NURS 6512 Assignment: A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition.
Case Study
CASE STUDY 3
A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment.
Write a detailed narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least five different references from current evidence-based literature.
A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. NURS 6512 Case Study: A 27-year-old man with Crohn’s disease
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Advanced Health Assessment: Crohn’s Disease
[elementor-template id="165244"]Financial management is often a problem for patients undergoing treatment for chronic illnesses like Crohn’s disease. Lack of access to healthcare, thus complicates the quality of their lives, thus posing another health burden besides financial constraints. The hospitalization costs for Crohn’s disease, for instance, cost upwards of $11,345 every year (CDC, 2019). The disease also necessitates adherence to medications as the condition is characterized by inflammatory bowel disease, which must be managed. Nursing care for a Crohn’s disease patient entails accessing providers, administering medications, and diagnosis. Medical ethics task practitioners with ensuring access to healthcare and patient adherence (Lichtenstein et al., 2018). This paper explores evidence-based approaches that enhance healthcare affordability for the treatment of Crohn’s disease. NURS 6512 Case Study: A 27-year-old man with Crohn’s disease
The prevention of extreme flare-ups requires specific information that focuses on the condition and other symptoms surrounding the flare-ups. The diagnosis of Crohn’s disease is an established process hence the need for clarity in the information. Clear patient on their medical history, the severity of the symptoms (any improvements/worsening factors), auscultation of bowel sounds and movement (the absence or presence of bowel obstruction), and the medical records (abdominal distension, anemia, dehydration, and malnutrition) is important (Lichtenstein et al., 2018). Other symptoms clinicians must look out for include palpation for tenderness, rigidity, enlargement, fullness, or displacement of the spleen/liver. It is evident that the patient in question is undergoing extreme pain. An in-depth rectal exam could reveal the development of a fistula (Ball et al., 2019). The medical history for the case study is limited to the gastrointestinal tract, which sets the pace for the diagnostic tests to use. Necessary tests include a complete blood count, comprehensive metabolic panel, abdominal flat plate, endoscopy, urinalysis, fluoroscopy, and CT abdomen, among others.
Crohn’s disease increases the risk of the patient developing gastrointestinal emergencies. The severity of the condition results in abscesses in the walls of the bowel, gut/bowel perforations, and small/large bowel obstruction. Experiencing several flare-ups necessitates admission to the hospital to calm the gut down through colostomy or a nasogastric tube for small bowel obstruction (Lichtenstein et al., 2018). There may also be a need for surgery following reoccurring abscesses, perianal fistulas, and perforations in the bowel walls. In some cases, the patient may require bowel resections leaving them with re-anastomosis or colostomy ((National Institute of Health, 2017). There is also a possibility for developing complications from the obstructions, thus causing decimated intravascular coagulation or sepsis. NURS 6512 Case Study: A 27-year-old man with Crohn’s disease
As it is, the financial burden for Crohn’s disease is enormous, and the US is yet to create evidence-based ethical approaches for the issue. The ethical load during management and treatment, thus lies with the medical practitioner and their capacity to facilitate out-patient sessions and patient adherence. Also, the patient may enroll in medication assistance programs such as Medicare and Medicaid to help ease the financial load. It is clear that the healthcare provider understands the importance of long-term disease management hence their role in encouraging compliance (Perry et al., 2018). Enhanced patient compliance and consistent hospital visits are crucial for the case study and will go a long way in lowering the financial load on the patient.
NURS 6512 Case Study: A 27-year-old man with Crohn’s disease Conclusion
Crohn’s disease is a chronic health condition that affects the gastrointestinal tract. The condition is often characterized by small/large bowel obstruction, perforations in the bowel walls, anemia, dehydration, and malnutrition, among other symptoms. Diagnosis of Crohn’s disease involves various procedures, including abdominal plate count, endoscopy, fluoroscopy, urinalysis, whole blood count, white blood count, comprehensive metabolic panel, among other diagnostic tests. The management and treatment of the chronic condition have proven to be costly, considering the necessity of constant hospitalizations and tests. Healthcare practitioners are ethically tasked with ensuring access to medication and patient adherence. The patient may enroll for Medicare and Medicaid, among other medication access programs to lower the financial burden of medication.
NURS 6512 Case Study: A 27-year-old man with Crohn’s disease References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An inter-professional approach (9 ed.).
Centers for Disease Control and Prevention. (2019). Inflammatory bowel disease. Retrieved from https://www.cdc.gov/ibd/data-statistics.htm
Lichtenstein, G. R., Loftus, E. V., Isaacs, K. L., Regueiro, M. D., Gerson, L. B., & Sands, B. E. (2018). ACG Clinical Guideline: Management of Crohn’s disease in adults. American Journal of Gastroenterology, 113(4), 481-517.
National Institute of Diabetes and Digestive and Kidney Diseases. (2017). https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease/all-content
Perry, J., Chen, A., Kariyawasam, V., Collins, G., Ling, W., & Leong, R. (2018). Medication non-adherence in inflammatory bowel diseases is associated with disability. Intestinal Research, 4, 571. NURS 6512 Case Study: A 27-year-old man with Crohn’s disease
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