Podcast
Questions and Answers
Which of the following is a common characteristic of both Crohn's disease and ulcerative colitis?
Which of the following is a common characteristic of both Crohn's disease and ulcerative colitis?
- Associated with fistula formation
- Limited to mucosal layer inflammation
- Involves only the colon
- Causes chronic inflammation of the GI tract (correct)
Which of the following are key differences between Crohn's disease and ulcerative colitis? (Select all that apply)
Which of the following are key differences between Crohn's disease and ulcerative colitis? (Select all that apply)
- Ulcerative colitis affects all layers of the bowel wall
- Ulcerative colitis presents with continuous lesions (correct)
- Crohn's disease is curable with surgery
- Crohn's can affect the entire GI tract (correct)
- Cobblestone appearance is typical in Crohn's (correct)
Which finding best differentiates Crohn's disease from ulcerative colitis?
Which finding best differentiates Crohn's disease from ulcerative colitis?
- Presence of blood in stool
- Continuous inflammation in the colon
- RLQ pain and skip lesions (correct)
- Onset during adolescence
A nurse is assessing a patient with a new diagnosis of ulcerative colitis. Which findings should the nurse expect? (Select all that apply)
A nurse is assessing a patient with a new diagnosis of ulcerative colitis. Which findings should the nurse expect? (Select all that apply)
A patient reports symptoms of chronic diarrhea, RLQ pain, and significant weight loss. Lab tests reveal anemia and low albumin. What is the most likely diagnosis?
A patient reports symptoms of chronic diarrhea, RLQ pain, and significant weight loss. Lab tests reveal anemia and low albumin. What is the most likely diagnosis?
Which surgical procedure is most commonly used for ulcerative colitis?
Which surgical procedure is most commonly used for ulcerative colitis?
Which of the following statements best describes the pathophysiology of Crohn's disease?
Which of the following statements best describes the pathophysiology of Crohn's disease?
What is the hallmark appearance of the intestinal mucosa in Crohn's disease during endoscopy?
What is the hallmark appearance of the intestinal mucosa in Crohn's disease during endoscopy?
Which of the following are common signs and symptoms of ulcerative colitis? (Select all that apply)
Which of the following are common signs and symptoms of ulcerative colitis? (Select all that apply)
A patient presents with steatorrhea, fatigue, and RLQ tenderness. What condition should the nurse suspect?
A patient presents with steatorrhea, fatigue, and RLQ tenderness. What condition should the nurse suspect?
Which areas of the GI tract may be affected in Crohn's disease? (Select all that apply)
Which areas of the GI tract may be affected in Crohn's disease? (Select all that apply)
In ulcerative colitis, inflammation is limited to which part of the gastrointestinal wall?
In ulcerative colitis, inflammation is limited to which part of the gastrointestinal wall?
A nurse is analyzing a client's symptoms: low-grade fever, weight loss, intermittent diarrhea, and cramping abdominal pain with malnutrition. What is the most likely underlying mechanism?
A nurse is analyzing a client's symptoms: low-grade fever, weight loss, intermittent diarrhea, and cramping abdominal pain with malnutrition. What is the most likely underlying mechanism?
A patient with Crohn's disease is experiencing symptoms of malnutrition. Which factors may contribute to this? (Select all that apply)
A patient with Crohn's disease is experiencing symptoms of malnutrition. Which factors may contribute to this? (Select all that apply)
A patient with ulcerative colitis is having 10–12 episodes of bloody diarrhea daily. Which electrolyte imbalance is the priority concern?
A patient with ulcerative colitis is having 10–12 episodes of bloody diarrhea daily. Which electrolyte imbalance is the priority concern?
What is the primary goal of nursing care during an acute exacerbation of ulcerative colitis?
What is the primary goal of nursing care during an acute exacerbation of ulcerative colitis?
Which nursing interventions are appropriate for a patient with Crohn's disease during a flare-up? (Select all that apply)
Which nursing interventions are appropriate for a patient with Crohn's disease during a flare-up? (Select all that apply)
A nurse is caring for a patient with IBD who is scheduled for a colonoscopy. Which of the following pre-procedure actions is most important?
A nurse is caring for a patient with IBD who is scheduled for a colonoscopy. Which of the following pre-procedure actions is most important?
Which discharge teaching point is most important for a patient newly diagnosed with ulcerative colitis?
Which discharge teaching point is most important for a patient newly diagnosed with ulcerative colitis?
Which are appropriate dietary recommendations for a patient with inflammatory bowel disease? (Select all that apply)
Which are appropriate dietary recommendations for a patient with inflammatory bowel disease? (Select all that apply)
Which lab value is important to monitor in a patient with chronic ulcerative colitis?
Which lab value is important to monitor in a patient with chronic ulcerative colitis?
Which of the following patient teaching points are important for a client with a new ileostomy following UC surgery? (Select all that apply)
Which of the following patient teaching points are important for a client with a new ileostomy following UC surgery? (Select all that apply)
A patient asks, “Why do I need to avoid milk products with this condition?” What is the best response?
A patient asks, “Why do I need to avoid milk products with this condition?” What is the best response?
A nurse reviews lab results for a patient with Crohn's disease: WBC 14,000; Hgb 10 g/dL; Albumin 2.9 g/dL. What should the nurse do first?
A nurse reviews lab results for a patient with Crohn's disease: WBC 14,000; Hgb 10 g/dL; Albumin 2.9 g/dL. What should the nurse do first?
A nurse is caring for a patient hospitalized for IBD exacerbation. Which assessments require immediate attention? (Select all that apply)
A nurse is caring for a patient hospitalized for IBD exacerbation. Which assessments require immediate attention? (Select all that apply)
Which of the following complications is more commonly associated with Crohn's disease than ulcerative colitis?
Which of the following complications is more commonly associated with Crohn's disease than ulcerative colitis?
A patient with ulcerative colitis is at greatest risk for developing which of the following complications?
A patient with ulcerative colitis is at greatest risk for developing which of the following complications?
Which of the following lab values may be abnormal in patients with active IBD? (Select all that apply)
Which of the following lab values may be abnormal in patients with active IBD? (Select all that apply)
A patient with Crohn's disease is experiencing severe diarrhea and fatigue. Which lab value should the nurse monitor most closely?
A patient with Crohn's disease is experiencing severe diarrhea and fatigue. Which lab value should the nurse monitor most closely?
Which medications are commonly used in the treatment of inflammatory bowel disease? (Select all that apply)
Which medications are commonly used in the treatment of inflammatory bowel disease? (Select all that apply)
A patient taking corticosteroids for UC reports new bruising and facial swelling. What is the nurse's best response?
A patient taking corticosteroids for UC reports new bruising and facial swelling. What is the nurse's best response?
Which action is most important before administering infliximab (Remicade) to a patient with Crohn's disease?
Which action is most important before administering infliximab (Remicade) to a patient with Crohn's disease?
What are potential side effects of immunosuppressant therapy in IBD? (Select all that apply)
What are potential side effects of immunosuppressant therapy in IBD? (Select all that apply)
Which vitamin deficiency is most associated with Crohn's disease involving the terminal ileum?
Which vitamin deficiency is most associated with Crohn's disease involving the terminal ileum?
A nurse is preparing to administer mesalamine (5-ASA). What should be included in patient education? (Select all that apply)
A nurse is preparing to administer mesalamine (5-ASA). What should be included in patient education? (Select all that apply)
Why might a patient with ulcerative colitis be placed on total parenteral nutrition (TPN)?
Why might a patient with ulcerative colitis be placed on total parenteral nutrition (TPN)?
A patient with IBD has developed iron deficiency anemia. What is the most likely cause?
A patient with IBD has developed iron deficiency anemia. What is the most likely cause?
Which assessments are important to monitor for patients receiving corticosteroids long-term for IBD? (Select all that apply)
Which assessments are important to monitor for patients receiving corticosteroids long-term for IBD? (Select all that apply)
A nurse notes a patient with UC has abdominal distention, tachycardia, and no bowel sounds. What complication should the nurse suspect?
A nurse notes a patient with UC has abdominal distention, tachycardia, and no bowel sounds. What complication should the nurse suspect?
A nurse is evaluating a patient's response to infliximab. Which findings suggest effectiveness of therapy? (Select all that apply)
A nurse is evaluating a patient's response to infliximab. Which findings suggest effectiveness of therapy? (Select all that apply)
Which antibiotic is sometimes used short-term for complications of Crohn's disease like fistulas or abscesses?
Which antibiotic is sometimes used short-term for complications of Crohn's disease like fistulas or abscesses?
A patient with Crohn's disease presents with fever, localized abdominal pain, and guarding. What is the nurse's priority?
A patient with Crohn's disease presents with fever, localized abdominal pain, and guarding. What is the nurse's priority?
Which complications are more common in Crohn's disease than in ulcerative colitis? (Select all that apply)
Which complications are more common in Crohn's disease than in ulcerative colitis? (Select all that apply)
A patient on azathioprine for Crohn's disease reports a sore throat and fatigue. What is the priority nursing action?
A patient on azathioprine for Crohn's disease reports a sore throat and fatigue. What is the priority nursing action?
A patient with IBD is being discharged on long-term corticosteroids. Which statement by the patient indicates a need for further teaching?
A patient with IBD is being discharged on long-term corticosteroids. Which statement by the patient indicates a need for further teaching?
Flashcards
Common characteristic of Crohn's and UC
Common characteristic of Crohn's and UC
Both Crohn's disease and ulcerative colitis cause long-term inflammation of the GI tract.
Key differences between Crohn's and UC
Key differences between Crohn's and UC
Crohn's can affect any part of the GI tract with patchy lesions; UC is continuous and limited to the colon and mucosa.
Differentiating Crohn's from UC
Differentiating Crohn's from UC
RLQ pain and skip lesions (non-continuous areas of inflammation) are classic.
Expected findings in Ulcerative Colitis (UC)
Expected findings in Ulcerative Colitis (UC)
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Chronic diarrhea, RLQ pain, and weight loss cause
Chronic diarrhea, RLQ pain, and weight loss cause
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Common surgical procedure for UC
Common surgical procedure for UC
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Pathophysiology of Crohn's disease
Pathophysiology of Crohn's disease
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Hallmark appearance of intestinal mucosa in Crohn's
Hallmark appearance of intestinal mucosa in Crohn's
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Common signs and symptoms of UC
Common signs and symptoms of UC
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Steatorrhea, fatigue, and RLQ tenderness
Steatorrhea, fatigue, and RLQ tenderness
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Areas of GI tract affected in Crohn's disease
Areas of GI tract affected in Crohn's disease
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Inflammation limited in UC
Inflammation limited in UC
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Underlying mechanism: Low fever, weight loss, intermittent diarrhea, cramping
Underlying mechanism: Low fever, weight loss, intermittent diarrhea, cramping
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Factors contributing to malnutrition in Crohn's
Factors contributing to malnutrition in Crohn's
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Electrolyte imbalance priority in UC with bloody diarrhea
Electrolyte imbalance priority in UC with bloody diarrhea
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Primary goal of nursing care during UC
Primary goal of nursing care during UC
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Assessments for IBD needing immediate attention
Assessments for IBD needing immediate attention
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Complication common with Crohn's
Complication common with Crohn's
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Greatest risk complication in UC
Greatest risk complication in UC
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Lab value for Crohn's + diarrhea
Lab value for Crohn's + diarrhea
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Study Notes
Similarities Between Crohn's Disease and Ulcerative Colitis
- Both Crohn's disease and ulcerative colitis cause chronic inflammation of the GI tract.
Key Differences Between Crohn's Disease and Ulcerative Colitis
- Crohn's disease can affect any part of the GI tract, while ulcerative colitis is limited to the colon and mucosa.
- Crohn's disease can cause patchy lesions (cobblestoning), while ulcerative colitis presents with continuous lesions.
- Neither Crohn's disease nor ulcerative colitis is curable, but symptoms can be managed.
Differentiation of Crohn’s Disease from Ulcerative Colitis
- RLQ pain and skip lesions are classic for Crohn’s disease because the inflammation is non-continuous.
Ulcerative Colitis: Expected Findings
- Frequent bloody diarrhea, weight loss, and abdominal cramping are typical.
- Cobblestoning and fistulas are not as commonly associated with ulcerative colitis compared to Crohn’s.
Crohn’s Disease: Characteristic Symptoms
- Chronic diarrhea, right lower quadrant (RLQ) pain, and significant weight loss are indicative of Crohn's.
- Anemia and low albumin levels can occur.
Ulcerative Colitis: Surgical Procedures
- Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is commonly used when medications fail and to provide curative purposes.
Crohn's Disease Pathophysiology
- Characterized by transmural inflammation with "skip" lesions throughout the GI tract
Endoscopic Findings in Crohn’s Disease
- A cobblestone pattern appearance is a hallmark due to deep ulcerations and edema.
Ulcerative Colitis: Common Signs and Symptoms
- Bloody diarrhea, urgency to defecate, and tenesmus are common signs.
- Fistula formation is rare in ulcerative colitis but common in Crohn's disease.
Crohn's Disease: Typical Symptoms
- Steatorrhea (fatty stool) and RLQ pain are more typical because of malabsorption and ileal involvement.
Crohn's Disease: Affected Areas of the GI Tract
- May affect any part of the GI tract from mouth to anus, excluding the esophagus.
Ulcerative Colitis: Affected Areas of the Intestinal Wall
- Primarily affects the mucosa and submucosa layers of the colon.
Classic Crohn's Symptoms
- Low-grade fever, weight loss, intermittent diarrhea, cramping abdominal pain, and malnutrition are common.
- Symptoms stem from inflammation through all layers of the bowel wall.
Malnutrition in Crohn's Disease
- Impaired absorption in the ileum, chronic blood loss, steatorrhea, and fistula formation contribute to malnutrition.
Ulcerative Colitis: Electrolyte Imbalance
- Hypokalemia (potassium loss) is a common complication due to chronic diarrhea.
Acute Ulcerative Colitis: Nursing Care
- Reducing inflammation and promoting bowel rest via diet modifications, medications, and supportive care.
Nursing Interventions for Crohn's Disease Flare-Up
- Monitoring intake/output and daily weight is essential.
- Corticosteroids, bowel rest (NPO if ordered), and stress management are appropriate.
- Raw fruits/vegetables can irritate during flares.
IBD and Colonoscopy
- Bowel prep is essential for a clear view of the colon during colonoscopy, particularly in patients with IBD.
Ulcerative Colitis: Key Discharge Teaching
- Report any signs of blood in stool or increased diarrhea promptly.
Inflammatory Bowel Disease: Dietary Recommendations
- High protein and high-calorie intake is needed due to malnutrition.
- Low-fiber is preferred during exacerbations.
- Eliminate dairy products if lactose intolerant.
Ulcerative Colitis: Lab Values
- Hemoglobin is important to monitor due to blood loss from ulceration which can cause anemia.
New Ileostomy: Key Education Points
- Change the pouch every 3-5 days and expect liquid stool output.
- Avoid high-residue foods like corn and nuts and monitor skin around the stoma for irritation.
Lactose Intolerance and IBD
- Lactose intolerance can worsen diarrhea and abdominal discomfort.
Crohn's Disease: Analyzing Lab Results
- Assess dietary intake and weight to guide interventions and referrals when inflammation is present and anemia and malnutrition have been flagged from lab results.
IBD Exacerbation: Immediate Attention Needed
- Tachycardia, low BP, and reduced urine output suggest dehydration or hypovolemia, which is a priority.
Crohn’s Disease Complications
- Fistula formation is more common in Crohn's due to transmural inflammation.
Ulcerative Colitis Complications
- Toxic megacolon (severe dilation of the colon) is a life-threatening complication more often seen in UC.
IBD: Abnormal Lab Values
- Elevated C-reactive protein (CRP), decreased hemoglobin, increased ESR, and low potassium may occur.
- Albumin is usually decreased, not elevated.
Crohn's Disease: Lab Monitoring
- Monitor potassium levels closely because potassium loss is common with frequent diarrhea and can lead to cardiac arrhythmias and muscle weakness.
Inflammatory Bowel Disease: Medications
- Sulfasalazine, corticosteroids, immunomodulators (e.g., azathioprine), and antidiarrheals are commonly prescribed.
- Anticholinergics are avoided due to the risk of toxic megacolon.
Corticosteroids for Ulcerative Colitis
- New bruising and facial swelling may indicate Cushing's syndrome from long-term steroid use.
Infliximab (Remicade) for Chron's Disease
- Patients must be screened for latent TB prior to administration due to risk of reactivation as an immunosuppressant
Immunosuppressant Therapy in IBD: Side Effects
- Potential side effects include increased infection risk, bone marrow suppression, and nausea and vomiting.
Crohn's Disease: Vitamin Deficiency
- Vitamin B12 deficiency is commonly associated with Crohn's disease involving the terminal ileum as B12 absorption occurs here.
Patient Education: Mesalamine (5-ASA)
- Should report any signs of kidney dysfunction and continue the medication even during remission.
- Take with a full glass of water.
Total Parenteral Nutrition in Ulcerative Colitis
- TPN may be used to provide nutrition during severe UC exacerbations when oral intake is not tolerated.
Iron Deficiency Anemia in IBD
- Chronic blood loss from ulcerated intestinal mucosa is the most common cause.
Long-Term Corticosteroids for IBD: Monitoring
- Monitor blood glucose levels, signs of infection, peripheral edema, and mood changes.
- Corticosteroids can cause hyperglycemia, immune suppression, fluid retention, and mood disturbances.
Ulcerative Colitis: Severe Complication
- Toxic megacolon is characterized by colonic dilation, systemic symptoms, and absence of bowel sounds.
Evaluating Infliximab Effectiveness
- Decreased number of stools, reduced C-reactive protein, weight gain, and no blood in stool indicate effective therapy.
Crohn's Disease: Antibiotics
- Metronidazole is a possible solution for anaerobic infections or abscesses.
Crohn's Disease: Nurse Priority
- Fever, localized abdominal pain, and guarding may indicate perforation or intra-abdominal abscess.
- Notify the provider immediately.
Crohn's Disease: Common Complications
- Malnutrition, fistula formation, perianal abscess, and small bowel obstruction stem from transmural inflammation.
- Colon cancer risk is higher in long-term UC.
Azathioprine for Crohn’s Disease
- A sore throat and fatigue could indicate bone marrow suppression or infection like azathioprine.
- The provider must be notified.
Long-Term Corticosteroids for IBD
- Corticosteroids must be tapered and not stopped or skipped abruptly to avoid adrenal crisis.
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