An understanding of the principles of perioperative nursing care in relation to a person who has ulcerative colitis (Learning outcome 1). • An understanding of alterations in body fluid homeostasis...

An understanding of the principles of perioperative nursing care in relation to a person who has ulcerative colitis (Learning outcome 1). • An understanding of alterations in body fluid homeostasis and the management of fluid balance in the perioperative period (Learning outcome 1). • An understanding of the role of the nurse in the perioperative period in relation to a person who has ulcerative colitis (Learning outcome 2). • An understanding of the pathophysiology of ulcerative colitis (Learning outcome 5). • An understanding of pharmacological agents that may be used in the perioperative care of a person who has ulcerative colitis (Learning outcome 6). • An understanding of how safe and effective administration of pharmacological agents support people in perioperative care (Learning outcome 1, 6 & 7). • An evaluation of relevant literature to support an understanding of the pathophysiology, pharmacological and nursing management of a person experiencing Crohn’s disease and express this in a clear and succinct writing style (Learning outcome 9). Details Eleanor Brown has been admitted to hospital with complications of ulcerative colitis. Eleanor, now 48 years old, was diagnosed with ulcerative colitis when she was 31 years old. Over the years, she has had numerous admissions to hospital for acute episodes of ulcerative colitis. Eleanor’s ulcerative colitis has been managed with a combination of diet, medication (infliximab) and medical monitoring. Eleanor has been experiencing an acute exacerbation of ulcerative colitis over the last two weeks. She has had up to fourteen episodes of diarrhoea with blood and pus per day and severe pain in her lower abdomen. She has been experiencing a sensation of abdominal bloating and cramping pain. Eleanor states she has been feeling too ill to eat and drink much and that she has lost nine kilograms in the last two weeks. She also states that she is feeling fatigued and has been unable to complete daily activities. 401010 – Health Variations 1 Learning Guide – Autumn 2017 ©School of Nursing and Midwifery Page 11 of 28 University of Western Sydney trading as Western Sydney University ABN 53 014 069 881 CRICOS Provider No: 00917K A colonoscopy performed four years ago revealed that Eleanor had developed a large number of pseudopolyps in her descending and sigmoid colon. Due to her current exacerbation of ulcerative colitis, Eleanor’s gastroenterologist ordered an MRI scan of Eleanor’s abdomen as a colonoscopy posed a risk of perforation and haemorrhage. The MRI scan revealed that Eleanor had now developed pancolitis. The gastroenterological surgeon has recommended that Eleanor has a total colectomy and construction of an ileostomy. On examination, Eleanor has a tender distended abdomen. Her skin is dry, pale and cool to touch with poor turgor. Eleanor’s capillary refill is slow and she has flat neck veins. She states she has had reduced urine output over recent weeks.