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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Acute Pain

Nursing Diagnosis

May be related to

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  • Hyperperistalsis, prolonged diarrhea, skin/tissue irritation, perirectal excoriation, fissures, fistulas

Possibly evidenced by

  • Reports of colicky/cramping abdominal pain/referred pain
  • Guarding/distraction behaviors, restlessness
  • Facial mask of pain; self-focusing

Desired Outcomes

  • Report pain is relieved/controlled.
  • Appear relaxed and able to sleep/rest appropriately.
Nursing InterventionsRationale
Encourage patient to report pain.May try to tolerate pain rather than request analgesics.
Assess reports of abdominal cramping or pain, noting location, duration, intensity (0–10 scale). Investigate and report changes in pain characteristicsColicky intermittent pain occurs with Crohn’s disease
Note nonverbal cues (restlessness, reluctance to move, abdominal guarding, withdrawal, and depression). Investigate discrepancies between verbal and nonverbal cues.Body language or nonverbal cues may be both physiological and psychological and may be used in conjunction with verbal cues to determine extent and severity of the problem.
Review factors that aggravate or alleviate pain.May pinpoint precipitating or aggravating factors (such as stressful events, food intolerance) or identify developing complications.
Encourage patient to assume position of comfort (knees flexed).Reduces abdominal tension and promotes sense of control.
Provide comfort measures (back rub, reposition) and diversional activities.Promotes relaxation, refocuses attention, and may enhance coping abilities.
Cleanse rectal area with mild soap and water or wipes after each stool and provide skin care (A&D ointment, Sween ointment, karaya gel, Desitin, petroleum jelly).Protects skin from bowel acids, preventing excoriation.
Provide sitz bath as appropriate.Enhances cleanliness and comfort in the presence of perianal irritation or fissures.
Observe for ischiorectal and perianal fistulas.Fistulas may develop from erosion and weakening of intestinal bowel wall.
Observe and record abdominal distension, increased temperature, decreased BP.May indicate developing intestinal obstruction from inflammation, edema, and scarring.
Implement prescribed dietary modifications (commence with liquids and increase to solid foods as tolerated).Complete bowel rest can reduce pain, cramping.
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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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