- Deficient Knowledge related to Inadequate knowledge about Crohn’s disease and Misinformation about remission and exacerbation of Crohn’s disease as evidenced by expressed concerns about Crohn’s disease and Worsening symptoms leading to exacerbations
- Diarrhoea related to Inflammation of the GI tract Irritation in the bowel and trigger foods that aggravate symptoms as evidenced by Abdominal cramping and Defecation more than three times a day
- Dysfunctional Gastrointestinal Motility related to Inflammatory process as evidenced by Abdominal distension and Altered bowel sounds
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: Verbalizes poor understanding Seeks additional information Denial of a need to learn Objective data: -Inaccurate demonstration or teach-back of instructions -Inability to recall instructions -Exhibiting aggression or irritability regarding teaching follow-up -Poor adherence to recommended treatment or worsening medical condition | Deficient Knowledge related to Inadequate knowledge about Crohn’s disease and Misinformation about remission and exacerbation of Crohn’s disease as evidenced by expressed concerns about Crohn’s disease and Worsening symptoms leading to exacerbations | Patient will be able to verbalize knowledge about Crohn’s disease and its signs and symptoms. Patient will list three trigger factors that can exacerbate Crohn’s disease. Patient will not experience an exacerbation of Crohn’s disease symptoms. | 1. Involve the patient in the development of the care plan. Patient engagement in the care plan will promote independence, commitment, and adherence to the prevention of exacerbations and management of symptoms of Crohn’s disease. 2. Welcome clarifications and questions. Patients with Crohn’s disease experience anxiety, embarrassment, fear, and powerlessness. Clarification and questions from patients should be encouraged and welcomed. An approachable manner will create a trusting environment between the nurse and patients. 3. Appreciate the patient’s efforts. Express appreciation for the patient’s efforts and commitment to their care plan. Adhering to the management of Crohn’s disease requires a lifetime commitment. When patients achieve their health goals, exacerbations and complications can be prevented. 4. Ask the patient to list the preventive measures for Crohn’s disease. Avoiding triggering factors is the best way to manage symptoms and prevent flare-ups. Evaluate the patient’s understanding by having them list factors that trigger their symptoms. 5. Refer to an IBD specialist. Inflammatory bowel disease (IBD) specialists deliver professional advice and expertise. They can answer inquiries and guide the patient about Crohn’s disease care. | |
| Subjective data: Abdominal pain Gas, bloating Urgency and frequency Objective data: -Hyperactive bowel sounds -Three or more loose stools per day -Blood or mucus in the stool | Diarrhoea related to Inflammation of the GI tract Irritation in the bowel and trigger foods that aggravate symptoms as evidenced by Abdominal cramping and Defecation more than three times a day | Patient will be able to manifest decreased urgency and frequency of stools less than 3 per day. Patient will report a more formed and solid stool consistency without the presence of blood. Patient will be able to express the alleviation of abdominal cramps. | 1. Maintain hydration. There is a risk of dehydration in Crohn’s disease due to diarrhea. It is essential to maintain proper hydration. Water, broth, soup, and rehydration solutions can be given orally. If severe, the patient may require inpatient admission with IV fluids. 2. Promote complete bed rest. Complete bed rest promotes the relaxation of gastric muscles and lowers peristaltic movements. 3. Encourage a clear liquid diet. To avoid dehydration during the acute phase of diarrhea, avoid oral intake that may trigger peristalsis and gradually increase clear fluid consumption. 4. Encourage a low-fiber and low-residue diet. Low-fiber and low-residue diets decrease bowel movements, urgency, and frequency of defecation. 5. Control the inflammation. Amino salicylates are used for mild inflammation in the gastrointestinal tract. Biologic therapies help the immune system to tame the inflammation of the intestines. Corticosteroids manage the swelling caused by moderate to severe Crohn’s disease. 6. Manage the symptoms. Acetaminophen relieves the pain in Crohn’s disease. Antibiotics target infections in the GI tract that could result in abscesses or fistulas. Loperamide is a short-term anti-diarrheal treatment. 7. Avoid the triggers. Avoid triggering factors such as food (dairy products, fatty and greasy foods), smoking, and medications (ibuprofen, naproxen, and aspirin) that can aggravate the symptoms. 8. Prepare for possible surgery. Most patients with Crohn’s disease eventually require surgery. Surgery can remove the scarred portion of the intestine and preserve the healthy sections. | Patient manifested decreased urgency and frequency of stools less than 3 per day. Patient reported a more formed and solid stool consistency without the presence of blood. Patient expressed the alleviation of abdominal cramps. |
| Subjective data: Verbalizes abdominal distention and discomfort Objective data: -Abdominal cramping -Abdominal distension -Abdominal pain -Altered bowel sounds -Chronic diarrhoea | Dysfunctional Gastrointestinal Motility related to Inflammatory process as evidenced by Abdominal distension and Altered bowel sounds | Patient will remain free from abdominal distention and discomfort. Patient will display formed, brown stools no more than twice per day. | 1. Administer prescribed medications as ordered. Depending on the severity of Crohn’s disease, 5-aminosalicylate (5-ASA) therapy is often indicated. These medications help control the symptoms and inhibit the production of substances that cause inflammation, allowing the gastrointestinal tract to heal and improve its function and motility. 2. Administer total parenteral nutrition as indicated. Nutritional deficits are common in patients with Crohn’s disease, further affecting normal gastrointestinal function and motility. During exacerbations, bowel rest is initiated by keeping the patient NPO and starting total parenteral nutrition (TPN). 3. Encourage the patient to avoid irritating foods and fluids. Once the patient is allowed to eat, encourage the patient to avoid foods and beverages that can further irritate the intestines as this can cause further issues with motility and aggravate symptoms of Crohn’s disease like diarrhoea, abdominal pain, and abdominal bloating. 4. Prepare the patient for surgery. Surgery in patients with Crohn’s disease is often indicated for those with complications like bleeding, fistula, obstructions, and strictures. Resolving these complications improves gastrointestinal function and motility. 5. Encourage alternative therapies for gut health. Patients with Crohn’s disease may benefit from alternative therapies like naturopathy, acupuncture, functional nutrition, hypnotherapy, and Ayurveda to relax and soothe the gastrointestinal tract. | Patient remained free from abdominal distention and discomfort. Patient expressed, brown stools no more than twice per day. |