Ulcerative colitis is associated with weight loss due to different reasons. Firstly, patients often face psychological stress and poor emotional functioning. For the case of Eleanor, instances of diarrhoea were common. The argument could be associated with a significant fluid loss in the body. A major causative factor for diarrhoea in UC patients can be attributed to the loss of sodium absorptive capacity which is evident in the colonic mucosa. Besides, the process is also hindered by reduced active transport and misplaced and defective transport of the sodium ions. The underlying mechanism, for the loss of the salt and fluid absorption, can be explained based on the structural and functional changes linked to fluid intake. Increase in the cellular permeability is further attributed to structural and functional changes in the tight junction. Impaired functionality of beta and alpha subunits of sodium is altered during the process of electrolyte transportation. The balance between the sodium and hydrogen ion plays a crucial role in absorptive pathways expressed from the duodenum to the colon

The patient also reported cases of colitis. The condition often alters electrolyte water transport The changes thus gave rise to the symptoms encountered by the patient

The process of UC is also mediated by the buildup of the white blood levels within the mucosal linings of the intestines.

The pale and dry skin can be attributed to the excessive loss of body fluids during diarrhea. Also, bleeding also contributes to loss of blood thus causing the effect of the color change. The rate of UC can have both structural and functional damage through the intestinal layers thus causing anorectic inconsistencies. Based on the presented symptoms, the damage to the bowel wall is evident. Some of the complainings can be attributed to changes in the colon and the rectum damage.  The lesions have been shown to occur as a result of ulceration which then affects the integrity of the gut.

2. Pain is a pathological process that results from both physical and psychological responses. It results from a complex set of pathways initiated by both peripheral and the central nervous system. The pain stimuli often activate the nociceptors and receptors in tissues; thus pain is relayed in an electrical signal which s transmitted from the periphery to the central nervous system. It is then transmitted through the axon to the central nervous system. The process can then occur through the high threshold mechanoreceptors and polymodal nociceptors.

Morphine has often been used as one of the joint pain relievers. It achieves the process by binding to the receptors. When binding occurs, molecular signaling activates the receptors to initiate the pain relieving process. Based on the type of receptors, pain relievers interact with different receptors. Morphine interacts a higher affinity for the receptor. Activation of the m receptor is achieved through the opioid antagonist which inhibits all the receptors giving a room only for those that have a high affinity for the receptor. It produces an effect to neurons by acting on the receptors which are often located at major neurological membranes where the pain is detected. The three opioid receptors include the m, d, and k. The receptors are further described in a 7 transmembrane spanning domains linked to different amino acids. The naturally, occurring peptide d endorphin interacts with the m receptor and d and k receptors Morphine has a high affinity for the

Deteriorating ulcerative colitis symptoms include the worsening abdominal pain, distending bloated abdomen, high fever. Fulminating diarrhea is a sign of infective colitis. Common infections such as salmonella can also occur in patients with UC. The symptoms of bowel obstruction also create an emergency case of UC. The process is manifested through repeated flares and colitis which often results in serious complications. An increase in limb deficiencies and obstructive urinary congenital also show deteriorating effects of the condition

The objection would be done with the aim of administering antibiotics, steroids, or drugs that affect the immune system. Since the gastroenterological surgeon has recommended total colostomy and construction of ileostomy, the rationale would involve close monitoring of fluids and electrolyte to stabilize the patient’s condition.  The step is vital since Elenor reported an excessive fluid loss. The injection should be able to address the loss of sodium. The process would require monitoring and replacement of the fluid used to correct dehydration. The electrolyte used should be regularly changed to address the imbalance of sodium. The case of Elena also provided a clue for malnourished patients. Thus she should be provided with additional nutritional supports. Enteral nutrition would, therefore, be the most appropriate for Elenear. Based on the skin turgor issues and loosened neck veins it is essential to monitor the patient’s blood count. The response to treatment should then be observed with the aim of checking for any improvement or deterioration. The process can be achieved by monitoring the patient’s full blood counts and electrolytes. Radiography can also be used to access the extent of the infection and predict the desired response to treatment.

 
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