Nursing Assessment, Management and Treatment of Autoimmune Diseases
218
● Insoluble fiber foods that are difficult to digest including raw green vegetables, fruits with skin and seeds, whole nuts, and whole grains. ● Lactose, the sugar found in dairy products such as milk and cream. ● Non-absorbable sugars that are found in sorbitol, mannitol, sugar-free gum, candy, and ice cream. ● Foods that are high in sugar such as baked goods, candy, and juices. ● High-fat foods including butter, coconut, margarine, cream, and foods that are fatty, fried, or greasy. ● Alcohol and caffeinated beverages including beer, wine, liquor, coffee, and soda. Nursing interventions Nurses have a great deal of responsibility to provide effective patient/family educa- tion. Education topics of particular impor- tance include the following (Rebar et al., 2019): ● Medication. ● Stress reduction. ● Diet and nutrients. ● Emotional support and counseling. ● Lifestyle changes and how to implement them. During hospitalization nurses should carefully monitor patients’ intake and out- put and weight and monitor for signs of dehydration. It is important for patients to be monitored for fever and pain on urina- tion, which may suggest the development of a bladder fistula. Abdominal pain, fe - ver, and a hard distended abdomen are signals of an intestinal obstruction (Rebar et al., 2019). If patients have an ileostomy, they must be able to demonstrate proper ostomy care and should have a consultation with an ostomy therapist. Patients should also
| NURSING CONSIDERATION
Surgery is necessary in cases of bow- el perforation, massive hemorrhage, fistulas unresponsive to medication, or acute intestinal obstruction. A col- ectomy with ileostomy may be per- formed in patients who have exten- sive disease of the colon and rectum (Rebar et al., 2019). Lifestyle changes Lifestyle changes are an integral part of the treatment plan. Patients must try to reduce the stressors in their lives as well as reducing physical activity to allow the bowel to rest (Rebar et al., 2019). Dietary changes are implemented to de- crease bowel activity while still providing adequate nutrition. Suggestions for meal planning and intake include recommend- ing the following actions for patients to implement (Crohn’s & Colitis Foundation, 2021c): ● Eat four to six small meals daily rather than three large meals. ● Stay hydrated with water, broth, tomato juice, or a reduction solution. ● Drink beverages slowly. Avoid using a straw, which can cause the ingestion of air that leads to flatulence. ● Prepare meals in advance. ● Keep foods that are well tolerated on hand. ● Use simple methods to cook such as boiling, grilling, steaming, and poaching. ● Use a food journal to keep track of what is eaten and what foods cause or exacerbate symptoms. The Crohn’s and Colitis Foundation (2021c) suggests that patients avoid the following foods when experiencing a flare-up of the disease:
Powered by FlippingBook