Complete the following case study. The nurse is meeting a 4-year-old East Indian
ID: 124335 • Letter: C
Question
Complete the following case study.
The nurse is meeting a 4-year-old East Indian child for the first time; the child is being admitted for his monthly Remicade (infliximab) infusion for his chronic Crohn disease. In the past, the family has been cared for by a different GI team in a rural area of Northern California. Due to the chronic nature of his symptoms, his progressive and alarming weight loss, and his delayed growth and development, the child is now being admitted to a large urban hospital that has a GI specialty team.
The hospital is more than a 3-hour drive from the family’s home. The father is visibly upset by the hospitalization and his separation from the other family members. The child’s expected length of stay is 3 days, during which he will receive his infusion treatment, a bowel tissue biopsy, and a full nutritional work-up.
1.) What is the relationship between GI disorders, growth disorders, and low weight-for-age for children with Crohn disease?
2.) What are the classic symptoms of severe Crohn disease?
3.) What will the pediatric healthcare team and nutritionist ask the family about the child’s diet?
4.) Are there any nursing concerns or special infusion guidelines for an infliximab infusion?
Explanation / Answer
1.The most common relationship between GI disorders,growth disorders and crohns disease is inflammation of the intestinal tracts resulting in bowels,constipation and also malabsorption.Malabsorption results in growth disorders as small intestine cannot absorb enough of nutrients and fluids and excretion of nutrients is also done quickly as the intestine will not be in a state to absorb nutrients,minerals etc required for a body.This causes weight loss and delayed growth in humans.
2.symptoms of crohns disease: Diarrhoea,fever,fatigue,abdominal pain and cramping,blood in stool,reduced appetite and weight loss,inflammation of skin,eyes,joints,liver.
3.Intake of foods like milk products rich in lactose(lactose intolerant),wheat,maize,fatty foods,nuts and seeds,meatetc shoul be avoided who have GI problems.So the pediatric team should ask about all these foods whether the child ate or not.They should also give them a diet plan for which only few foods can be prescribed.
4.Yes there are special infusion guidelines maintained for different helathcare organizations for infliximab infusion which generally involves patient arrives then general consent form to be filled,wait for the results and observe before infusion,administration,monitoring of patients and discharge.