Answer Happy

Case Study Inflammatory Bowel Disease and Intestinal Obstruction Madison Jones is a 22 year old female with a history of Crohn's disease. She was brought into the ER with complaints of severe abdominal pain. Medical History: appendectomy 10 years ago; Crohn's disease for 5 years with multiple hospitalizations for flare ups. Current Medications: oral contraceptives, Pepcid OTC, Sulfasalazine (Azulfidine), Infliximab (Remicade) 1. What objective and subjective data does the nurse gather first? Choose the top 3. (vital signs count as 1). Stop after #1 and get assessment results from instructor 100/62, 106, 22, 99.9, alert and oriented, pain all quads of Abd for 3 days, worsens with food 2. List the remaining subjective and objective data that the nurse should gather. Stop after #2 and get assessment results from instructor Diarrhea: light brown, 8 times per day for 3 days, started out thick but has changed to watery; skin dry and hot, Abd. Distended, firm and tender to light palpation, 1cm round open area in right lower quad that is draining stool, BMI low 3. Is the nurse surprised that Madison does not have hematochezia ? Explain. (hint: do not over think this one). 4. Explain why Madison's BMI might be low.
5. Based on the information gathered from #1 and #2, list priority collaborative interventions. a. What should we do (nursing and medical)? b. What should we teach? c. What should we assess/monitor? d. What consults are needed (interdisciplinary care)? 6. An MRI is completed. It shows an obstruction in the ileum. Explain what is occurring and why. 7. A nasogastric tube to low continuous suction is placed by the nurse. What is the purpose and benefit of NG tube placement and suction? List the associated nursing care. 8. Madison has a strictureplasty (minimally invasive) and IV fluid replacement. What discharge planning/teaching is required for her?