NR 324 Week 6 RUA Case Study Presentation_Crohn s Disease

RUA Crohn’s Disease Crohn’s Disease An inflammatory bowel disorder called Crohn's disease results in long-term inflammation of the gastrointestinal tract (Overview of Crohn's disease, 2022). The mouth to the anus is all possible locations for Crohn's disease to develop in the GI tract. Usually, the proximal colon and distal ileum are affected. Health History Ashley Fernandez is a 25-year-old Caucasian female who was diagnosed with Crohn’s disease about a year ago. A.F. reports that there is a family history of Crohn’s disease and her grandfather was diagnosed when he was a teenager as well. The patient stated that she smokes four to five cigarettes a day and she is a social drinker but denies using any drugs. The patient has an allergy to latex. The patient came into the emergency room with severe stomach pain, blood in the stool, nausea, diarrhea, and slight weight loss. She seemed to be in pain and stated that her pain level is an 8 out of 10. A physical exam showed that she had a temperature of 38.5 °C, a blood pressure of 101/62, and a heart rate of 100 bpm. The heart and lungs were normal. On mild probing, her epigastrium seemed subjectively painful; however, her abdomen was soft. She also felt rebound pain and a little sensitivity in her right bottom area. She stated that she had an endoscopy done about a year ago when she was in the hospital for a Crohn’s flare-up. During the perirectal examination, areas of scars consistent with previous fistulous tracts were discovered. Skin and neurological tests were negative. She also has a past history of anemia with low levels of hemoglobin and red blood cells. Laboratory/Diagnostic Testing RUA Crohn’s Disease The goal of collaborative care for the patient is to control her inflammatory process, relieve symptoms, correct metabolic and nutritional problems, and promote healing. Drug therapy and nutritional support are the mainstays of the treatment. Treatment Plan Based on the patient’s labs, exams, and symptoms, I would place her in a mild to the moderate range to determine medication therapy. For present diarrhea the patient is experiencing, I will start her on Mesalamine along with Imodium as ordered by her physician to also help reduce her inflammation. Aminosalicylates are used to treat mild to severe acute flare- ups and to keep IBD symptoms under control (Arcangelo et al., 2017). Immune system suppressors like azathioprine, mercaptopurine, cyclosporine, and methotrexate are part of the second line of treatment. These drugs suppress the immune response that causes the lining of the intestines to release chemicals that cause inflammation (Mayo, 2020). Due to her low hemoglobin and high white blood cell count, she will need to take an iron treatment as well as an antibiotic like Cipro. The doctor ordered enteral feeding for the patient to promote bowel rest while supplying her with proper nutrients. For some patients, a combination of drugs will be required, such as antibiotics like Cipro or Flagyl, an anti-diarrheal, painkillers like Tylenol, iron supplements, calcium