a 28-year-old male with a past medical history significant for Crohn's Disease diagnosed at age 22, presents to the outpatient clinic with complaints of persistent abdominal pain, diarrhea, weight loss, and fatigue. He reports increased frequency of diarrhea (up to 8 times daily), occasional blood in stool, and feelings of cramping. His medical history includes previous hospitalizations for flare-ups managed with corticosteroids and biologic therapies. Recently, he has been experiencing more severe symptoms, leading to weight loss of approximately 10 pounds over the past month. Subjective data include reports of stress related to work and dietary variations. Objective data reveal pallor, tenderness in the lower right quadrant, and laboratory findings showing anemia, elevated erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Physical examination indicates dehydration and cachexia. Nutritional assessment shows decreased caloric intake secondary to abdominal discomfort.

Pathophysiology of Crohn's Disease

Crohn's Disease is characterized by chronic transmural inflammation that can involve any segment of the GI tract, leading to ulceration, fibrosis, and fistula formation. The disease process involves immune dysregulation where the immune system mistakenly attacks the intestinal wall, initiating inflammation. Genetic predisposition plays a significant role, with mutations in genes such as NOD2/CARD15 contributing to susceptibility. Environmental factors, including smoking and diet, can exacerbate disease activity. The inflammation causes thickening of the intestinal wall, narrowing of the lumen, and predisposes to complications like strictures and fistulas. These physiological changes disrupt normal digestion and absorption, leading to symptoms such as diarrhea, malnutrition, anemia, and abdominal pain.

Clinical Manifestations and Diagnostic Evaluation

The clinical manifestations of Crohn's Disease depend on the affected GI segment but commonly include persistent diarrhea, weight loss, abdominal pain, fever, and malaise. Extraintestinal manifestations such as joint pain, skin lesions, and ocular inflammation are also common. Diagnostic tests include colonoscopy with biopsy, which reveals granulomatous inflammation, transmural involvement, and skip lesions characteristic of Crohn's. Imaging studies like CT enterography or MRI can evaluate the extent of bowel involvement, strictures, and fistulas. Laboratory findings often demonstrate anemia, elevated ESR and CRP indicating inflammation, and nutritional deficiencies such as iron, vitamin B12, and vitamin D deficiencies due to malabsorption.

Treatment and Nutritional Management

The mainstay treatments include anti-inflammatory agents such as aminosalicylates, corticosteroids to reduce inflammation during flare-ups, immunomodulators (azathioprine), and biologic therapies targeting tumor necrosis factor-alpha (TNF-α). Surgical intervention may be necessary for obstructions or fistulas unresponsive to medical therapy. Nutritional therapy is essential, emphasizing a high-protein, high-calorie diet to combat weight loss and meet increased metabolic demands. Patients often require supplementation of vitamins and minerals, particularly B12, iron, and vitamin D. In cases of severe malnutrition or intolerance to oral intake, alternative feeding methods such as enteral nutrition or total parenteral nutrition (TPN) may be employed. Dietary modifications include avoiding trigger foods such as dairy, high-fiber foods during flare-ups, and promoting easy-to-digest, nutrient-rich foods.

Patient Education and Evaluation

Patient teaching involves educating Mr. Doe on disease understanding, medication adherence, recognizing symptoms of relapse, and dietary management strategies. He should be instructed on maintaining hydration, avoiding known dietary triggers, and the importance of follow-up appointments. Education should include signs of complications such as fistula formation or bowel obstruction that require prompt medical attention. Evaluation of teaching effectiveness involves assessing the patient’s knowledge through feedback and monitoring symptom control, weight stability, and nutritional status during follow-up visits.

Nursing Diagnoses and Interventions

Common nursing diagnoses for Crohn’s Disease include Imbalanced Nutrition: Less than Body Requirements, Risk for Deficient Fluid Volume, and Knowledge Deficit related to disease management. Priority nursing interventions involve monitoring fluid and electrolyte status, administering prescribed medications, providing nutritional support, and educating the patient. Managing symptoms, preventing complications, and promoting psychological support are integral to comprehensive care. Interventions such as assisting with dietary planning, offering stress management techniques, and ensuring medication adherence are essential.

Classroom Questions

1. What are the key features on colonoscopy that differentiate Crohn's Disease from ulcerative colitis?
2. How does nutritional therapy assist in managing Crohn’s Disease during a flare-up?
3. What are common complications of Crohn’s Disease, and how can they be prevented or managed?

References

• Baumgart, D. C., & Sandborn, W. J. (2012). Crohn's disease. The Lancet, 380(9853), 1590–1605.
• Hanauer, S. B. (2006). Inflammatory bowel disease: epidemiology, mechanisms, and therapeutic strategies. The American Journal of Gastroenterology, 101(3), 559–570.
• Lichtenstein, G. R., Hanauer, S. B., & Sandborn, W. J. (2018). Practice guidelines on the management of Crohn’s disease. The American Journal of Gastroenterology, 113(4), 481-517.
• Khan, N., & Proctor, M. (2020). Nutrition and Crohn’s disease: A comprehensive review. Nutrition Reviews, 78(4), 276–289.
• Rutter, M. D., et al. (2015). Fistulizing Crohn's disease: Management and outcomes. Gastroenterology Clinics, 44(2), 365–378.