NURSING DIAGNOSIS: Nutrition: imbalanced, less than body requirements
May be related to
- Altered absorption of nutrients
- Hypermetabolic state
- Medically restricted intake; fear that eating may cause diarrhea
Possibly evidenced by
- Weight loss; decreased subcutaneous fat/muscle mass; poor muscle tone
- Hyperactive bowel sounds; steatorrhea
- Pale conjunctiva and mucous membranes
- Aversion to eating
Desired Outcomes
Nutritional Status (NOC)
- Demonstrate stable weight or progressive gain toward goal with normalization of laboratory values and absence of signs of malnutrition.
7 Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Diarrhea — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Risk for Deficient Fluid Volume — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Anxiety — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Acute Pain — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Ineffective Coping — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Imbalanced Nutrition — Inflammatory Bowel Disease Nursing Care Plan (NCP)
- Knowledge Deficit — Inflammatory Bowel Disease Nursing Care Plan (NCP)
Imbalanced Nutrition — Inflammatory Bowel Disease Nursing Care Plan (NCP): Nursing Interventions & Rationale
| Nursing Interventions | Rationale |
| Weigh daily. | Provides information about dietary needs/effectiveness of therapy. |
| Encourage bedrest and/or limited activity during acute phase of illness. | Decreasing metabolic needs aids in preventing caloric depletion and conserves energy. |
| Recommend rest before meals. | Quiets peristalsis and increases available energy for eating. |
| Provide oral hygiene. | A clean mouth can enhance the taste of food. |
| Serve foods in well-ventilated, pleasant surroundings, with unhurried atmosphere, congenial company. | Pleasant environment aids in reducing stress and is more conducive to eating. |
| Avoid/limit foods that might cause/exacerbate abdominal cramping, flatulence (e.g., milk products, foods high in fiber or fat, alcohol, caffeinated beverages, chocolate, peppermint, tomatoes, orange juice). | Individual tolerance varies, depending on stage of disease and area of bowel affected. |
| Record intake and changes in symptomatology. | Useful in identifying specific deficiencies and determining GI response to foods. |
| Promote patient participation in dietary planning as possible. | Provides sense of control for patient and opportunity to select foods desired/enjoyed, which may increase intake. |
| Encourage patient to verbalize feelings concerning resumption of diet. | Hesitation to eat may be result of fear that food will cause exacerbation of symptoms. |
| Keep patient NPO as indicated. | Resting the bowel decreases peristalsis and diarrhea, limiting malabsorption/loss of nutrients. |
| Resume/advance diet as indicated, e.g., clear liquids progressing to bland, low residue; then high-protein, high-calorie, caffeine-free, nonspicy, and low-fiber as indicated. | Allows the intestinal tract to readjust to the digestive process. Protein is necessary for tissue healing integrity. Low bulk decreases peristaltic response to meal. Note: Dietary measures depend on patient’s condition, e.g., if disease is mild, patient may do well on low-residue, low-fat diet high in protein and calories with lactose restriction. In moderate disease, elemental enteral products may be given to provide nutrition without overstimulating the bowel. Patient with toxic colitis is NPO and placed on parenteral nutrition. |