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A 14 year-old male was admitted to the hospital today for treatment of persistent stomach pain and diarrhea related to Crohn’s disease. This disease is a chronic, recurrent inflammatory disease of the intestinal tract. Normal bacteria grow in the lower gut and promote inflammation. Crohn’s disease is a chronic, recurrent inflammatory disease of the intestinal tract. The patient, with the help of his mother, provides the nurse with pertinent information for the admission and summary in order to determine his level of communication/interaction, mobility, nutritional status, and creative measures.
Erik Erikson’s psychosocial theory emphasizes development of individual identity throughout a normal life span. It consists of 7 stages that are based on age and developmental tasks. My patient is in the 5th stage of life known as Identity vs. Role Confusion for ages 12-20. At this stage adolescents should establish a sense of identity, experience physiological and emotional changes, and search for peer acceptance. He is developing properly according to Erikson’s theory. Before the onset of his illness he experienced the teenage life of running around with his friends, playing basketball, and showing of his sense of humor. After the onset of the illness he no longer goes out with his friends or allow them to visit. He is at the age where he understands that his disease does have a treatment and he is willing to “do whatever it takes to get better”.
By the age of 14, the proper usage of nouns, verbs, and adjectives are used to describe his feelings, thoughts, and point of views. Slang and vulgar words begin to increase as a part of peer influences. He communicates clearly and effectively about his wants and needs. He is able to state his discomforts and useful information to the staff. The family has effective communication as demonstrated in the initial assessment of the patient. Both parties spoke of his symptoms and expressed their concerns.
It is assumed that my patient is mobile. He states that he ceased his participation in activities because of his lack of energy and the fear of returning symptoms- not because he was immobile. His growth and development appear to be normal as evidence by his height of 60 inches and his current weight of 125 pounds. In Crohn’s Disease there may be limited mobility caused by pain. Limited mobility may cause further decrease in social interactions.
The human body needs proteins, fats, calories, vitamins, and minerals to grow, build new cells and tissues, and carry out many vital functions. Nutritional deficiencies are a serious problem for teens with Crohn’s Disease. Some of these problems include stunted growth and the prevention of medications to work properly. In this patient his nutritional deficit is leaving him to feel tires, weak, and depressed. It also may be the cause of him looking pale and being thin. His breakfast consisted of two doughnuts and a glass of milk. His mother states that his appetite has greatly diminished and he has lost an average of fifteen pounds within the last 3 months.
The patient is currently not interacting with others. He insists that his mother turns away his friends from visiting. He doesn’t hang out with them anymore, for the fear that he did not know when his stomach pain and diarrhea would return. The patient could be ashamed of his appearance and is afraid for his friends to see him in that condition. He has a good relationship with his brother and has a supportive family. The patient interacts age appropriately with the nurses by answering questions appropriately.
Creative measures should be implemented to help the patient achieve optimum health as soon as possible. As a nurse you could bring in pamphlets or brochures for the teen that are easily understood. Those would lead into conversation about what he is expecting out of his treatment. Nurses could also bring in things that the patient may like to divert his attention from his pain and worry and make him a little more comfortable. The nurse could see if there are more adolescents in the hospital that have Crohn’s and are willing to talk with him about the disease. The nurse could also go in a spend a little time with the patient and see if he would like to play a game or just seeing if he wants to talk to avoid depression. All of these measures would also help him with social interaction.
Most people with Crohn’s disease can live active lives with very few restrictions. There is no cure for the disorder but is manageable with treatments. For few patients the disease can be both difficult and complicated to deal with. Surgery is sometimes required. Follow-up care is essential to treat the disease and prevent or deal with the complications that may arise.