NSG 110 Case Study for Concept Map #9

C.W. is a 36-year-old woman, who was admitted several days ago with a diagnosis or recurrent inflammatory bowel disease (IBD) and possible small bowel obstruction. She is married, and her husband and 11-year-old son are supportive, but she has no extended family in state. She has had IBD for 15 years and has been taking medications to help control it.

C.W. is very thin, 5’2” tall and weighs 87pounds. She has lost 40 pounds over the past 10 years. She has an average of 5-10 loose stools per day. The life has slowly become dominated by the disease which includes anorexia, profound fatigue, nausea and diarrhea, frequent hospitalizations for dehydration, and reoccurring crippling abdominal pain.

She explains that the pain comes unexpectedly and is incapacitating. She rates her pain at the present time an “8” on the numeric scale. She says they only thing that has helped is a small dose of valium, Pedialyte and bed rest. “I just cannot tolerate the pain. When it hits, I can’t do anything. I just lay in bed and cry.”

She confides in you that sexual activity is difficult: “It always causes diarrhea, nausea, and lots of pain. It is difficult for both of us.” “I feel like I am missing out on my son’s life also. I can’t go to his ball games or school events. My husband goes for both of us.”

Your assessment reveals Vital signs 99.8 F oral temp, heart rate is 100 and regular, blood pressure is 98/60. Lungs are clear. Bowel sounds are hyperactive. She is showing signs and symptoms of dehydration.