Nursing Care of a Patient with Active Crohn’s Disease Complicated with Small Intestinal Obstruction
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Keywords

Crohn's disease
Intestinal obstruction
5A nursing model
Health belief
Enteral nutrition

DOI

10.26689/jcnr.v8i12.9276

Submitted : 2024-12-04
Accepted : 2024-12-19
Published : 2025-01-03

Abstract

This study summarizes the nursing experience of a patient with active Crohn’s disease in the acute stage, complicated by small bowel obstruction. Key aspects of nursing include psychological response guidance during the active phase of Crohn’s disease, support before and after various gastroenteroscopy procedures and related reports, and self-monitoring guidance for symptoms such as intestinal obstruction combined with endoscopic mucosal ulcers. Using the 5A nursing model, nursing staff assessed the patient’s needs, provided targeted nursing recommendations in stages, implemented health behavior strategies, and offered continuous nursing care, including positive support for sexual health beliefs. These interventions helped the patient overcome psychological challenges, such as resistance to indwelling gastric tubes, and adopt healthy behaviors. After six weeks of follow-up through phone and WeChat consultations, the patient demonstrated significant improvement, including a weight gain of 15 kg. Various test results indicated normalized nutritional and inflammatory indexes, and the Crohn’s Disease Activity Index decreased by ≥ 70 points. In conclusion, establishing a nursing team and applying the 5A nursing model to formulate detailed nursing diagnoses and interventions can significantly improve outcomes for patients with active Crohn’s disease complicated by small intestinal obstruction.

References

Kaplan GG, Windsor JW, 2021, The Four Epidemiological Stages in the Global Evolution of Inflammatory Bowel Disease. Nat Rev Gastroenterol Hepatol, 18(1): 56–66. https://doi.org/10.1038/s41575-020-00360-x

Li G, Ren J, 2017, Emphasis on the Epidemiology of Crohn’s Disease in China. Parenteral and Enteral Nutrition, 24(3): 135–137.

Wang G, 2019, Diagnosis and Treatment of Intestinal Obstruction in Crohn’s Disease. Parenteral and Enteral Nutrition, 26(1): 1–5.

Limketkai BN, Wolf A, Parian AM, 2018, Nutritional Interventions in the Patient with Inflammatory Bowel Disease. Gastroenterol Clin North Am, 47(1): 155–177. https://doi.org/10.1016/j.gtc.2017.09.007

Zheng D, He Y, 2019, Interpretation of Guidelines for Diagnosis and Treatment of Crohn’s Disease in China (Guangzhou 2023). Chinese Journal of Integrated Traditional and Western Medicine Digestion, 32(8): 678–682.

Yan G, 2014, Numerical Rating Scale of NRS Pain Evaluation Scale. Chinese Journal of Joint Surgery, 2014(3): 410.

Inflammatory Enterology Group, Gastroenterology Branch, Chinese Medical Association, 2018, Consensus Opinion on Diagnosis and Treatment of Inflammatory Bowel Disease (Beijing 2018). Sinositis Chinese Journal of Enteropathy, 2(3): 173–190.

Zhu X, Zhang S, Wang X, et al., 2019, Expert Consensus on Nursing of Adult Active Inflammatory Bowel Disease. Journal of Nursing, 37(8): 1–6.

Gu Y, Jiang H, Xu Y, et al., 2016, Early Enteral Nutrition Care Improve Intensive Evaluation of Nutritional Status After Pancreatitis Infection. Chinese Journal of Nosocomial Infectiology, 26(17): 4008–4010.

Li X, 2017, Basic Nursing. People’s Medical Publishing House, Beijing, 315–317.

Chen Y, Zhu X, Zhou Y, et al., 2019, Best Evidence Practice for Nasogastric Tube Placement in Patients with Inflammatory Bowel Disease. Journal of Advanced Nursing, 36(20): 1825–1829.

Cao P, Wang Y, Jia J, et al., 2019, Study on the Correlation Between the Compliance of Nasogastric Tube Family Enteral Nutrition and Quality of Life in Patients with Crohn’s Disease. Modern Digestive and Interventional Diagnosis and Treatment, 26(8): 965–968 + 972.

Feng J, Wei J, Wang F, 2022, Progress in Medical Treatment of Crohn’s Disease Combined with Abdominal and Pelvic Abscess. Southeast Defense Medicine, 24(1): 54–58.

Zhang Y, Tu D, Zhang C, et al., 2023, Construction and Application of Nutritional Management Program for Home Patients with Ulcerative Colitis. Contemporary Nurses, 30(4): 78–81

Li P, Zhang L, Yu Z, et al., 2017, Domestic and International Research Progress of Family Enteral Nutrition. Journal of Nursing, 32(11): 105–109.

Dong Y, Yin J, 2012, Health Belief Model in Peptic Ulcer Intervention Effect Analysis. China Med Innovation, 9(7): 104–105.

Ma J, Mao Y, Niu S, et al., 2019, Qualitative Study on the Evaluation of Home Rehabilitation Effect of Ischemic Stroke by Experts in Related Fields. Chinese Journal of General Medicine, 24(27): 3489–3493 + 3500.

Teng J, 2018, Application of WeChat in Continuous Care of Inflammatory Bowel Disease. Contemporary Nurses, 25(9): 55–56.