NSG2ANB Assessment Answers Bachelor of Nursing Assignment

According to the case study, Mr. Bob Jackson was admitted to a hospital’s emergency ward due to the increasing pain in his abdomen and diarrhea in the last few weeks. This assignment would define the use of medicine along with their work-mechanism that is suitable for the use and the rational. Further, this assignment describes the approach that the nursing staff of the hospital can use to address their health problems.

Answer 1:

As per the analysis of the situation defined in the case of Bob, it can be stated that the management of pain in ulcerative colitis may be challenging since the majority of pain relievers might exacerbate the illness. It can be shown from the case study that Bob had been given Celebrex at some point. Compared to alternative non-steroidal anti-inflammatory medication therapies for ulcerative colitis, a randomized controlled study found Celebrex to be much more helpful in managing pain. Celebrex is a member of the Celecoxib medication family, which works by inhibiting the enzyme cyclooxygenase 2 (responsible for the production of prostaglandin, which is responsible for the sensation of pain) (Page, Anand, and DeWilde, 2021). Most non-steroidal anti-inflammatory drugs (NSAIDs) inhibit both COX-1 and COX-2, while Celebrex is a selective COX-2 inhibitor.

(Source: Page, Anand, and DeWilde, 2021)

When it comes to operating principles, Endone pills are quite similar to the action of opioid analgesics, and they may be used to treat moderate to severe pain, such as Bob experienced. The active component in this medication is an opioid known as oxycodone hydrochloride, a kind of morphine. It works by activating opioid receptors in the central nervous system, which interferes with the transmission of pain signals via the central nervous system and, as a result, lowers the experience of pain in the patient (Mayo Foundation for Medical Education and Research (MFMER), 2022). The use of aminosalicylates in the treatment of mild to severe ulcerative colitis should be avoided in Bob’s case. The use of aminosalicylates, such as Mesalamine, may prevent the symptoms from reoccurring. Mesalamine reduces inflammation in the colon by inhibiting the enzyme cyclooxygenase and inhibiting the formation of prostaglandins, but it may induce a number of adverse effects, including dizziness, and it has been linked to renal issues (Mayo Foundation for Medical Education and Research (MFMER), 2022). Corticosteroids may also be administered orally or intravenously for the purpose of decreasing inflammation in the lining of the bowel (Al-Kaf, 2018). However, corticosteroids should not be administered for an extended period of time since they might lead to steroid dependency in the patient. Even though paracetamol is a poor inhibitor of prostaglandin, it may not be good for Rob due to the fact that paracetamol may not function for him.

Because the management of painkillers is related to a number of side effects, including breathing difficulties, dizziness, and disorientation, therefore; clinical professionals should be familiar with the patient’s medical history and the dosage of the medications before administering them to avoid any contraindications from occurring.

Answer b

As a result of the diagnosis of ulcerative colitis that is accompanied by extraintestinal symptoms, a multidisciplinary approach is required for analyzing the full disease spectrum of the patient with ulcerative colitis and giving effective treatment to him. As per this, it can be stated that he will need the services of a trained dietitian in addition to health care specialists such as physicians and nurses, among others. When a patient is admitted to the hospital, a licensed dietician works with them to encourage a balanced diet and nutrition appropriate for their condition. A dietician is a professional person who does not belong to the nursing group but is in charge of educating the patient on a balanced diet and probable food allergies and intolerances, among other things. With the help of this, a patient can be able to get quick recovery from the health issues through healthy food.

Further, it is also admitted that when a disease is active, like ulcerative colitis, patients’ body demands energy, nutrients, and a rise in calories. When the condition flares up, maintaining a healthy weight might be challenging and maintaining enough nourishment. The calorie requirements of Bob in the above-defined situation may be met with the help of a dietitian who can propose an appropriate protein and calorie intake for him.

Brandes, Stenner, and Martini (1979) suggest that eating behaviors might be one of the etiological variables in the advancement of ulcerative colitis. In this regard, a patient needs more potatoes and cereal products, but they do not need milk and related products, coffee, fruit juice, tea, vegetables, lemonade, alcohol, and fruit.

In this regard, Bob may have abdominal pain, discomfort, and diarrhea as a result of inadequate nourishment. According to Tilg and Kaser (2021), there are several meals that may actually increase the symptoms of diarrhea in those who are experiencing them. According to research, a high intake of food products and a low intake of fibers are connected with a recurrence of ulcerative colitis. Research has established once again that the elements sulfur and sulfate may be responsible for the relapse of the condition (Tilg and Kaser, 2021). As a result, the patient’s eating preferences often serve as predisposing factors for gastrointestinal diseases.

A dietician will advise on the inclusion of certain foods, such as probiotics or folic acid supplements, in one’s eating plan. The deficit of folic acid has been shown to be connected with the development of colitis-associated carcinogenesis. Probiotic bacteria have an effect on the function of immune cells as well as the cells that line the intestines. The probiotic bacteria compete with the disease-causing bacteria and prevent them from producing infection and inflammation (Verschuere, 2000).

According to the case study, Bob Jackson had been suffering from osteoarthritis and joint discomfort, which might have been caused by a decrease in bone mineral density relative to his body weight. As a result, a qualified dietician may also prepare an iron-rich diet for a patient (betterhealth.vic.gov, 2021).

Conclusion

As per the findings of the case study of Bob Jackson and the symptoms experienced by him, pain treatment would be a top therapeutic concern for him to address the pain. This report had focused on the side effects of every selected medication such as paracetamol, Endone, corticosteroids, and Celebrex. But the antibiotics with Celebrex were chosen as the best options for Bob that had been selected as per his medical condition. Endone and antibiotics were also selected for him as the best possible options available by a doctor for Bob. Furthermore, the assignment had focused on the need for a trained dietician to analyze Bob’s nutritional requirements, which was a condition of the task. The assignment correctly identified the risks associated with painkillers and gave an in-depth discussion of the importance of nutrition in the management of the symptoms of ulcerative colitis, both of which were excellent contributions. A complete and holistic treatment was necessary for Bob Jackson to avoid the advancement of the illness as well as recurrence of the condition.

References

Al-Kaf, A. (2018). Corticosteroids. BoD – Books on Demand. Retrieved from

betterhealth.vic.gov. (2021). Dietitians. Retrieved from https://www.betterhealth.vic.gov.au/health/servicesandsupport/dietitians

Brandes, J., Stenner, A. and Martini, G. (1979). Dietary habits of patients with ulcerative colitis (author’s transl). Retrieved from https://pubmed.ncbi.nlm.nih.gov/532245/

Mayo Foundation for Medical Education and Research (MFMER) (2022). Mesalamine (Oral Route). https://www.mayoclinic.org/drugs-supplements/mesalamine-oral-route/proper-use/drg-20064708?p=1#:~:text=Mesalamine%20is%20used%20to%20treat,other%20symptoms%20of%20the%20disease.

Tilg, H. and Kaser, A. (2021). Diet and relapsing ulcerative colitis: take off the meat? Retrieved from https://gut.bmj.com/

Verschuere, L. (2000). Probiotic Bacteria as Biological Control Agents in Aquaculture. Microbiol Mol Biol Rev, 64(4), pp. 655–671.

Weatherspoon, D. (2018). Diarrhea After Eating: Why It Happens and How to Stop It. Retrieved from https://www.healthline.com/health/digestive-health/diarrhea-after-eating

Page, C., Anand, R. and DeWilde, S. (2021). Trounce’s Clinical Pharmacology for Nurses and Allied Health Professionals – E-Book. Elsevier Health Sciences.