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).

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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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Ineffective Coping

Nursing Diagnosis

May be related to

  • Multiple stressors, repeated over period of time; situational crisis
  • Unpredictable nature of disease process
  • Personal vulnerability; inadequate coping method; lack of support systems
  • Severe pain
  • Lack of sleep, rest

Possibly evidenced by

  • Verbalization of inability to cope, discouragement, anxiety
  • Preoccupation with physical self, chronic worry, emotional tension, poor self-esteem
  • Depression and dependency

Desired Outcomes

  • Assess the current situation accurately.
  • Identify ineffective coping behaviors and consequences.
  • Acknowledge own coping abilities.
  • Demonstrate necessary lifestyle changes to limit/prevent recurrent episodes.
Nursing InterventionsRationale
Assess patient’s and SO’s understanding and previous methods of dealing with disease process.Enables the nurse to deal more realistically with current problems. Anxiety and other problems may have interfered with previous health teaching and patient learning.
Determine outside stressors (family, relationships, social or work environment).Stress can alter autonomic nervous response, affecting the immune system and contributing to exacerbation of disease. Even the goal of independence in the dependent patient can be an added stressor.
Provide opportunity for patient to discuss how illness has affected relationship, including sexual concerns.Stressors of illness affect all areas of life, and patient may have difficulty coping with feelings of fatigue and pain in relation to relationship and sexual needs.
Help patient identify individually effective coping skills.Use of previously successful behaviors can help patient deal with current situation and plan for future.
Provide emotional support:Active-Listen in a nonjudgmental manner;Maintain nonjudgmental body language when caring for patient;Assign same staff as much as possible.Aids in communication and understanding patient’s viewpoint. Adds to patient’s feelings of self-worth.Prevents reinforcing patient’s feelings of being a burden, (frequent need to empty bedpan or commode). Provides a more therapeutic environment and lessens the stress of constant adjustments.
Provide uninterrupted sleep and rest periods.Exhaustion brought on by the disease tends to magnify problems, interfering with ability to cope.
Encourage use of stress management skills, (relaxation techniques, visualization, guided imagery, deep-breathing exercises).Refocuses attention, promotes relaxation, and enhances coping abilities.
Include patient and SO in team conferences to develop individualized program.Promotes continuity of care and enables patient and SO to feel a part of the plan, imparting a sense of control and increasing cooperation with therapeutic regimen.
Administer medications as indicated: antianxiety agents, such as lorazepam (Ativan), alprazolam (Xanax).Aids in psychological and physical rest. Conserves energy and may strengthen coping abilities.
Refer to resources as indicated (local support group, social worker, psychiatric clinical nurse specialist, spiritual advisor).Additional support and counseling can assist patient and SO in dealing with specific stress and problem areas.
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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:

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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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