Case Study Assignment
Patients with Crohns disease are faced with many challenges managing their long-term care. Access to healthcare and financial burdens are two barriers to healthcare often found with chronic health conditions. This is especially true with Crohns. Hospitalization for flare-ups related to Crohns averages $11,345 annually (CDC, 2019). Patient adherence to medications for their inflammatory bowel disease is key for flare-up prevention. Providers frequently encounter patients who stop taking their medications due to the financial burden. The purpose of this assignment explores evidence-based guidelines which address patient affordability of prescribed treatment for Crohns disease. Provision of care includes providing the patient with resources to obtain their medications, diagnostic tests, and access providers. Ethically, practitioners are to do all that they can to promote patient compliance. Treatment is only as good as patient compliance.
The necessary information for addressing the extreme flare-up would focus on the chief concern itself and any associated symptoms. Crohns diagnosis is established, so Information is needed to decrease the severity of symptoms (finding out what they are, where they are, and exacerbating/relieving factors), medical records (EGD/Coloscopy/GI series/CT scan/), prior and current medications and if they were effective. Vital signs and overall appearance (dehydration, anemia, abdominal distension, signs of malnutrition), auscultation of bowel sounds (small bowel obstruction/large bowel obstruction/absent), palpation for tenderness, spleen/liver enlargement, rigidity, fullness, or displacement. Deep palpation may be contraindicated risk for pancreatitis/obstruction/perforation of the bowel. No percussion. The man is in a lot of pain. If there are fistula involved, a rectal exam will be necessary (Ball et al. 2019).
The case study history or localized symptom with severity within the GI determines the type of diagnostic testing. Abdominal flat plate/KUB, CT abdomen with contrast, barium enema, endoscopy, and fluoroscopy. Bloodwork CBC, CMP, lipase, sed rate, and CPK. Stool, WBC, UA, and UDS.
Identifying the Location of Flare-Up is Necessary to Prevent Patient Mortality Crohns disease predisposes the case study to develop serious GI emergencies. Severe Crohns can develop small/large bowel obstructions, gut/bowel perforations, and abscesses within bowel walls. Severe flare-ups require hospitalization for resting the gut by NG tube for SBO or colostomy. Re-occurring abscess, perforation, and perianal fistulas may require surgery to rest the gut. Bowel resections leaving the patients with colostomy, or hopefully re-anastomosis. (National Institute of Health, 2017). Hepatobiliary complications of obstructions can create sepsis or pancreatic-related DIC. Evidence-based Intervention for Reducing Crohns disease Cost of Care Today, there are no evidence-based ethical resolutions for the financial burden of Crohns disease. Resolution of the case studys extreme flare-up regardless of the cost falls under the federal law of (EMTALA, 2014). The ethical burden falls upon the provider coordinating outpatient healthcare services and providing resources facilitating patient compliance (Chrons and Colitis Foundation, n.d.). Our case study can apply for Medicare and Medicaid services and prescription medication assistance programs. Crohns disease charitable organizations can offer financial aid. Healthcare practitioners understand long-term management improves the quality of life, preventing disability (Perry et al., 2018). Overall, this decreases the financial burden for the case study and the rest of the population needing healthcare.
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