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
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 Interventions | Rationale |
|---|---|
| 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. |
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