Crohn's Disease Case Study: Nursing Care and Ethics
This case study examines nursing care for a 27-year-old male patient admitted to the emergency room during a Crohn's disease flare-up caused by an inability to afford his medication. The paper addresses key diagnostic tests appropriate for assessing disease severity, including C-reactive protein, liver function, complete blood count, and electrolyte panels. It also explores the psychosocial impact of Crohn's disease on a young adult's work, social, and financial life. Ethical considerations focus on non-judgmental patient advocacy and connecting the patient with financial and social support resources. Finally, the paper applies Dorothea Orem's Self-Care Deficit Theory to frame nursing intervention, patient education, and long-term self-management of this chronic condition.
- Introduction and Initial Assessment: Patient background, initial interview, and clinical context
- Diagnostic Testing and Psychosocial Impact: Recommended lab tests and psychosocial burdens for patient
- Ethical Considerations: Non-judgmental advocacy and financial support resources
- Concepts, Theories, and Principles: Orem's Self-Care Deficit Theory applied to nursing care
- References: APA citations for all sources used
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What makes this paper effective
- The paper moves logically from clinical assessment to ethical concerns to theoretical frameworks, giving the analysis a clear, progressive structure suited to a nursing case study format.
- It balances biomedical detail (specific lab tests and their rationale) with holistic nursing concerns, including psychosocial impacts and financial barriers to adherence.
- The application of Orem's Self-Care Deficit Theory grounds the nursing interventions in a recognized theoretical framework, strengthening the academic credibility of the argument.
Key academic technique demonstrated
The paper demonstrates applied theoretical reasoning by linking Orem's Self-Care Deficit Theory directly to a concrete clinical scenario. Rather than describing the theory in the abstract, the author uses it to justify specific nursing actions — patient education, financial navigation, and emotional support — showing how theory informs practice in a coherent, evidence-based way.
Structure breakdown
The paper opens with an introduction to the patient and the clinical context, followed by a section on appropriate diagnostic tests and the psychosocial burden of the disease. An ethical considerations section addresses non-judgmental advocacy and resource connection. The final analytical section applies nursing theory before a standard APA reference list closes the paper. Each section builds on the last, moving from clinical to ethical to theoretical analysis.
Introduction and Initial Assessment
Crohn's disease can often be difficult to diagnose, given that it shares many similarities with inflammatory bowel disease (IBD), colitis, and irritable bowel syndrome (IBS). In this case, a 27-year-old man with Crohn's disease has been admitted to the emergency room. Crohn's disease is usually initially treated with drug therapy, although depending on its severity, surgical intervention may be required. "Though most patients respond to medical therapy, mainly steroids, with the addition of immunomodulators and more recently biologic agents, surgical intervention is usually required only for obstructing gastroduodenal disease secondary to strictures" (Schwartzberg et al., 2019, p. 231). Asking the patient whether he has had any prior surgery, reviewing his drug treatment regimen, and assessing the degree to which he had been adhering to it — including when he discontinued specific medications — would all be essential components of an initial interview.
Diagnostic Testing and Psychosocial Impact
One advantage for the patient in this instance is that his diagnosis is already clear, given that he has experienced a flare-up of his condition due to being unable to afford his medication. Still, even though his diagnosis is established rather than uncertain, a series of diagnostic tests should be performed. One common test is a C-reactive protein (CRP) test, which screens for signs of inflammation (Roybal, 2020). Testing liver function is useful to determine the degree of disease activity as well as for predicting the course of the disease (Roybal, 2020). One of the most common complications of Crohn's disease is malnutrition. A complete blood cell count can be used to detect anemia, and iron and B12 levels should also be screened (Roybal, 2020). Since electrolytes — particularly potassium — may be low due to dehydration, an electrolyte panel would likely also need to be performed (Roybal, 2020).
After determining the physical severity of the condition, the nurse should also discuss its impact on the patient's psychological health. Diseases affecting food, digestion, and excretion can be profoundly disruptive to a patient's ability to maintain a normal social life (Chiba et al., 2018). Avoiding certain foods and alcohol is often necessary to manage the effects of the condition. Given that the patient is 27 years old, this may present significant obstacles to living a normal social life. It can also create challenges in maintaining a demanding work or school schedule, particularly during a flare-up, which can cause the patient to miss both work and school. This, in turn, can make it difficult to secure adequate employment with the type of health insurance needed to sustain what can be an expensive drug and treatment regimen. The patient should also be interviewed to describe, on a personal level, what led him to go to the emergency room and seek medical attention this time, including his pain, discomfort, and other presenting symptoms.
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