Nursing Care

Because Ulcerative Colitis and Crohn’s Disease are similar and have similar treatments, the nursing care involved in each is also similar and consists largely of a supportive role

Ulcerative Colitis

The goals of treatment include resting the bowel, controlling inflammation, managing fluids and nutrition, managing stress, providing education about disease and treatment, and symptomatic relief. The nurse, therefore, must support the client in reaching and maintaining these goals.

Nursing care includes:

• Establish a good relationship with the client directed toward a therapeutic and supportive program
• Management of acute phase (hemodynamic stability, pain control, fluid and electrolyte balance, nutritional support.
• Accurate record of intakes and outputs
• Record/monitoring of number and characteristics of stools
• Good explanation of procedures, acknowledging any client apprehension
• Psychosocial support for emotional problems including frustration, fear, feelings of discouragement, grief, anxiety, embarrassment, and depression
• Management of discomfort and pain control
• Recognition of ineffective coping
• Restricted activity and possible bedrest (during severe exacerbation), and accompanying nursing interventions to prevent complications of immobility
• Adequate rest; schedule activities around rest periods
• Perianal skin care and prevention of skin breakdown (no harsh soap, barrier creams)
• Ensuring close proximity to bathroom and use of deodorizers can be helpful for episodes of diarrhea
• Client teaching is of utmost importance. Provide teaching related to disease progress and management, treatment (drugs, diet) and diagnostic tests and procedures
• Pre- and postoperative care for those clients undergoing surgery

Crohn's Disease

The goals of care and treatment include relieving symptoms, controlling inflammation, correcting nutritional problems, and promoting healing. The nursing care is similar to that of UC; the nurse must provide support in attaining and maintaining these goals.

Nursing care includes:

• Encourage self-care as client’s condition improves
• Provide frequent rest periods, advising of the importance of rest
• Promote the avoidance of emotional stress and strategies to control or minimize stress, while teaching about the stress components of the disease
• Skin care (specialized for clients that have perianal fistulas or abscesses)
• Pre- and postoperative care for those undergoing surgery
• Help client and family set realistic short- and long-term goals, acknowledging the chronic and intermittent nature of the disease
• Teaching is of utmost importance and needs to include the topics of diet management, drugs, perianal care, recurrent symptoms, and when to seek medical care

For clients that are using complimentary or alternative therapies, such as herbal remedies, to help treat and manage their IBD, the nurse should assess for and teach about dangerous interactions that can occur with other medications (N. Taylor & K. Taylor, 2011).

In contrast with the literature that stresses technical competence, research by Belling, Woods, and McLaren (2008) suggests that clients with IBD perceive the nursing roles and attributes of advice, support, caring, empathy, and disease management, to be of significant importance in their care.

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