1. True or False. Crohn’s disease is closely related to ulcerative colitis.
- True. Both Crohn’s disease and ulcerative colitis (UC) are types of inflammatory bowel disease (IBD), but the main difference is that ulcerative colitis only affects the the colon while Crohn’s can affect any part of the digestive tract including the entire thickness of the bowel wall.
2. As an experienced nurse practitioner who continually treats patients with IBD, you know that the main cause of Crohn’s Disease is?
- B. Unknown, but believed to be related to a bacterial infection. Although stress can potentially increase flare ups, it is not the reason one may develop Crohn’s. The cause is unfortunately unknown, but usually begins with a lesion that becomes further inflamed leading to the “cobblestone” appearance of the bowel lining.
3. A patient is undergoing an acute exacerbation of inflammatory bowel disease. They are scheduled to receive total parenteral nutrition (TPN) and lipids. Which is most important when providing care for this patient as a practitioner?
- C. Monitor their blood glucose closely. Total parenteral nutrition contains electrolytes, vitamins, amino acids, and hypertonic glucose. Due to the hypertonic glucose, it needs to be administered by a central venous catheter and bacteria growth is enhanced due to the lipids and high glucose. Due to the lipids, it needs changed every 24 hours. It can also lead to hyperglycemia, which could lead to more problems down the road.
4. You are seeing a 35 year old patient in an outpatient clinic that presents with severe malnourishment, ulcers in the mouth, diarrhea, and abdominal cramping in the right lower quadrant. Which disease would you suspect your patient has from these symptoms?
- D. Crohn’s Disease. All of the symptoms listed lead to a diagnosis of Crohn’s. The one symptom that stands out most is malnourishment, which doesn’t fit with the other diagnoses listed. Crohn’s Disease is most likely to affect the small intestine, which is where nutrients from food are absorbed. If one’s small intestine isn’t functioning as it should, the risk of malnourishment is drastically increased.
5. As a patient undergoing treatment for Crohn’s Disease with flare ups related to different foods, which food should be avoided?
- A. Fresh salad. If a patient is having flare ups, it is important to avoid high fiber foods, such as a salad or any other vegetables, which are hard to digest. It is important to have a diet high calorie and high protein diet. It’s necessary to give the inflammation in your intestines time to heal and rest. If the patient is lactose intolerant, dairy should be avoided, but the yogurt listed should provide the patient with some probiotics which will help relieve symptoms.