I have an Ulcerative Colitis patient to care for tomorrow. Questions about diet?

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So tomorrow, I'm assigned to care for a patient on the med/surg floor with an admitting diagnosis of "Ulcerative Colitis with Exacerbation". Simple enough, right?

The patient's charts say their diet is "Soft, low fiber". So what should I be doing when their breakfast and lunch come in (other than measuring the Is and Os)? Am I supposed to puree any food? Or can they eat it as is?

Okay, so now I need a little help on my Client Data Base (CDB).

It says: "1) Describe the client and 2) the situation (Is the client at higher risk than average for complications (ie. DM, elderly, etc)? List and briefly explain the reasons why. List factors that might decrease risk.)"

So I described the client (i.e., the client is a such-and-such year old Caucasian female with an exacerbation of ulcerative colitis, etc. etc."

But I need help on "2) the situation." What am I supposed to write for this?

For instance, the patient's chart showed that she uses an antidepressant medication, and has had previous surgeries (cholecystectomy, ganglion cyst removal, tubal ligation, bladder sling).

But HOW am I going to tie that stuff into the diagnosis's risk factors?

If a person has a history of clinical depression, wouldn't that put them at a greater risk for Anxiety, which would thus precipitate another exacerbation of UC?

And for the previous surgeries, how do I tell which ones could and couldn't affect her UC?

I feel so lost :/

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Is this the same patient or a new one?

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same pt

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

What is ulcerative colitis? Ulcerative Colitis - National Digestive Diseases Information Clearinghouse

What are the complications of ulcerative colitis? Ulcerative colitis - MayoClinic.com

  • Severe bleeding
  • A hole in the colon (perforated colon)
  • Severe dehydration
  • Liver disease (rare)
  • Kidney stones
  • Osteoporosis
  • Inflammation of skin, joints and eyes
  • An increased risk of colon cancer
  • A rapidly swelling colon (toxic megacolon)

what meds are they on? what are the side effects of those meds? What are the effects of long term chronic disease on the psyche?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Coping

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

has had previous surgeries (cholecystectomy, ganglion cyst removal, tubal ligation, bladder sling).

But HOW am I going to tie that stuff into the diagnosis's risk factors?

And for the previous surgeries, how do I tell which ones could and couldn't affect her UC? Tubal is birth control. Bladder sling is from having babies. Gaglion cyst is on the wrist and the Gallbladder? incidental.

What else do you know? :brb:

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Hmmmm. So when it says "Factors that DECREASE risk", what does that mean?

Let me go out there and suppose our patient had HIV (purely made-up) instead of UC.

The factors that INCREASE risk would be 'men who have sex with men', 'not using protection', 'also using drugs'. Factors that DECREASE risk would be 'using a condom', 'not sharing needles', etc.

But how can there be factors that decrease the risk of UC exacerbation? I don't get it.

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Specializes in OB/NICU.
Hmmmm. So when it says "Factors that DECREASE risk", what does that mean?

Let me go out there and suppose our patient had HIV (purely made-up) instead of UC.

The factors that INCREASE risk would be 'men who have sex with men', 'not using protection', 'also using drugs'. Factors that DECREASE risk would be 'using a condom', 'not sharing needles', etc.

But how can there be factors that decrease the risk of UC exacerbation? I don't get it.

Just to name a few:

Following the appropriate diet, reducing stress, following prescribed medication regimens, keeping scheduled follow up appts with PCP,etc ....are ways to decrease the risks of a UC flair up.

Think of it like this:

What can cause a UC flair up? Not doing those things decreases your risks..

Hope that helps you...

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

If you click on the links I provided to you......they will give you what you need.

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Okay, I looked through those links, and they did help a bit. Thanks for that.

I now need some help for the labs. On my CDB sheet, it says this:

"1) List abnormal and significant "Normal" lab values. Include pertinent changes over time.* 2) include possible rationale for these changes and 3) collaborative & nursing interventions for each change. Cite reference.

* For example: If hemoglobin & hematocrit (H&H) have fluctuated over last week, explain why. If unsure, list possible reasons and give rationale. Include implications for nursing care of this client."

So I'm looking over the lab values. The AST (84) and the ALT (180) are way way elevated, but I can't figure out why. Don't those two lab thingies have to do with the liver? But when I felt for this patient's liver, I couldn't feel it. What's up with that?

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But what if they go to the toilet when I'm not in the room and void and then flush?

You bring in a hat into the patient's room. Show the patient the hat and tell them that you will be putting this on the toilet. Tell them you want them to urinate in it because you want to measure their output. Also-- keep in mind that it's very common to see blood in the stool of somebody who has ulcerative colitis. You can ask your patient if they noticed this the last time they had a bowel movement.

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I had UC until my ileostomy. Using the hat is so embarrassing for patients. But they're all correct, the patient should know what their trigger foods are.

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