Report: 

NURBN 3033 Assessment Task 2 Self-Manage bh

NURBN 3033 Assessment Task 2 Self-

Manage bh
by Gatumbo Gatumbo

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Report: NURBN 3033 Assessment Task 2 Self-Manage bh

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Report: NURBN 3033 Assessment Task 2 Self-Manage bh

NURBN 3033 Assessment Task 2 Self-

Manage bh
NURBN 3033 Assessment Task 2 Analyse and Develop a Self-Management Plan
Student Name:
Student Number:
Due Date:
Word Count:

Introduction and SMART Goals

Simon, a 65-year-old man, was diagnosed with Crohn's disease when he was a
teenager. When the lining of the digestive system becomes inflamed, as in
Crohn's disease, it causes several unpleasant symptoms. Simon describes
many symptoms, including chronic diarrhoea, rectal bleeding, an urgent need
to pass stools, abdominal cramping, the discomfort of incomplete evacuation,
and constipation (Lu et al.,2019). Although Crohn's can afflict anyone of any
age, ethnicity, or gender, it is most common in young adults. What triggers this
illness is still a mystery to scientists. While Crohn's disease often manifests at
the proximal end of the small intestine and the proximal end of the colon, it can
affect any portion of the gastrointestinal tract, from the mouth to the anus.
Possible side effects of this condition include lack of appetite, weakness, and
lethargy (Schreiber et al.,2021). Since Crohn's is a long-term condition, people
can go through periods of symptomatic flare-ups and symptom-free remission.
Simon was just taken to the hospital with worsening symptoms, including
severe stomach discomfort, bloating, and diarrhoea with melena. The
upcoming hospital discharge of Simon necessitates a self-care management

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Report: NURBN 3033 Assessment Task 2 Self-Manage bh

plan for him to follow once he returns home. In addition, Simon's

catheterisation necessitates nearly autonomous care, as the device might
function as a route for the spread of infection if sterility is not maintained.
Along with medical treatment (such as antibiotics or surgery), self-care is
crucial in managing Crohn's disease (Van et al.,2021). Self-management of
inflammatory bowel disease, including medication adherence, is linked to
better health and results for individuals. Although patient self-management is
multifaceted, it can be broken down into three distinct sub-concepts: patient-
centred, provider-centred, and socially inclusive. Self-management activities,
especially treatment adherence, can be improved at the individual level by
fostering problem-solving abilities and self-efficacy (Lichtenstein et al.,2018).
While there is currently no treatment for Crohn's disease, it may be controlled
with antibiotics like Flagyl or corticosteroid, as well as dietary and lifestyle
modifications, including increasing fibre intake (Chateau et al.,2020). Crohn's
disease has no known cure; however, it may be managed, and its symptoms
mitigated with the proper medication. Generally, medication is used to manage;
however, surgical intervention may be necessary in some cases. In extreme
instances, colon resections remove a portion of the affected bowel. It is
discouraging to deal with Crohn's disease day-to-day, but science is
progressing, and treatment options are expanding.
The three SMART goals are:
1. Because of his various medical issues, including a bowel blockage, anal
fissures., ulcers, fistulas, malnutrition, and more, Simon will need to take many
medications around the clock.
2. Simon should take a multivitamin daily and see a physiotherapist once
weekly for three months to replenish his depleted vitamin levels.

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Report: NURBN 3033 Assessment Task 2 Self-Manage bh

3. To reduce the severity of his Crohn's disease, Simon should follow the
treatment plan, which includes a healthy diet, regular exercise, social support,
and medication.
Discuss and Critically Analyse Consumer Directed Care/Self-Management
The term "consumer-directed care" (CDC) or "Self-Management" refers to a set
of practices in nursing informatics and planning that provide patients and their
caretakers greater involvement in how they are cared for (Wildman et al., 2021).
According to Wildman et al. (2021), Consumer-directed care and self-
management planning are crucial if Simon and other patients like him are to
maintain their independence in the community. If care for the client is well-
organised, they may be able to maintain their health and independence for a
more extended period (Logan et al.,2020). Although self-management
education interventions for Crohn's disease have been created, their efficacy
has not been extensively examined.
The Centres for Disease Control and Prevention (CDC) are based on many key
ideas;
1. Enhanced capacity for adaptation and natural selection.
2. An increase in people's capacity to receive the necessary data to make well-
informed health-related decisions, such as treatments to seek out, which
providers to work with, and how these therapies will be offered.
3. More open communication and teamwork between healthcare providers and
patients may improve patient health and patients' ability to make treatment
decisions. The CDC's primary objective is to promote self-sufficiency among its
constituents. By reversing the traditional decision-making sequence and
providing residents with more involvement in day-to-day challenges, this
empowerment aims to promote individual autonomy and quality of life.

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Report: NURBN 3033 Assessment Task 2 Self-Manage bh

Creating a strategy for self-management is an integral part of the CDC. It is a

method for handling chronic health issues prioritising individuality and self-
responsibility. The word "self-care" refers to the wide variety of actions one
does for oneself in order to deal with the discomfort associated with a chronic
illness. An individual's responsibility for their health is emphasised throughout
the strategy (Al-Yateem et al., 2016). Incorporating assessment, collaborative
care, client empowerment, expanded capacity, referrals to community
resources, and a focus on taking personal responsibility for one's health, this
approach aims to improve health outcomes throughout a person's lifetime
(Attauabi et al.,2021). Clients like Simon can rely on CDC planning and self-
management planning to help them stay in their homes and communities.
Clients may enjoy more prolonged periods of good health and independence if
their treatment is planned precisely (Eberl et al., 2019). Simon, whose Crohn's
disease symptoms have been controlled, has been discharged from the
hospital and will soon return home.
Due to his chronic disease, Simon has to learn to take care of himself in old age.
Now that he is divorced and lives alone, he must continue to do so in order to
protect his autonomy and quality of life. So that he can function independently
in the community, Simon requires consumer-directed care and self-
management planning (Gomollón et al.,2017). Simon can maintain his health
and independence by being well-prepared for each day. In order to avoid
unnecessary hospitalisations while maintaining optimal health when self-
managing a chronic condition like Crohn's disease, careful attention to detail is
required daily. Simon has to be reminded to take his medicine as prescribed,
participate in his physical therapy, and keep track of his diet and nutrition
because of his GIT condition (Kennedy et al.,2019).

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Furthermore, he must be sensitised to the point where he can notice the signs
of discomfort and understands when to seek expert treatment. Simon, now an
adult, must shoulder the psychological and interpersonal demands of self-care
for the lifetime of his chronic condition (Al-Yateem et al., 2016). His loved ones
and the individuals under his care must support him. Furthermore, he needs a
strategy outlining his self-management technique and what to do in the event
of aggravation. To combat chronic malnutrition, vitamin deficiencies, and
possibly fatal GIT and urinary tract infections resulting from Crohn's disease,
high-frequency percussion is used with other drugs and treatments (Attauabi
et al.,2021). There is a need for a GIT physiotherapist and a clinical nurse expert
to assess his health. Some people with Crohn's disease experience early-onset
symptoms, such as constipation (which can develop into bowel blockage),
chronic diarrhoea, and stomach cramps and discomfort; nevertheless, these
signs are not caused by the illness but rather by external factors.
Consumer-guided care/self-management planning is essential for patients
with chronic diseases like Crohn's disease who wish to maintain their
functional autonomy. An excellent care plan can help the individual stay
healthy and independent by informing them about their chronic condition,
instructing them in the proper use of drugs and other treatments (such as
physical therapy), and alerting them to the earliest indications of decline
(Kammermeier et al.,2016). Healthcare planning in which the patient is involved
plays an instrumental part in making decisions, also known as consumer-
directed care or chronic disease self-management planning (CDT/SMP), which
is increasingly becoming the norm in the medical community (Vernia et
al.,2020). The training should cover the individual's medications, dosage
instructions, and a discussion of any possible side effects.

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Report: NURBN 3033 Assessment Task 2 Self-Manage bh

Design a Self-Management Care Plan

Nutritional adherence

SMART GOAL 1:

Constipation, malnutrition, and vitamin inadequacy are a few Crohn's disease

complications that necessitate constant nutritional observance for Simon (Ding
et al., (2016).

SMART GOAL 2:

Simon should ensure that every food he eats contains fibre daily. Foods rich in
soluble fibre can help him slow his digestion and ease diarrhoea.

SMART GOAL 3:

Simon should take a multivitamin daily to boost his body's vitamin stores and
availability (Ding et al., (2016).
Abdominal pain management by using analgesics Panadol PRN for 14 days

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Within hours of an exacerbation, the pain level should decrease by a scale of 2-

3 when it arises at home using the Panadol PRN.

Simon shows enhanced mobility in a week. Enhanced movement lessen the

likelihood of additional pain abnormalities when at home.

Simons' vital signs, such as heart rate, blood pressure, respiratory rate, and
muscle tone or posture, return to normal within a week.

Simon's two-hour education sessions aim to increase his understanding of

Crohn's disease.

Simon should participate in a self-management education program that

teaches him to how to control their own Crohns disease. Benefits to his health
and infection management will be realised as he will get more insight into

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pharmacological and non-pharmacological therapies for Crohn's disease

(Dolinger et al.,2020).

Education in the use of balance exercises, regular intervals of rest, and

pharmacological therapies to boost joint activity, facilitate mobility, and
decrease inflammation

Effective nutrition management and fewer carbohydrates are both possible for
Simon's education on nutritional management (Chateau & Peyrin-Biroulet,
2020).

Enhancing Patient Compliance with Medication through teaching their

importance to Simon for 30 minutes.

Simon has been given prednisolone to increase his immune system and bring
down the inflammation in his colon. Disease development can be halted by
patient adherence to medication (Bullock et al., 2018). Simon must follow the
prescribed course of treatment. It is necessary to develop the ability to keep
medication on one's habits regarding medication non-adherence and replace
those unhealthy ones with ones that promote more confidence in one's abilities
(Adamina et al.,2020).

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Simon needs to take his medication each day without fail timely.
The symptoms will worsen if the medication is not taken as prescribed. Simon
has to learn to self-manage the medicine he takes to lower his risk of
developing poor QoL and mental health issues due to his limited mobility and
poor self-care (Adamina et al.,2020).

Simon is to receive a monthly 0.9%;1000 millilitres of normal saline to maintain

the hydration level in the body and prevent constipation.

Educating Simon on dressing for peripherally inserted central catheter for 15

minutes.

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During dressing the peripherally inserted central catheter, the insertion site
should be checked for signs of infection every two days for redness or swelling.

Simon requires instruction on maintaining the PICC line, including the

possibility that he will need to flush it once a day while it is not in use.

Simon must examine the dressing to guarantee it is clean and in good shape.
The dressing may need to be changed if it shows signs of wear and tear, such as
peeling edges, dirt, or blood.
Self-management of Crohn's disease via a multidisciplinary team (MDT) or
other health specialists.

Simon needs to be exercising by using the physiotherapist after every two days.
Studies show that exercise effectively alleviates Crohn's symptoms by lowering
stress (Lu et al., 2019).

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These exercises, performed under a physiotherapist's guidance, aid in restoring

normal bowel and muscular function and reducing inflammatory processes in a
month.

Simon needs to see a nutritionist every month so that he may make dietary
changes to help him manage the risks associated with his Crohn's disease.

Providing psychological support for one month.

Simon requires a counselling session regarding his stress for two weeks visit to
a counsellor.
His risk of mental stress and anxiety will decrease by two weeks of counselling,
and he will be more motivated to live a healthy lifestyle by sticking to a
nutritious diet, avoiding flare-ups, and prioritising his health care if he receives
psychological assistance (Logan et al.,2020).

Through a visit to counselling services for two weeks, Simon's

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social interaction will help him move about more efficiently and reduce the
likelihood of future deformities. Reduced body image and self-esteem are
avoided when people have access to psychosocial help (Logan et al.,2020).

1
There is a need for the counsellor to engage the relatives, such as his sons, so
show him support throughout his disease process for an hour of counselling.
His insecurities may cause him to withdraw from friends and family. These
issues stem from stress, despair, and anxiety. Better Crohn's disease
management can be achieved by increased social engagement, which he
should be encouraged to pursue (Van Rheenen et al.,2021)

Reference List

Adamina, M., Bonovas, S., Raine, T., Spinelli, A., Warusavitarne, J., Armuzzi, A.,
... & Zmora, O. (2020). ECCO guidelines on therapeutics in Crohn's disease:
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https://doi.org/10.1093/ecco-jcc/jjz187
Attauabi, M., Burisch, J., & Seidelin, J. B. (2021). Efficacy of ustekinumab for
active perianal fistulising Crohn's disease: a systematic review and meta-
analysis of the current literature. Scandinavian Journal of Gastroenterology,
56(1), 53-58.https://doi.org/10.1080/00365521.2020.1854848
Chateau, T., & Peyrin-Biroulet, L. (2020). Evolving therapeutic goals in Crohn's
disease management. United European gastroenterology journal, 8(2), 133-139.
https://doi.org/10.1177/2050640619887316
Dolinger, M. T., Person, H., Smith, R., Jachin, L., Pittman, N., Dubinsky, M. C., &
Lai, J. (2020). Pediatric Crohn's disease and multisystem inflammatory

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syndrome in children (MIS-C) and COVID-19 treated with infliximab. Journal of

pediatric gastroenterology and nutrition.
https://doi.org/10.1097/mpg.0000000000002809
Ding, N. S., Hart, A., & De Cruz, P. (2016). Systematic review: predicting and
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Eberl, A., Hallinen, T., af Björkesten, C. G., Heikkinen, M., Hirsi, E., Kellokumpu,
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Gomollón, F., Dignass, A., Annese, V., Tilg, H., Van Assche, G., Lindsay, J. O., ... &
Ecco. (2017). 3rd European evidence-based consensus on the diagnosis and
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Gionchetti, P., Dignass, A., Danese, S., Magro Dias, F. J., Rogler, G., Lakatos, P.
L., ... & Ecco. (2017). 3rd European evidence-based consensus on the diagnosis
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Kammermeier, J., Morris, M. A., Garrick, V., Furman, M., Rodrigues, A., Russell,
R. K., & BSPGHAN IBD Working Group. (2016). Management of Crohn's disease.
Archives of disease in childhood, 101(5), 475–480.
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Kennedy, N. A., Heap, G. A., Green, H. D., Hamilton, B., Bewshea, C., Walker, G.
J., ... & Bell, A. (2019). Predictors of anti-TNF treatment failure in anti-TNF-
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Logan, M., Gkikas, K., Svolos, V., Nichols, B., Milling, S., Gaya, D. R., ... &
Gerasimidis, K. (2020). Analysis of 61 exclusive enteral nutrition formulas used
in managing active Crohn's disease—new insights into dietary disease triggers.
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Lichtenstein, G. R., Loftus, E. V., Isaacs, K. L., Regueiro, M. D., Gerson, L. B., &
Sands, B. E. (2018). ACG clinical guideline: management of Crohn's disease in
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Lu, C., Holubar, S. D., & Rieder, F. (2019). How I approach the management of
2
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Lim, A., ... & D'Haens, G. R. (2021). OP26 Risankizumab induces early clinical
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Vernia, F., Di Ruscio, M., Stefanelli, G., Viscido, A., Frieri, G., & Latella, G. (2020).
Is faecal calprotectin an accurate marker in the management of Crohn's

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disease? Journal of gastroenterology and hepatology, 35(3), 390-400.

https://doi.org/10.1111/jgh.14950
van Lingen, E., van der Marel, S., Maljaars, J., Keller, J., & van der Meulen-de
Jong, A. (2022). Comment on Szczubełek et al. Effectiveness of Crohn's Disease
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... & Ruemmele, F. M. (2021). The medical management of paediatric Crohn's
disease: an ECCO-ESPGHAN guideline update. Journal of Crohn's and Colitis,
15(2), 171-194. https://doi.org/10.1093/ecco-jcc/jjaa161
Wildman, M. J., O'Cathain, A., Maguire, C., Arden, M. A., Hutchings, M., Bradley,
J., Walters, S. J., Whelan, P., Ainsworth, J., Buchan, I., Mansfield, L., Sutton, L.,
Tappenden, P., Elliott, R. A., Hoo, Z. H., Drabble, S. J., & Beever, D. (2021). A
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Thorax, thoraxjnl-2021-217594. https://doi.org/10.1136/thoraxjnl-2021-
217594

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Crohn's disease. sentences

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