CROHN’S DISEASE
WHAT IS IT?
A form of chronic inflammatory bowel disease, in which
parts of the digestive tract become inflamed. This disease
may affect either the small or large intestine.
INCIDEN CE:
Crohn’s disease occurs most commonly in men than
women. Usually, the age of onset is between 10-35 years
of age. About 7 of every 100,000 people in the USA have
Crohn’s disease.
RISK FACTORS:
There are many risk factors that may contribute to Crohn’s
disease, but the cause is unknown. Certain risk factors that
can be identified include age, ethnicity, family history,
cigarette smoking, area of residency (increased risk in
urbanized areas), & one’s immune response to intestinal
bacteria.
PATHOPHYSIOLOGY:
Crohn’s disease is an inflammatory disorder. This disease
affects the digestive tract (small/large intestine, or colon)
location varies greatly for each person. Inflammation is
thought to begin in the sub mucosa and spreads to the
mucosa and serosa. Tissue injury is due to the activated
neutrophils and macrophages (white blood cells) in the
body, which promote inflammation. This process of
inflammation is thought to be caused from increased levels
of interferon-gamma and tumor necrosis factor-alpha in
one’s body
.
REFERENCES
Crohn's disease - National Library of Medicine - PubMed
Health. (2012, October 29). National Center for
Biotechnology Information. Retrieved April 16,
2013, from
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH
0001295/
Davidson, T., Newton, D., & Frey, R. (2011). Crohn's disease. In
L. J. Fundukian (Ed.), Gale Encyclopedia of
Medicine, Vol. 2.
(4th ed.). Detroit: Gale. Retrieved April 19,
2013, from NRCX via Gale:
http://-find.galegroup.com.libcat.ferris.edu
/nrcx/start.do?prodId=NRC
CROHN’S
DISEASE
STEPHANIE TWAIT
NURS 300
Elsevier NCLEX Exam Practice Question of the Week: NCLEX
Exam Practice Question of the Week - 03/16/11.
(n.d.). Elsevier NCLEX Exam Practice Question of
the Week. Retrieved April 16, 2013, from
http://elseviernclexreview.blogspot.com/2011/03/
nclex-exam-practice-question-of-week_16.html
Gastrointestinal Diseases NCLEX Review Questions Part 1 RNpedia.com . (n.d.). RNpedia.com . Retrieved
April 16, 2013, from
http://www.rnpedia.com/home/exams/nclexexam/gastrointestinal-diseases-nclex-reviewquestions-part-1
Huether, Sue E., and Kathryn L. McCance. "Alterations of
Digestive Function." Understanding
Pathophysiology. St. Louis, Mo: Elsevier, 2012.
909-10. Print.
Ladwig, G., & Ackley, B. (2011). Mosbey’s guide to nursing
diagnosis. (3 ed.). Maryland Heights, MS: Mosby
Elsevier.
Wexler, Barbara. "Crohn's disease." Gale Encyclopedia of
Nursing and Allied Health. Ed. Jacqueline L.
Longe. Vol. 1. 2nd ed. Detroit: Thomson Gale,
2006. Nursing Resource Center. Gale. Ferris State
University Library. 19 Apr. 2013
http://0-find.galegroup.com.libcat.ferris.edu/
nrcx/infomark.do?&source=gale&prodId=NRC&
userGroupName=lom_ferrissu&tabID=T001&
docId=DB2621410216&type=retrieve&content
Set=GREF&version=1.0
Image from The University of Florida Academic
Health Center Website:
https://ufandshands.org/crohns-disease
CLINI CAL MANIFESTATI ONS:
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Diarrhea(persistent/watery)
Bloody stool
Abdominal Pain/cramping
Fatigue
Anorexia
Loss of appetite
Fever
Joint pain
Arthritis
Mouth sores/ulcers
Eye inflammation
POTENTIAL COMPLICATI ONS:
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Fistulas (internal or external)
Ulcers
Bowel Obstruction
Malnutrition
Anal fissure
Colon cancer
LIFE SPAN:
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Crohn’s can interfere with growth and
development in children.
May affect school, social, and family life for
children.
CULTURAL CONSIDERATIONS
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More prevalent in whites, than African
Americans or Asian Americans.
2 to 4 times more likely among Jewish people
than any other ethnic group.
POTENTIAL OUT COMES
Outcomes expected for patients in relation to the previous
diagnosis include maintaining a steady weight, identifying
foods that negatively affect their GI system, identify
nutritional requirements, identify own pain & establish a
comfortable level, report pain regimens that alleviate pain
to a comfortable level, identify uncontrollable factors
related to their health, participate in planning, and
verbalize hope for the future.
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No cure for Crohn’s disease.
Treatment is supportive, not curative.
Treatment varies greatly for each patient and
depends on what part of digestive tract is
affected.
Goals of treatment are to manage symptoms,
put the disease in remission, and avoid relapse.
Recommended to eat a low-residual diet (low in
fiber & hard to digest foods) Children with
Crohn’s may need a high-caloric/nutrient diet
due to vitamin and mineral deficiencies.
Avoid foods that cause flare ups (specific to
each person)
Patient’s usually take medications to alleviate
pain and discomfort.
Surgery to remove diseased part of the
digestive tract.
HEALTH CARE PROFESSI ONALS ON YOUR TEAM
Patient’s may want, need, or have many different health
care professionals in dealing with Crohn’s disease. These
professionals include:

Imbalanced nutrition: less than body
requirements r/t diarrhea and altered ability to
digest and absorb food.
Acute pain r/t increased peristalsis
Powerlessness r/t chronic disease.
1.
2.
TREATMENT
NURSING D IAGNOSIS
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NCLEX QUESTIONS
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Primary health care provider or
gastroenterologist: For diagnosis and check ups.
Surgeon: If surgery is needed
Nurse: For teaching & managing disease
Dietician: Client teaching on managing diet
Social Worker: Educating patient and providing
support.
3.
4.
Older patients with longstanding or severe
Crohn’s disease can exhibit which of the
following?
a.
Nausea and Vomiting
b. Hypoalbuminemia
c.
Hyperalbuminemia
d. Decreased sedimentation rate
Crohn’s disease is a chronic relapsing disease.
Which area of the GI tract is involved in this
disease?
a.
Entire length of L intestine
b. The sigmoid area only
c.
The S intestine & colon, the entire
thickness of the bowel.
d. The S intestine, mucosa only
A 28-year-old client is admitted with
inflammatory bowel syndrome (Crohn’s
disease). Which therapies should the nurse
expect to be part of the care plan? Select all
that apply.
a.
Lactulose therapy
b. High-fiber diet
c.
High-protein milkshakes
d. Corticosteroid therapy
e. Antidiarrheal medications
The nurse is reviewing the record of a female
client with Crohn’s disease. Which stool
characteristics should the nurse expect to note
documented in the client’s record?
a.
Diarrhea
b. Chronic constipation
c.
Constipation alternating with
diarrhea
d. Stools constantly oozing from the
rectum