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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Deficient Knowledge

Nursing Diagnosis

May be related to

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  • Information misinterpretation, lack of recall
  • Unfamiliarity with resources

Possibly evidenced by

  • Questions, request for information, statements of misconceptions
  • Inaccurate follow-through of instructions
  • Development of preventable complications/exacerbations

Desired Outcomes

  • Verbalize understanding of disease processes, possible complications.
  • Identify stress situations and specific action(s) to deal with them.
  • Verbalize understanding of therapeutic regimen.
  • Participate in treatment regimen.
  • Initiate necessary lifestyle changes.
Nursing InterventionsRationale
Determine patient’s perception of disease process.Establishes knowledge base and provides some insight into individual learning needs.
Review disease process, cause and effect relationship of factors that precipitate symptoms, and identify ways to reduce contributing factors. Encourage questions.Precipitating or aggravating factors are individual; therefore, patient needs to be aware of what foods, fluids, and lifestyle factors can precipitate symptoms. Accurate knowledge base provides opportunity for patient to make informed decisions and choices about future and control of chronic disease. Although most patients know about their own disease process, they may have outdated information or misconceptions.
Review medications, purpose, frequency, dosage, and possible side effects.Promotes understanding and may enhance cooperation with regimen.
Remind patient to observe for side effects if steroids are given on a long-term basis (ulcers, facial edema, muscle weakness).Steroids may be used to control inflammation and to effect a remission of the disease; however, drug may lower resistance to infection and cause fluid retention.
Stress importance of good skin care (proper handwashing techniques and perineal skin care).Reduces spread of bacteria and risk of skin irritation or breakdown, infection.
Recommend cessation of smoking.Can increase intestinal motility, aggravating symptoms.
Emphasize need for long-term follow-up and periodic reevaluation.Patients with IBD are at increased risk for colon or rectal cancer, and regular diagnostic evaluations may be required.
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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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