7 Inflammatory Bowel Disease (IBD) Nursing Care Plans

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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.

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Here are seven (7) nursing care plans (NCP) and nursing diagnosis for patients with inflammatory bowel diseases: ulcerative colitis, Crohn’s disease, and ileocolitis:

  1. Diarrhea
  2. Risk for Deficient Fluid Volume
  3. Anxiety
  4. Acute Pain
  5. Ineffective Coping
  6. Imbalanced Nutrition: Less Than Body Requirements
  7. Deficient Knowledge
  8. Other Possible Nursing Care Plans
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Anxiety

Nursing Diagnosis

  • Anxiety

May be related to

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  • 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 InterventionsRationale
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.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

More nursing care plans related to gastrointestinal disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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