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
Assess vital signs including temperature every 4 hours
and as needed. Report any abnormal findings to the
healthcare provider.
Assess mental status and level of consciousnesses
every 4-6 hours.
Report and note any abnormal laboratory values (i.e.
elevated WBC count) to the healthcare provider.
Rationals
Fever is often one of the first signs of infection.
Mental status changes, confusion, or any deterioration
from baseline can signify infection.
Certain abnormal laboratory results could be an
indicator of infection.

Other possible nursing diagnosis:

Risk for imbalanced fluid volume
Impaired gas exchange