Editing Medical-Surgical Nursing (section)

=== Inflammatory Bowel Disease ===

Ulcerative colitis affects the colon and rectum continuously with mucosal inflammation and produces frequent bloody diarrhea with mucus, tenesmus, and left lower quadrant cramping. Crohn disease can affect any part of the gastrointestinal tract in skip lesions with transmural inflammation and produces right lower quadrant pain, nonbloody diarrhea, fistulas, strictures, and malabsorption with nutritional deficiencies.

Nursing care during exacerbation includes bowel rest, monitoring for dehydration and electrolyte loss, a low-residue and low-fat diet as tolerated, and administration of aminosalicylates, corticosteroids, immunomodulators, or biologics. Toxic megacolon, marked by abdominal distention, fever, tachycardia, and a silent abdomen, is a surgical emergency.