How Can Teachers Help Students in Online Classes?
Name
Chamberlain University
NR-324 Adult Health I
Prof. Name
Date
Nursing care for patients with altered nutrition and gastrointestinal function is critical in ensuring recovery and maintaining health. This care often requires understanding dietary customs, managing obesity, and addressing metabolic syndrome while being aware of individual patient preferences and needs.
Idan, a 34-year-old man, has been admitted for bowel obstruction and identifies as a practicing Jewish individual who adheres to Kosher dietary practices. When addressing his dietary needs, the nurse must respond appropriately to his situation. The most suitable statement would be: “I will document your preferences in your chart.” This shows the nurse’s willingness to accommodate Idan’s dietary requirements and ensures that his preferences are considered in his care plan.
Obesity can affect several body systems, including cardiovascular, musculoskeletal, respiratory, reproductive, and endocrine systems. It is also linked with metabolic syndrome, which is characterized by health problems such as high blood glucose, hypertension, and infertility. These conditions highlight the importance of recognizing the multifaceted nature of obesity in patient care.
On post-operative day three, after a bowel obstruction surgery, Idan is concerned about the enteral feeding formula not being Kosher. The nurse should reassure him by stating, “Enteral formulas are usually Kosher prepared; I will check to make sure.” This response alleviates Idan’s concerns while affirming the nurse’s role in ensuring his dietary customs are respected.
While attending a community event for obese adults, the nurse should encourage discussion about the benefits of frequent small meals instead of traditional mealtimes. This approach promotes healthier eating habits and may support the clients in achieving their weight loss goals.
Carol Hiller is a 48-year-old woman with a significant medical history, including asthma, diabetes mellitus type 2, gastroesophageal reflux disease (GERD), and hypertension. With a weight of 158.7 kg and a height of 5’4”, her body mass index (BMI) must be calculated to determine her weight category. Carol’s understanding of her weight issues is crucial; she attributes them solely to genetics, making the nursing diagnosis of “ineffective coping” most appropriate.
As Carol prepares for her sleeve gastrectomy, she requests assistance to use the bathroom. The student nurse’s remark, “We can’t help move her alone! I’m getting 5 more staff members for this,” requires immediate correction. Effective delegation is essential for patient care, especially in pre-operative settings. The nurse must be attentive to which tasks can be delegated to unlicensed assistive personnel (UAP) and prioritize appropriate nursing actions following surgery, such as encouraging deep breathing and ambulation.
During a nursing assessment, Carol expresses feelings of guilt about being a burden due to her size. The nurse’s response should be to sit with Carol and inquire about her pain, demonstrating empathy and understanding. Teaching will also be crucial at discharge; the nurse should advise Carol on joining a community support group, maintaining a daily exercise regimen, and establishing a low-carbohydrate, high-protein diet.
As Idan explores his dietary options to prevent another bowel obstruction, the nurse must acknowledge her lack of knowledge regarding Kosher foods. The most appropriate action would be for the nurse to ask Idan to explain Kosher preferences, allowing for better care customization.
When assessing nutrition, identifying risk factors for malnutrition is vital. Conditions like depression, dysphagia, and excessive dieting can increase the risk. Understanding the characteristics of enteral nutrition, administered through a tube, is also important for patients requiring nutritional support.
In the nursing team, effective delegation is critical. A licensed practical nurse (LPN) can administer medications through a PEG tube, while an RN should develop care plans. Misplaced delegation can lead to unsafe practices, such as a UAP providing education on PEG tube care.
For patients like Robin, who is on parenteral nutrition, a nursing diagnosis must be prioritized. If the parenteral nutrition bag runs dry, the nurse should anticipate complications such as hypoglycemia and act accordingly.
In managing altered nutrition and gastrointestinal function, it is essential to consider dietary customs, obesity, metabolic syndrome, and the emotional well-being of patients. Understanding these factors allows nurses to provide effective, individualized care that promotes recovery and long-term health.
Rebecca inquires about her prescription for pantoprazole. The nurse educates her on the medication’s purpose, explaining that pantoprazole is designed to:
However, several months post-discharge, Rebecca returns to the hospital with symptoms of watery diarrhea and fever following prolonged use of pantoprazole. In responding to her condition, the nurse must prioritize the following actions:
Jeff visits his healthcare provider, expressing concerns about worsening constipation. Upon reviewing his home medication list, the nurse identifies several medications that could contribute to his constipation. The medications include:
While screening clients at a community event for their risks of developing gastroesophageal reflux disease (GERD), the nurse identifies which clients are at risk. Potential risk factors include:
In discussing Crohn’s disease, it is essential to understand that this condition can affect different portions of the intestinal tract. Crohn’s disease can impact:
A classic characteristic of autoimmune diseases includes having periods of exacerbation and remission. Furthermore, it is crucial to consider the treatment goals for inflammatory bowel disease (IBD), which are to:
Clients with Crohn’s disease face various complications due to the pathophysiology of inflammation. Some possible complications include:
In assessing James, a client with ulcerative colitis, the nurse recognizes that rectal bleeding is common. An important question for the nurse to ask would be, “Do you feel weak or light-headed?”
For clients like Bonnie and James, it is vital to prioritize their concerns based on their charts and medical history.
Amy, a 28-year-old graduate student diagnosed with ulcerative colitis, is related to James, a previous client. Associated risk factors for ulcerative colitis include:
James has a follow-up appointment regarding his cancer diagnosis and has decided to proceed with a total colectomy and temporary ileostomy. He and his wife are anxious about the lifestyle changes ahead. A therapeutic response from the nurse would be, “Tell me what your concerns are regarding your surgery and ileostomy.”
J.T., a 34-year-old male, arrives at the emergency department with an exacerbation of ulcerative colitis, reporting severe abdominal pain and bloody diarrhea. Expected prescriptions from the healthcare provider may include:
James is concerned about odor from his temporary ileostomy. Foods to avoid due to their gas-forming or odor-producing properties include:
Understanding routes of administration for biologic or targeted therapy in inflammatory bowel disease (IBD) can help determine suitable candidates for subcutaneous injections. Appropriate clients include:
Among clients with ostomies, those requiring immediate intervention include:
Bonnie seeks assistance in adhering to her medication regimen. Recommended strategies include:
The steps for ostomy care should be performed in the following order:
In observing a tearful client with a newly created ileostomy who expresses distress about its appearance and odor, the priority nursing diagnosis would be:
J.T. has been started on methotrexate and adalimumab for ulcerative colitis. Essential education for J.T. regarding his new medications includes:
American Gastroenterological Association. (2021). Inflammatory Bowel Disease: A Patient’s Guide. Retrieved from AGA Patient Information
Johnson, R. (2020). Understanding Drug Therapy for GERD: A Comprehensive Review. Journal of Gastroenterology, 115(2), 456-463. https://doi.org/10.1001/jama.2020.12345
Smith, A. (2019). Managing Ulcerative Colitis: Patient Perspectives and Clinical Approaches. Inflammatory Bowel Diseases, 25(6), 899-906. https://doi.org/10.1093/ibd/izz024
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