Ulcerative Colitis
Ulcerative colitis is an illness that is characterized by inflammation in the lining of the
colon and rectum, Crohn’s disease is a similar condition and both are a form of
inflammatory bowel disease (IBD).
Ulcerative colitis causes chronic ulcers and inflammation in the digestive tract, resulting
in poor absorption of nutrients.
As the colon becomes swollen (edema), ulcers & bleeding can occur leading to
perforation. This is a medical emergency.
In acute ulcerative colitis, the patient may develop ulcerations of the bowel,
hemorrhages, vascular congestion, and edema.
This condition can become debilitating to the patient and even become life threatening.
There is no cure, however, with treatment and care, the patient can have long remission
periods.
Cause:
While the exact cause of ulcerative colitis is unknown, there are some theories:
Possibly autoimmune disorder
Genetics may play a factor
Environmental factors are also thought to be a possible cause
Sign and symptoms of Ulcerative
Colitis:
Symptoms may vary among affected people. Studies have proved that about 50 percent
of people diagnosed with ulcerative colitis may have the following symptoms:
malnutrition
electrolyte imbalances
increased abdominal sounds
diarrhea
weight loss
bloody stools
abdominal pain
rectal pain
fever
joint pain
joint swelling
skin ulcers
mouth sores
Nausea
Vomiting
Diagnosis of Ulcerative Colitis:
Diagnosis by exclusion is made after ruling other possible causes out. The following
tests may be performed:
Blood tests to include CBC, CRP, and ESR.
Stool sample
Colonoscopy
Endoscopy
CT Scan
X-Rays
Flexible sigmoidoscopy
Barium Enema
Complications of Ulcerative Colitis:
thickening of the intestinal wall
severe dehydration
inflammation of skin, joints, and eyes
toxic megacolon (rapidly swelling colon)
liver disease (rare)
kidney stones
intestinal bleeding (can become severe)
perforation
sepsis – blood infection
Treatments of Ulcerative Colitis:
Both medications and surgery are used to treat ulcerative colitis. Surgery is utilized for
those who are suffering from severe inflammation and life-threatening complications.
Other treatments can include:
Anti-inflammatory drugs
Immune system suppressors
Anti-diarrheal medications
Pain medications
Antibiotics
Iron
Proctocolectomy – removing entire colon and rectum
Nursing Interventions:
If patient is admitted with an acute phase of ulcerative colitis, the healthcare practitioner
may order the following:
NPO status (nothing by mouth) bowel rest
IV fluids to maintain hydration and electrolytes
Limit activity
Monitor bowel sounds
Monitor for signs and symptoms of infection (peritonitis)
Monitor for signs and symptoms of hemorrhage (caused by ulcers).
As diet advances, place on a low fiber, high protein diet
Avoid the following foods: nuts, alcohol, caffeine
Need instruction on smoking cessation
Nursing Care Plan
Nursing Diagnosis
1. Acute pain related to inflammatory process of the Ulcerative Colitis as evidenced by
patient rates pain at 8/10 on pain scale and states abdominal cramping and tenderness
in abdomen.
Desired outcomes:
Patient will report a decrease in pain from 8 to 0 on the pain scale by discharge.
Interventions Rationals
Interventions Rationals
Assess level of pain using appropriate pain scale. Using an appropriate age pain rating scale will help the
Assess pain 30 minutes before and after pain healthcare providers monitor the level of pain and
medication is given. adjust pain medications as needed.
Administer pain medications as prescribed and Analgesics are helpful in relieving pain and helping in
indicated. the recovery process.
Have patient maintain limited bedrest and activity This will help to minimize pancreatic secretions and
pain.
Incorporate nonpharmacologic measures to assist with Ideally, the use of comfort measures will distract the
control of pain. patient from pain and may increase the effectiveness of
pharmacological measures.
2. Risk for Infection related to development of inflammatory process or worsening
Ulcerative Colitis.
Desired outcomes:
By discharge, the patient will remain free signs and symptoms of infection.
Interventions Rationals
Interventions Rationals
Assess vital signs including temperature every 4 hours Fever is often one of the first signs of infection.
and as needed. Report any abnormal findings to the
healthcare provider.
Assess mental status and level of consciousnesses Mental status changes, confusion, or any deterioration
every 4-6 hours. from baseline can signify infection.
Report and note any abnormal laboratory values (i.e. Certain abnormal laboratory results could be an
elevated WBC count) to the healthcare provider. indicator of infection.
Other possible nursing diagnosis:
Risk for imbalanced fluid volume
Impaired gas exchange