KASAMA COLLEGE OF NURSING AND MIDWIFERY

CLINICAL LESSON PLAN 01

Course: Surgical Nursing

Topic: Ulcerative colitis Date: 5/01/23

Target Group: first year students Tim[Link]hrs to 12:00

Teaching Method: lecture. Duration: 1 hour

Audio Visual Aids: laptop, LCD Projector, Black board and chalk

Number of student: 20

Venue: Mungwi District Hospital Conference room

Presenter: (BSc student Midwifery and New born Care)

Supervisor: Mr Phiri
INTRODUCTION

Good morning class, my names are Mary Kazani, today we are going to look at Ulcerative colitis. With me is my supervisor Mr. Phiri
who is going to be with us throughout the lesson. Ulcerative colitis is an inflammatory bowel disease which causes irritation,
inflammation and ulcers in the lining of the large intestines.
OBJECTIVES
GENERAL OBJECTIVE: At the end of the lesson students should be able to demonstrate the understanding of ulcerative colitis
SPECIFIC OBJECTIVES: At the end of the lesson students should be able to;
1. Definition ulcerative colitis
2. State the types of ulcerative colitis
3. list the causes of ulcerative colitis
4. State risk factors of ulcerative colitis
5. Discuss the pathophysiology
6. Explain signs and symptoms of ulcerative colitis
7. Discuss management of a patient with this condition
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2 min [Link] DEFINATION Lecture Laptop and Lecture and Listening What is
ulcerative colitis projector explaining ulcerative colitis
Ulcerative colitis is a
diffuse non-
specific,chronic
inflammatory disease of
the large intestine of
idiopathic cause affecting
the mucosa characterised
by erosion and
ulcerations,characterised
by repeated cycle of
relapes and remission

TYPES

[Link] are the [Link] proctitis.

types ulcerative Inflammation is confined
to the area closest to the What are the
colitis
anus(rectum) and rectal types of
bleeding may be the only ulcerative colitis
sign of the disease
[Link]. Laptop
Inflammation involves
And projector Lecture and
5 min the rectum and the sigmoid lecture listening
explaining
colon the lower end of the
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colon.
[Link] sided colitis.
Inflammation extends
from the rectum up to the
rectum up through the
sigmoid colon and
descending colon .
[Link] This type
often affects the entire
colon and causes boults of
bloody diarrhoea that may
be severe.

8 min [Link] the causes Causes Lecture and Laptop and Asking Answering State the causes
of ulcerative explaining projector questions and questions of ulcerative
The cause of ulcerative
colitis explaining and listening colitis
colitis is idiopathic

predisposing factors
[Link] factors
-stress; leads to less blood
supply to the colon
[Link] factors
-Family history of
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inflammatory bowel
disease
[Link] factors
-Incidence is higher in
developed countries
[Link] infection of the
large intestines
[Link] to some food
stuff which cause an
antibody antigen reaction
8 min 3. list the causes [Link] reaction Listening State the causes
of ulcerative of ulcerative
Lecture and Laptop and Asking
colitis colitis
explaining projector questions and
explaining
20 [Link] the Pathophysiology Lecture Laptop and Asking Answering Explain the
min pathophysiolog projector questions and questions pathophysiolog
Ulcerative colitis usually
y of ulcerative begins as inflammation in
explaining and listening y of ulcerative
colitis the base of the mucosal colitis
layer of the large
intestine. The colon's
mucosal surface becomes
dark, red, and velvety.
Inflammation leads to
erosions that coalesce
and form ulcers. The
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mucosa becomes
diffusely ulcerated, with
hemorrhage, congestion,
edema, and exudative
inflammation. Abscesses
in the mucosa drain
purulent pus, become
necrotic, and ulcerate.
Sloughing causes bloody,
mucus-filled stools. As
abscesses heal, scarring
and thickening may
appear in the bowel's
inner muscle layer. As
granulation tissue
replaces the muscle
layer, the colon narrows,
shortens, and loses its
characteristic pouches
(hiatal folds).

20 [Link] the signs Signs and symptoms Lecture Laptop and Asking Answering List the signs
min and symptoms projector questions questions and symptom of
Symptoms vary from
and listening
Of ulcerative person to person Ulcerative
Discussion
colitis colitis
[Link] of appetite
[Link]/urgency bowel
movements
[Link] pains and
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cramps
[Link]/mucus in stool
[Link]
[Link]
[Link]
[Link] (rectal pain)

Management of
30 INVESTIGATIONS
min

[Link] taking will

Discuss the reveal signs and symptoms Lecture Laptop and Asking Answering Outline the
management of [Link] culture to exclude projector questions and questions management of
ulcerative colitis superimposed infection in explaining and listening ulcerative colitis
those who present with
exacerbations
-special culture condition Discussion
is required for possibility
of E. coli
[Link] with barium
enema may reveal the
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extent of the disease
[Link] will reveal
signs of inflammation in
the colon
[Link] for histology to
rule out colon cancer
[Link] to
evaluate for pattern and
character of mucosal
inflammation
Stool specimen analysis
reveals blood, pus, and
mucus but no disease-
causing organisms.
[Link] · Serum potassium,
management of magnesium, and albumin
Answering
ulcerative colitis levels are decreased.
· White blood cell count Laptop and questions Outline
is decreased. projector and listening management of
Lecture Asking
· Hemoglobin level is ulcerative colitis
decreased. questions and
explaining
· Prothrombin time is
prolonged.
· Elevated erythrocyte
sedimentation rate
correlates with severity of
the attack.
· Abdominal X-ray may
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reveal mucosal edema, and
absence of formed stool in
the diseased bowel

30 MEDICAL
min MANAGEMENT
The main principle of
therapy for the treatment Laptop and Answering Outline
are projector questions, management of
Asking
listening
[Link] active disease questions and Ulcerative
Lecture and writing notes
rapidly discussion colitis
discussion
[Link] cancer at an early
stage
[Link] patients for whom
surgery is appropriate
[Link] as good a quality
of life as possible
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non pharmacological
In severe ulcerative colitis,
patient should be kept nill
orally and only fed
parenterally in order to
allow the gastrointestinal
tract rest.
-In patients with moderate
symptoms supplementary
[Link] the nutrition should be given
management of to prevent malnutrition
ulcerative colitis Pharmacological
30 [Link] (Topical
min /systemic) Laptop and Outline the
[Link] management of
(Prednisolone) Asking Answering
ulcerative colitis
[Link] questions and questions
Projector
discussion. and listening

Indications for surgery Lecture

[Link] dysplasia
[Link]
haemorrhage(uncontrolled
)
[Link]
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[Link] mega colon
[Link] retardation

NURSING
MANAGEMENT
AIMS
[Link] anxiety
[Link] normal
elimination patterns
[Link] pain
[Link] fluid intake
[Link] rest
[Link] skin
breakdown
[Link] complication Asking
questions and
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COMPLICATIONS Discussing
[Link] Answering
questions
[Link] Discussion
and listening
[Link] Black board and
chalk
[Link] and
peritonitis
[Link]
[Link]-benign and
malignant

Asking
questions
[Link] the List the
complications complications
of ulcerative of ulcerative
colitis colitis

Answering
Discussion
Laptop and
projector
TASK
Differentiate between ulcerative colitis and Crohn’s disease
SUMMARY
We have come to the end of the lesson of which we have looked at the definition ulcerative colitis, the signs and symptoms and the
management
Evaluation
1. What is ulcerative colitis
2. List signs and symptoms
3. State the management for ulcerative colitis

REFERENCES
1. [Link]
2. [Link]
3. [Link]
4. [Link]
5. [Link]
6. [Link]
7. [Link]
8. [Link]
9.