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Cleansweep RN

General Information:

  • Chronic relapsing disease that can develop discontinuously in any alimentary tract
  • Chronic inflammatory bowel disease that can affect both small and large intestines; terminal ileum, cecum and ascending colon.
  • Characterized by granulomas that can affect all the bowel wall layers with resultant thickening, narrowing and scarring of the intestinal wall
  • More common on Jewish population ages 20 – 30 years and 40 - 60 years old.

Assessment findings:

  • Right, lower quadrant tenderness and pain; abdominal distensions
  • Anorexia, Nausea and vomiting, 3-4 semi-soft stools/day with mucus and pus
  • Diarrhea, Decreased skin turgor and drug mucus membranesCramp like and colicky pain after meals
  • Fever, pallor and anemia
  • Decreased Hgb and Hct (if Anemic)
  • Negative Sigmoidoscopy or reveals scattered ulcers
  • Barium enema shows narrowing with areas of strictures separated by segments of normal bowel.

Nursing Interventions:

  • Provide appropriate nutrition while reducing bowel motility.
  1. Administer and monitor Total Parenteral Nutrition (TPN)
  2. Provide high protein, high calorie, and low residue diet with no milk products
  3. Weigh daily and take anthropometric measurements
  4. Administer anti-diarrheals and anti spasmodic and anti-cholinergics as ordered
  5. Omit gas producing foods/fluids from the diet, and foods such as whole wheat grains, nuts, raw fruits and vegetables, pepper, alcohol and caffeine containing products.
  6. In acute cases, maintain NPO status and administer fluids and electrolytes intravenously
  7. Monitor bowel sounds and for abdominal tenderness and cramping.
  8. Monitor stools noting its color, consistency and presence or absence of blood in stools
  9. Following acute phase, diet progress to clear liquids to a low residue diet as tolerated
  • Promote comfort and rest: provide good perineal care with frequent washing and adequate drying each bowel movement

Medical Management:

  • Diet: high calorie, high vitamin, high protein low residue, milk free diet
  • Drug therapy: antimicrobials (sulfasalazine) to prevent or control infection, corticosteroids, antidiarrheals, anticholinergics
  • Surgery: resection of diseased portion of bowel and temporary or permanent ileostomy

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