Inflammatory bowel disease (IBD) is an idiopathic disease caused by a dysregulated immune response to host intestinal microflora. It results from a complex interplay between genetic and environmental factors. Similarities involve (1) chronic inflammation of the alimentary tract and (2) periods of remission interspersed with episodes of acute inflammation. There is a genetic predisposition for IBD, and patients with this condition are more prone to the development of malignancy.
The two major types of inflammatory bowel disease are ulcerative colitis (UC) and Crohn disease (CD).
Ulcerative colitis (UC): A chronic condition of unknown cause usually starting in the rectum and distal portions of the colon and possibly spreading upward to involve the sigmoid and descending colon or the entire colon. It is usually intermittent (acute exacerbation with long remissions), but some individuals (30%–40%) have continuous symptoms. Cure is effected only by total removal of colon and rectum/rectal mucosa.
Regional enteritis (Crohn’s disease, ileocolitis): May be found in portions of the alimentary tract from the mouth to the anus but is most commonly found in the small intestine (terminal ileum). It is a slowly progressive chronic disease of unknown cause with intermittent acute episodes and no known cure. UC and regional enteritis share common symptoms but differ in the segment and layer of intestine involved and the degree of severity and complications. Therefore, separate databases are provided.
Nursing Care Plans
Nursing care management of patients with inflammatory bowel diseases (IBD) includes control of diarrhea and promoting optimal bowel function; minimize or prevent complications; promote optimal nutrition, and provide information about the disease process and treatment needs.
Here are seven (7) nursing care plans (NCP) and nursing diagnosis for patients with inflammatory bowel diseases: ulcerative colitis, Crohn’s disease, and ileocolitis:
- Diarrhea
- Risk for Deficient Fluid Volume
- Anxiety
- Acute Pain
- Ineffective Coping
- Imbalanced Nutrition: Less Than Body Requirements
- Deficient Knowledge
- Other Possible Nursing Care Plans
Anxiety
Nursing Diagnosis
- Anxiety
May be related to
- Physiological factors/sympathetic stimulation (inflammatory process)
- Threat to self-concept (perceived or actual)
- Threat to/change in health status, socioeconomic status, role functioning, interaction patterns
Possibly evidenced by
- Exacerbation of acute stage of disease
- Increased tension, distress, apprehension
- Expressed concern regarding changes in life
- Somatic complaints
- Focus on self
Desired Outcomes
- Appear relaxed and report anxiety reduced to a manageable level.
- Verbalize awareness of feelings of anxiety and healthy ways to deal with them.
- Identify healthy ways to deal with and express anxiety.
- Use support system effectively.
Nursing Interventions | Rationale |
---|---|
Review physiological factors, such as active medical condition; recent or ongoing stressors. | These factors can cause or exacerbate anxiety or anxiety disorders. |
Observe and note behavioral clues (restlessness, irritability, withdrawal, lack of eye contact, demanding behavior). | Indicators of degree of anxiety or stress (patient may feel out of control at home or at work managing personal problems. Stress may develop as a result of physical symptoms of condition and the reaction of others. |
Encourage verbalization of feelings. Provide feedback. | Establishes a therapeutic relationship. Assists patient and SO in identifying problems causing stress. Patient with severe diarrhea may hesitate to ask for help for fear of becoming a burden to the staff. |
Acknowledge that the anxiety and problems are similar to those expressed by others. Active-Listen patient’s concerns. | Validation that feelings are normal can help reduce stress, isolation and belief that “I am the only one.” |
Provide accurate, concrete information about what is being done (reason for bedrest, restriction of oral intake, and procedures). | Involving patient in plan of care provides sense of control and helps decrease anxiety. |
Provide a calm, restful environment. | Removing patient from outside stressors promotes relaxation; helps reduce anxiety. |
Encourage staff and SO to project caring, concerned attitude. | A supportive manner can help patient feel less stressed, allowing energy to be directed toward healing or recovery. |
Help patient identify and initiate positive coping behaviors used in the past. | Successful behaviors can be fostered in dealing with current problems and stress, enhancing patient’s sense of self-control. |
Assist patient to learn new coping mechanisms (stress management techniques, organizational skills). | Learning new ways to cope can be helpful in reducing stress and anxiety, enhancing disease control. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More nursing care plans related to gastrointestinal disorders:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans
Thanks a lot be blessed abundantly