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Welcome - personalize your path
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Safety first
- 1) Monitor perfusion and electrolytes during flares (MAP, HR, Na/K).
- 2) Infection precautions with steroids/biologics; screen TB before biologics.
- 3) Choose pain meds that spare motility; avoid NSAIDs (bleed risk) unless ordered.
- 4) Watch for toxic megacolon cues: fever, tachycardia, distention, pain.
Perfusion and absorption
"I line the villi. I need perfusion to pull nutrients, water, and electrolytes. In UC, my mucosa gets ulcerated; in Crohn, transmural inflammation can fistula and steal my surface."
"I defend the gut. In IBD I overreact; perfusion loss worsens tissue injury. Steroids calm me but raise infection risk."
| # | Perfusion input | Factory part | Tissue OK | Tissue LOW/Inflamed | Observable cue | Nursing action + reason |
|---|---|---|---|---|---|---|
| 1 | MAP and oxygen | Enterocyte ATP | Good absorption | Poor absorption, diarrhea | Loose stool, weight loss | Hydrate, replace electrolytes; monitor MAP. |
| 2 | Nutrients | Villus surface | Intact lining | Ulcerated mucosa | Bloody diarrhea (UC) | Monitor blood loss; prepare for iron/PRBC per order. |
| 3 | Venous return | Wall drainage | Normal | Transmural edema | RLQ pain, fistula drainage (Crohn) | Measure output; protect skin; nutrition support. |
| 4 | Perfusion reserve | Colon smooth muscle | Normal tone | Risk of toxic megacolon | Fever, tachycardia, distention, pain | Rapid notify, NPO, decompress per order, prepare OR?prevent perforation. |
Complication bridge: Hypoperfusion with active inflammation leads to deep wall edema. In UC that can progress to toxic megacolon or perforation. In Crohn it can progress to fistula or abscess. Early MAP support together with inflammation control lowers these risks.
Layer view
Crohn: transmural, skip, fistula risk. UC: mucosal, continuous from rectum upward.
Quick Cue Radar
Fast map: cue to meaning to move.
Bloody diarrhea with urgency
Meaning: mucosal ulceration (likely UC).
Actions:
1) Monitor H/H and electrolytes
2) Administer steroids/5-ASA per order
3) Watch for toxic megacolon cues
Why:
1) Blood and fluid loss affect perfusion
2) Calms inflammation
3) Early catch prevents perforation.
RLQ pain, weight loss, fistula drainage
Meaning: Crohn transmural disease.
Actions:
1) Nutrition support (high-calorie, may need TPN if ordered)
2) Skin protection around fistula
3) Steroids/biologics per order
Why:
1) Malabsorption risk
2) Prevents skin breakdown
3) Calms immune overdrive.
Fever, tachycardia, distended tender abdomen
Meaning: possible toxic megacolon.
Actions:
1) Notify provider rapidly
2) Keep NPO
3) Prepare for imaging and possible surgery
Why:
1) High risk for perforation
2) Reduce risk aspiration/pressure
3) Rapid diagnosis needed.
Read-aloud
Use neural TTS where available; falls back to browser SpeechSynthesis.