You are taking care of a 37 year old male with Crohn’s disease. This is a new diagnosis for him, after months of weight loss, fever, and diarrhea. Considering this please address the following prompts in your discussion:
Pick one assessment finding you are likely to see during your examination of this patient. Examples could be, but not limited to, pain, alteration in nutrition, a specific lab alteration (hypokalemia, low H & H, etc)
How does this finding compare to what you would find in a normal adult male exam?
Explain the pathophysiology of this finding.
Discuss the specific nursing assessment related to the selected alteration.
Discuss the nursing care you would implement to promote health.
How to solve
University of Southern California Health & Medical Discussion
In this case, we are presented with a 37-year-old male who has been diagnosed with Crohn’s disease. As the medical professor, we will analyze and discuss various aspects related to this patient’s assessment findings, their comparison to a normal adult male exam, the pathophysiology behind these findings, the specific nursing assessment related to the selected alteration, and the nursing care that should be implemented to promote the patient’s health.
1. Assessment Finding:
One assessment finding that is commonly seen in patients with Crohn’s disease is malnutrition. This finding is characterized by a significant alteration in nutrition and can be attributed to the chronic inflammation, reduced absorption of nutrients, and increased metabolic demands associated with the disease.
2. Comparison to a Normal Adult Male Exam:
In a normal adult male exam, malnutrition would not be commonly encountered. A healthy individual would typically have adequate intake and absorption of nutrients, leading to a normal nutritional status. However, in a patient with Crohn’s disease, malnutrition is a common finding due to various factors related to the disease pathology.
3. Pathophysiology of Malnutrition in Crohn’s Disease:
The pathophysiology of malnutrition in Crohn’s disease is multifactorial. The chronic inflammation within the gastrointestinal tract leads to tissue damage and disruption of the normal structure and function, impairing the absorption of essential nutrients. Additionally, Crohn’s disease commonly affects the small intestine, which is responsible for absorption of crucial vitamins, minerals, and other nutrients. The presence of ongoing diarrhea exacerbates the malabsorption issue, leading to further nutrient loss.
4. Nursing Assessment Related to Malnutrition:
Nursing assessment for a patient with malnutrition in Crohn’s disease should evaluate the patient’s dietary intake, weight history, and body mass index (BMI). Monitoring of laboratory values such as serum albumin levels, pre-albumin levels, and total lymphocyte counts can provide additional information about the patient’s nutritional status. Assessing for signs and symptoms related to vitamin and mineral deficiencies, such as dry skin, brittle nails, and poor wound healing, can guide further interventions.
5. Nursing Care to Promote Health:
To promote health in a patient with malnutrition in Crohn’s disease, nursing care should focus on addressing the underlying causes of malnutrition and optimizing the patient’s nutritional status. This can involve collaborating with a registered dietitian to develop a personalized dietary plan that is rich in essential nutrients and easy to digest. Regular monitoring of weight and BMI should be conducted to track progress. In severe cases, nutritional supplementation via enteral or parenteral routes may be necessary. Additionally, educating the patient about the importance of proper nutrition, adherence to medication regimens, and self-care measures becomes crucial.
By implementing comprehensive nursing care and addressing the specific needs of a patient with malnutrition in Crohn’s disease, we can help improve their overall health and well-being.
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