Ulcerative Colitis Concept Map


Rasmussen College

Author Note

This paper is being submitted on September 5, 2013, for Ms. Carole Guye’s NUR2034C

Fundamentals of Professional Nursing.



PATIENT TEACHING  Information about UC including acute

episodes, remissions and symptom mgmt.  Monitor for signs &symptoms of GI bleeding  Ostomy care management  Identify outpatient support groups  Self-management at home (Winkelman, 2013)

PATHOPHYSIOLOGY  Ulcerative Colitis (UC) usually begins in the rectum. It

may remain localized to the rectum (ulcerative proctitis) or extend higher, sometimes involving the entire colon. There is a sharp border between normal and affected tissue.

 It causes sores and inflammation of the lining, along with bleeding, pus, diarrhea and abdominal discomfort.

 Fistulas and abscesses do not occur  Toxic or fulminant colitis is when the ulcerations

extends through the intestinal wall, resulting in localized ileus and peritonitis. (Ulcerative Colitis, 2014 )

CAUSES  Not caused by stress or hypersensitivity to foods or

products but may trigger symptoms (Ulcerative Colitis, 2014)  Studies suggest caused by combination of heredity,

immune system, and environmental causes  Cause Unknown (What is Ulcerative Colitis, 2014)

NURSING CONSIDERATIONS  Ostomy or perineal wound care  Assess patient for pain pattern, occurrences  Monitor for signs/symptoms of GI bleeding  Monitor Vitals and Labs  Monitor pain and symptoms to maintain

comfort (Winkelman, 2013)

TREATMENTS & MEDICATIONS Treatments – No medical cure  Treatment goals to reduce symptoms:

1) Induce / maintain remission, 2) Improve quality of life, and 3) Individualize to treat patient

Diet & Nutrition  Avoid foods that aggravate UC

(What is Ulcerative Colitis, 2014)

Surgery  Total proctocolectomy with permanent

ileostomy – colon, rectum & anus removed  Total Colectomy – colon removal  Restorative Proctocolectomey with Ileal Pouch

Anal Anastomosis (RPC-IPAA) – create ileoanal reservoir

Medications  Route

– Enema – Rectal Foam – Suppository

– PO – IV

 Aminosalicylates – Reduce Inflammation – balsalazide – mesalamine – olsalazine – sulfasalazine

 Corticosteroids – Reduce immune system activity & Decrease inflammation – budesonide – hydrocortisone – methylprednisone – prednisone (Ulcerative Colitis, 2014)

 Immunomodulators – Decrease immune system activity – azathioprine – 6-mercaptopurine, or 6-MP

 Biologics – Decrease inflammation – adalimumab – golimumab – Infliximab – vedolizumab

 Other medications – Acetaminophen – mild pain – Antibiotics – prevent/treat infection – Loperamide – slow/stop diarrhea

(Ulcerative Colitis, 2014) – Cyclosporine – immunosuppresnt

(Cyclosporine, 2014)

SIGNS & SYMPTOMS  Bowel movements become looser and more urgent  Persistent diarrhea accompanied by abdominal pain

and blood in the stool (What is Ulcerative Colitis, 2014)  Anemia  Fever  Fatigue  Weight loss  Loss of appetite

 Skin lesions  Rectal Bleeding  Cramping abdominal pain  Growth failure in children  Loss of body fluid & nutrients

(Ulcerative Colitis, 2014)

DIAGNOSED  Physical Exam & Interview (health, diet, history)  Blood test – monitor anemia  Fecal matter – rule out bacterial/viral diarrhea causes  Sigmoidoscopy – see rectum/colon inflammation  Total Colonoscopy – visualize entire colon  Biopsy – sample of affect tissue removed for testing  Chromoendoscopy – blue spray during colonoscopy

to detect changes in lining (What is Ulcerative Colitis, 2014)  Computerized Tomography (CT) Scan – 3D image  Barium Enema X Ray – x-ray contrast (Ulcerative Colitis, 2014)

NURSING DIAGNOSES  Ineffective Coping r/t repeated episodes of diarrhea  Acute pain r/t abdominal cramp  Deficient fluid volume r/t frequent and loose stools  Impaired skin integrity r/t frequent stools, and

development of anal fissures  Imbalanced Nutrition: less than body requirements r/t

anorexia, decreased absorption of nutrients GI tract  Social Isolation r/t diarrhea (Ackley, 2014)



Ackley, B. J. and Ladwig, G. B. (2014). Inflammatory Bowel Disease [Child and Adult].

Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care (10th ed.).

Online: Mosby. Retrieved from Skyscape.

Ulcerative Colitis. (2014). National Digestive Disease Information and Kidney Diseases.

Retrieved from

What is Ulcerative Colitis? (2014). Crohn’s & Colitis Foundation of America. Retrieved from

Winkelman, C. (2013). Ulcerative Colitis. Clinical Company for Medical-Surgical Nursing:

Critical Thinking for Collaborative Care (7th ed.). Retrieved from Skyscape.

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