Patient Education Plan
This is a 65 year-old female who has a weight of 77.1 kg. She presented to the emergency room with increased lower abdominal pains (cramps), diarrhea for past five days, and decrease nutrition consumption because of pain. She states she has lost some weight over the past week but does not know how much. She has increased fatigue and weakness. She has allergies to Lipitor, Demerol, Florinef Acetate, penicillin, Vancomycin. The patient lives at home with her spouse and has a few friends she sees on a regular basis. The patient states she has never smoked, nor has she ever drunk alcohol and no one in the house does either. She does consume 3-4 diet pops a day that contain caffeine. The patient states she has no medical training or knowledge other than the conditions, which she has a history of. She seems to have memory deficits of unknown etiology and very high anxiety issues with very high dependency or separation issues (needing someone near her at all times and demanding). The patient’s medical history consists of kidney stones, urinary tract infection (UTI), high cholesterol, irritable bowel syndrome, diabetes mellitus (Type 1), acid reflux, allergic rhinitis, addison’s disease, osteoporosis, osteopenia, anxiety, and depression. She has a surgical history of: cholecystectomy, colonoscopy, liver biopsy, and hysterectomy. After asking the patient how she learns best, she states “I learn better with a hard copy and someone going over the information me and my husband.” Also assessed were her needs. The acute stage she needs IV access, pain meds, a strict diet of nothing by mouth or minimum, sips of water, IV fluids for dehydration, glucose control, urine sample, stool sample. The next stage of care would most likely consist of a gastroenterologist consult, x-ray (abdomen), CT scan (abdomen), colonoscopy, gastroscopy, and eventually a nasogastric tube. Depending on her nutritional status, her (5-10 day-range) needs may be total parenteral nutrition (TPN) if she cannot have anything on her stomach.
Introduction to Ulcerative Colitis (UC):
Ulcerative colitis is a chronic disease process. UC is predominantly seen between the ages of 13-25 and is less likely to be diagnosed in the later years (50-70) (Ulcerative Colitis, 2006). Studies show a hereditary connection and 2 out of 10 people diagnosed have another family member with UC too (Ulcerative Colitis, 2006). Ulcerative colitis symptoms are caused by inflammation and sores, called ulcers, which normally first appear in the rectum and large colon. UC is confused with crohn’s disease quite often because of the symptoms, but UC is limited to the large intestine (colon) and the inner most wall of the intestine, where Crohns can attack any portion of the bowel and the entire wall of the intestine (Crohn's & Colitis Foundation of America, n.d.). These areas of inflammation and sores can form pockets of pus and start bleeding. As stated by the CDC (2011), “the stool is generally bloody and may be associated with cramping abdominal pain and severe urgency to have a bowel movement. Loss of appetite and subsequent weight loss are common, as is fatigue” (para. 8). UC has no direct cause and there is no cure for the condition at this time. UC is a disease managed by long-term interventions such as diet and stress management, along with medications.
Age and Developmental issues:
The female patient is 65 and does have some short-term memory deficits, which make teaching a little difficult. She seems to have a high level of understanding even though she does not have any medical experience, her problem is remembering. Small pieces of information in short and frequent intervals would be the best plan for educational comprehension, making sure reinforcement of previous instructions is incorporated. Ensuring her spouse is in the room to aid in the education and learning process should be a