Mrs Bennett Mrs. Bennett is a 63-year-old woman with a history of malabsorption syndrome secondary to celiac disease. She is 168cm (5’6″) tall and weighs 45 kilos.

QUESTION

Mrs Bennett Mrs. Bennett is a 63-year-old woman with a history of malabsorption syndrome secondary to celiac disease. She is 168cm (5’6″) tall and weighs 45 kilos. She arrives in the emergency department with GI pain, an elevated temperature and heart rate and a decreased blood pressure. She describes severe bloating after meals, chronic diarrhoea, and weight loss, and notes she is always tired, and “can’t ever get warm enough”, especially her hands and feet. Her oxygen saturation is 89% on room air. She is pale and fatigued. She has a rash on her elbows that presents with erythema and blisters. She tells you she is regularly unwell and “catches everything going around” and often feels sad or anxious because of her health and lack of motivation to see friends and complete ADL’s. She states that she tries, but she is not always compliant with her dietary recommendations. Mrs. Bennett is placed on 4 litres of oxygen by nasal cannula. Her oxygen saturation improves to 96%. A regular diet is prescribed, with strict intake and output documentation and calorie counts. • Assessment: – Alert and orientated – Nil complaints of pain – Pale skin, lips, and fingernails – SOB • Vitals: – BP 100/65 – HR 115 – RR 24 – O2 Sats. 89% room air – 2L O2 applied O2 saturation increased to 95% – Temp 38.5

Develop two (2) nursing diagnoses for this patient. • For each diagnosis develop one (1) nursing interventions • Provide appropriate rationales for each intervention

Nursing Diagnosis:

Intervention:

Rational:

Nursing Diagnosis:

Intervention:

Rational:

ANSWER

Celiac Disease and Malabsorption Syndrome: Nursing Interventions for Improved Patient Outcomes

Introduction

Celiac disease is an autoimmune disorder characterized by an immune response to gluten, a protein found in wheat, barley, and rye. It leads to damage in the lining of the small intestine, resulting in malabsorption of nutrients. This essay will discuss two nursing diagnoses for Mrs. Bennett, a 63-year-old woman with a history of malabsorption syndrome secondary to celiac disease, and provide corresponding nursing interventions and rationales for each.

Nursing Diagnosis 1: Impaired Gas Exchange related to decreased oxygen saturation as evidenced by SOB, decreased oxygen saturation, and increased respiratory rate.

Intervention: Administer oxygen therapy as prescribed.

Rationale

Administering supplemental oxygen is essential in improving oxygenation and relieving symptoms of impaired gas exchange. By providing oxygen therapy through nasal cannula at a flow rate of 4 liters per minute, Mrs. Bennett’s oxygen saturation improved from 89% to 95%. This intervention increases the partial pressure of oxygen in arterial blood, facilitating better oxygen delivery to tissues and organs (Weekley, 2022). Improved oxygenation decreases the workload on the heart and respiratory system, alleviating Mrs. Bennett’s shortness of breath and promoting improved gas exchange.

Nursing Diagnosis 2

 Imbalanced Nutrition

Less than Body Requirements related to malabsorption syndrome secondary to celiac disease as evidenced by severe bloating after meals, chronic diarrhea, weight loss, and decreased weight (Zuvarox, 2022).

Intervention

Provide dietary education and reinforce the importance of compliance with a gluten-free diet.

Rationale

 Celiac disease causes damage to the lining of the small intestine, leading to impaired nutrient absorption and malnutrition. Providing dietary education to Mrs. Bennett is crucial in ensuring her understanding of the significance of adhering to a strict gluten-free diet (Cardo et al., 2021). By avoiding foods containing gluten, Mrs. Bennett can prevent further damage to the intestinal lining, promote healing, and improve nutrient absorption. Reinforcing the importance of compliance with the diet will help alleviate symptoms such as bloating, chronic diarrhea, and weight loss, while promoting weight gain. This intervention aims to optimize Mrs. Bennett’s nutritional status and overall well-being.

Conclusion

Nursing interventions play a vital role in improving patient outcomes for individuals with celiac disease and malabsorption syndrome. Administering oxygen therapy can enhance oxygenation and alleviate symptoms of impaired gas exchange, while providing dietary education and emphasizing compliance with a gluten-free diet can improve nutritional status and alleviate gastrointestinal symptoms. By implementing these interventions, nurses can contribute to the holistic care of patients like Mrs. Bennett, promoting their health and well-being.

References

Cardo, A., Churruca, I., Lasa, A., Navarro, V., Vázquez-Polo, M., Perez-Junkera, G., & Larretxi, I. (2021). Nutritional Imbalances in Adult Celiac Patients Following a Gluten-Free Diet. Nutrients, 13(8), 2877. https://doi.org/10.3390/nu13082877 

Weekley, M. S. (2022, April 28). Oxygen Administration. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK551617/ 

Zuvarox, T. (2022, July 25). Malabsorption Syndromes. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK553106/