251 Nursing Assessment, Management and Treatment of Autoimmune Diseases
● Protect their skin : Patients should avoid hot baths and showers and avoid using strong soaps, which can dry out the skin and cause further damage. Sunscreen should be used to protect the skin as well. ● Avoid tobacco products : Nicotine causes blood vessel contraction, which can worsen Raynaud’s disease. Smoking can also cause permanent narrowing of blood vessels and lead to or exacerbate lung issues. ● Manage heartburn : Patients should avoid spicy foods and beverages. They should be taught to identify and avoid other foods and beverages that trigger heartburn. Late night meals should be avoided as well. Sleeping with the head of the bed elevated helps to prevent gastric acid from backing up into the esophagus. Antacids or protein pump inhibitors may be suggested to relieve symptoms of heartburn. ● Protect from cold : Mittens should be worn anytime hands are exposed to cold, even when reaching into a freezer. If outside in cold weather several layers of warm clothing are recommended, and the face and head should be covered as much as possible. Ulcerative colitis Ulcerative colitis is a chronic inflamma - tory bowel disease (IBD). An autoimmune disease, ulcerative colitis causes inflam - mation and ulcerations of the mucosa in the colon. Ulcerative colitis affects the innermost lining of the colon and rectum (Mayo Clinic, 2021d; National Institute of Diabetes and Digestive and Kidney Dis- eases [NIDDK], n.d.; Rebar et al., 2019). Ulcerative colitis can develop at any age, but peak occurrence is between the
ages of 15 and 30 and between 50 and 70. The disease is slightly more prevalent in men compared to women. An estimat- ed 238 per 100,000 adults in the US may have ulcerative colitis (Rebar et al., 2019). Pathophysiology The exact cause of ulcerative colitis is not known but is likely linked to an ab- normal immune response in the gastro- intestinal tract (Rebar et al., 2019). Ulcer- ative colitis typically begins in the rectum, where it may remain localized (ulcerative proctitis) or extend proximally, progress- ing to involve the entire colon. Inflamma - tion affects the mucosa and submucosa. There is a distinct border between nor- mal and affected tissue (Merck Manual, 2020c). Figure 8 shows a picture of dam- age that occurs as the result of the dis- ease. | NURSING CONSIDERATION Stress does not cause ulcerative coli- tis. However, stress can increase the severity of the attack (Rebar et al., 2019). Patients should take steps to reduce stress whenever possible. Figure 8. Ulcerative Colitis
Note . Wikimedia Commons., 2006.
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