Causes and Management of Weight Loss in Ulcerative Colitis
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Added on  2023/04/11
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This document discusses the causes and management of weight loss in ulcerative colitis. It explores the structural and functional changes that occur, as well as the role of inflammation and pharmacological factors. The document also provides recommendations for addressing weight loss and minimizing symptoms.
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Assignment NameStudent ID Assignment Name Course Name Assignment Code 28 Mar 2019 1
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Assignment NameStudent ID Answer 1: In the present case, Eleanor is suffering from ulcerative colitis, which causes inflammation and ulcers in the inner lining of the colon and rectum. As a result of which, the ulcers developed on the inner lining male leads to bleeding and production of mucus. Further, according to the case history, the inflammation affects the whole colon, and the condition is known as pancolitis. The common symptoms associated with this condition include loss of appetite and weight loss. This is reflected in the present clinical intervention, as Eleanor has lost 9 kg in the past two weeks. According to a report, the indication of weight loss is because of malnutrition condition (Chiba, Tsuda, Komatsu, Tozawa & Takayama, 2016). As such, the body is not getting efficient calories to meet the routine requirement and thus results in significant weight loss. Apartfromappetite,othersignificantreasonsforweightlossincludestructuralchanges (inflammation), resulting in (Lemberg & Day, 2015): ï‚·Food aversion which causes nausea like symptom and gives inner feeling to avoid food intake. Further, the aversion is also resulting due to the association of food eating with pain. ï‚·Malabsorption of nutrients due to inflammation in the inner lining of the colon. This is also affected because of disturbance in the gastrointestinal tract that leads to upset and poor absorption. ï‚·Increase in utilization of calories by the body, in response to fighting the disease. ï‚·Loss of nutrients due to internal bleeding and diarrhea. Functional changes - According to the report ofIrwin, Raehtz, Parameswaran & McCabe (2016), thepharmacologicalreasonassociatedweightlossofappetiteislinkedwithincreased 2
Assignment NameStudent ID Morphine is considered as contraindicated in inflammatory colitis cases, as it causes high- pressure generation in the sigmoid colon region. For short-term action and immediate relief, morphine is a choice of drug, which exerts action by acting on μ-opioid receptors. The down regulation of the receptor is responsible for the reduction of pain. However, the contraindication is because of side effects including reduced motility of colon and constipation, which can elevate the pain significantly (Burnstock, Jacobson & Christofi, 2017). Furthermore, it reduces intestinal transit and induces gut spasm. These side effects are also known to cause nausea and food aversion symptoms that can worsen the conditions. Answer 3: The blood pressure of Eleanor is 90/50 mm of Hg which reflects hypotensive condition and is associated with loss of blood due to internal bleeding. The shortness of breath is also reflective in the clinical results, with 25 breath/min. These conditions can worsen the condition of the patient as it denotes a significant level of stress and is associated with irregular heartbeat 120/min and presence of blood and mucus in stool. The erythrocyte sedimentation rate (ESR) is very high (31.3 mm/hour) which reflects marks increase in globulins and denotes severe infection. Furthermore, the condition severity can also be accounted for low-level haemoglobin 86 g/L, which is resultant from bleeding (Taghvaei et al., 2015). Eleanor must also be taken care of adequate hydration. The clinical manifestation depicts the dark-colored urine which reflects dehydration condition (Frank & de Virgilio, 2015). Moreover, it also suggests that dangerous waste materials were not eliminated from the body and concerns about the liver condition, as bile can be present in the urine. Importantly, the medication measures adopted for managing the 4
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Assignment NameStudent ID condition must also be reviewed. For example, intramuscular administration of morphine can lead to further deterioration of the condition, including elevation of pain and constipation. Answer 4: Hartmann’s solution is a sterile solution used for infusion and is effective in the present case, to manage dehydration condition and hypovolemic state in which there is a significant drop in circulating blood volume. The prescribed volume of the solution is 1000 ml which comprises of sodium chloride 6 g, potassium chloride 0.4 g, dihydrate calcium chloride .27 g and 50% sodium lactate 6.3 g. The pH of this solution is approximately 6 and thus is compatible with body fluid to maintain the water volume. Care must be taken with the infusion of this solution, as it may cause alkalosis due to the presence of lactate ions (Poggioli, Gentilini, Coscia, Boschi & Ugolini, 2019). The oral route of administration is difficult in the present case, as it can reach the part of the affected intestine and colon region. IV route, in this case, will prevent irritation. More importantly, during the IV administration, it is important to note that no air entry should be existing as it may lead to the risk of air embolism. Additionally, the solution container must be used for a single time (not to reconnect the partial container), during the administration. 5