Inflammatory Bowel Disease and Ostomies

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Questions and Answers

What are the key nursing priorities when managing a patient with Inflammatory Bowel Disease?

Analgesic administration only

Frequent blood transfusions

Strict bed rest and isolation

Management of diarrhea and fluid balance (correct)

Which of the following symptoms is specifically indicative of Crohn’s disease in a patient with abdominal pain and rectal bleeding?

Inflammation in the mouth (correct)

Ulceration starting from the rectum

Absence of symptoms

Ulceration in the colon lining

What is a common characteristic of a new ostomy?

Light yellow irrespective of health

Gray and hardened appearance

Dark brown in color immediately

Bright red if healthy (correct)

What nursing priority is critical post-operatively for a patient with cholecystitis?

Assessing and managing skin integrity Signup and view all the answers

Why would a physician recommend both NPO and TPN for a patient with pancreatitis?

To avoid further inflammation of the pancreas Signup and view all the answers

What capability does an ERCP provide in assessing pancreatitis compared to other biliary disorders?

It shows signs of elevated serum lipase levels Signup and view all the answers

What main dietary consideration should a nurse have for a patient with pancreatitis who is on NPO status?

Consider nutritional support through TPN Signup and view all the answers

Which of these is NOT a typical nursing consideration for a patient with a colostomy?

Promoting a vegetarian diet exclusively Signup and view all the answers

What is a positive Brudzinski's sign indicative of?

Meningeal irritation Signup and view all the answers

Which of the following describes a generalized tonic-clonic seizure?

Stiffening of muscles followed by jerking movements Signup and view all the answers

What is the primary goal of treatment for status epilepticus?

To stop seizures quickly and ensure cerebral oxygenation Signup and view all the answers

Which of the following is NOT a common cause of seizures?

High blood sugar Signup and view all the answers

How should a nurse respond during a seizure to ensure patient safety?

Protect the patient from injury and time the seizure Signup and view all the answers

What type of seizure involves an impairment of consciousness?

Complex partial seizure Signup and view all the answers

Which statement accurately describes the infection strategies to prevent HIV transmission?

Medical male circumcision can reduce the risk of infection Signup and view all the answers

HIV primarily targets which type of cells in the human body?

Cells with CD4+ receptors Signup and view all the answers

Which of the following is a characteristic of generalized absence seizures?

They present as brief staring spells Signup and view all the answers

What is the main focus of post-exposure prophylaxis for healthcare providers after potential HIV exposure?

Immediate initiation of antiretroviral therapy Signup and view all the answers

What could be a significant factor contributing to hyperglycemia in a post-operative diabetic patient?

Decreased physical activity Signup and view all the answers

Which of the following is a common symptom associated with advanced hypoglycemia?

Perpetual confusion Signup and view all the answers

What is the primary reason for weight loss in a patient with type 1 diabetes?

Utilization of protein and fat for energy Signup and view all the answers

What nursing priority is essential for a patient diagnosed with tuberculosis (TB)?

Medication adherence Signup and view all the answers

Which neurotransmitter is significantly decreased in patients with Parkinson’s disease?

Dopamine Signup and view all the answers

In managing a patient with heart failure, which of the following interventions is NOT a typical nursing priority?

Increase physical activity Signup and view all the answers

What is a common cause of death in patients with Amyotrophic Lateral Sclerosis (ALS)?

Pneumonia Signup and view all the answers

Which of the following nursing priorities is important for a patient undergoing treatment for HIV/AIDS?

Pain management Signup and view all the answers

Which indication suggests a patient may be undergoing neurogenic shock?

Tachycardia and hypotension Signup and view all the answers

What type of insulin replacement method is being utilized by a patient who spreads their daily insulin dosage throughout the day?

Insulin pump Signup and view all the answers

What is a primary risk factor for the development of urinary calculi?

Inadequate hydration Signup and view all the answers

What complication is associated with hyperthyroidism?

Osteoporosis Signup and view all the answers

What is typically NOT a symptom of hypothyroidism?

Hypersensitivity to heat Signup and view all the answers

Which condition is defined by weakness that starts in the lower extremities and progresses upwards?

Guillian-Barre syndrome Signup and view all the answers

What type of brain injury occurs due to acceleration and deceleration forces, potentially leading to widespread damage?

Diffuse axonal injury Signup and view all the answers

Which of the following is not a common cause of brain injury?

Sports injuries Signup and view all the answers

What is the primary risk associated with repeated concussions?

Chronic traumatic encephalopathy Signup and view all the answers

Which statement regarding intracranial pressure is true after brain injury?

It may lead to herniation if it continues to rise. Signup and view all the answers

What is a characteristic sign of a skull fracture?

Halo sign Signup and view all the answers

What can lead to secondary brain injury?

Cerebral edema and ischemia Signup and view all the answers

Which type of spinal cord injury results in paralysis of all four limbs?

Quadriplegia Signup and view all the answers

What is a common consequence of neurogenic shock following a spinal cord injury?

Decreased cardiac output Signup and view all the answers

What is the primary management goal in a patient with a head injury?

Prevent secondary brain injury Signup and view all the answers

Which of the following signs indicates a possible cerebral hemorrhage?

Battle's sign Signup and view all the answers

What is the immediate nursing action for a patient with a suspected spinal cord injury?

Assume cervical spine injury Signup and view all the answers

Which of the following describes a contusion?

Severe injury with potential hemorrhage Signup and view all the answers

How does spinal shock manifest after injury?

Flaccidity and loss of reflexes Signup and view all the answers

In the case of intracerebral hemorrhage, what does the extent of injury depend on?

Amount of force applied to a small area Signup and view all the answers

Which of the following reflects a sudden depression of reflex activity in the spinal cord below the level of spinal cord injury?

Spinal shock Signup and view all the answers

What is a common trigger for autonomic dysreflexia?

Distended bladder Signup and view all the answers

Which assessment sign indicates meningeal irritation?

Kernig's sign Signup and view all the answers

What is the earliest sign of increasing intracranial pressure (ICP)?

Change in the level of consciousness Signup and view all the answers

Which of the following is a characteristic symptom of bacterial meningitis?

Stiff neck Signup and view all the answers

Which condition is NOT a potential complication of spinal cord injury?

Cerebral edema Signup and view all the answers

What intervention is appropriate immediately for a patient experiencing symptoms of autonomic dysreflexia?

Rapidly assess and relieve the triggering cause Signup and view all the answers

What is the recommended frequency for passive range-of-motion exercises for a patient to improve mobility after spinal injury?

At least four times a day Signup and view all the answers

Which age group is at the highest risk for meningococcal disease?

Individuals aged 11 to 26 years Signup and view all the answers

What is a common cause of bacterial meningitis?

Streptococcus pneumoniae Signup and view all the answers

Which of the following is a non modifiable risk factor for cardiovascular disorders?

Age Signup and view all the answers

What characterizes a myocardial infarction?

Severe and abrupt deprivation of oxygen to tissue Signup and view all the answers

What is the major type of stroke accounting for 80% of cases?

Ischemic stroke Signup and view all the answers

During a myocardial infarction, which vital sign typically increases initially?

Heart rate Signup and view all the answers

Which symptom is NOT associated with ischemic stroke?

Cool, clammy skin Signup and view all the answers

What is the primary treatment method for specific ischemic strokes within the initial window?

Thrombolytic therapy Signup and view all the answers

Which of the following conditions is associated with a loss of half of the visual field?

Hemianopia Signup and view all the answers

What is the purpose of percutaneous coronary intervention?

To relieve ischemia by restoring blood flow Signup and view all the answers

Which factor increases oxygen requirements during a myocardial infarction?

Increased pain and hypoxia Signup and view all the answers

What is a common manifestation of a transient ischemic attack (TIA)?

Temporary neurological deficits Signup and view all the answers

What is the CD4+ T-lymphocyte count that defines Stage 3 HIV infection?

Below 200 cells/mm3 Signup and view all the answers

Which symptom is commonly associated with the first stage of HIV infection?

Rash Signup and view all the answers

What is the primary goal of antiretroviral therapy (ART) in HIV treatment?

Suppress HIV replication Signup and view all the answers

Which type of angina is characterized by pain that occurs at rest and is not relieved by nitroglycerin?

Unstable angina Signup and view all the answers

Which manifestation is NOT typically associated with HIV/AIDS?

Angina pectoris Signup and view all the answers

How is Stage 1 HIV infection primarily defined?

Development of HIV-specific antibodies Signup and view all the answers

Which of the following is a potential complication of HIV/AIDS?

Wasting syndrome Signup and view all the answers

What is the normal range for CD4+ T-cell counts in healthy individuals?

500-1,500 cells/mm3 Signup and view all the answers

Which form of angina is characterized by episodes of chest pain that may be relieved by rest?

Stable angina Signup and view all the answers

What ethical dilemma surrounds HIV-positive individuals in Canada?

Disclosure of HIV status before sexual activity Signup and view all the answers

Which medication is NOT typically used to treat anginal pain?

Ibuprofen Signup and view all the answers

Which of the following describes silent ischemia?

No reports of pain but evident on ECG changes Signup and view all the answers

What is the main characteristic of intractable or refractory angina?

Severe incapacitating chest pain Signup and view all the answers

What distinguishes acute coronary syndrome from stable angina?

Symptoms occurring at rest Signup and view all the answers

Which statement is true regarding thrombolytic therapy?

It is indicated for patients who cannot speak. Signup and view all the answers

What characteristic is associated with right hemisphere communication impairments?

Difficulty understanding non-verbal cues. Signup and view all the answers

In the context of muscular dystrophy, which type is known for early onset and rapid progression?

Duchenne muscular dystrophy. Signup and view all the answers

Which of the following treatments is essential for managing Parkinson's disease symptoms effectively?

Antiparkinsonian agents taken consistently. Signup and view all the answers

What is a primary risk factor for hemorrhagic strokes?

Uncontrolled hypertension. Signup and view all the answers

Which symptoms are typically seen in Guillain-Barré syndrome?

Weakness starting from lower extremities and moving upward. Signup and view all the answers

What defines status epilepticus in seizure management?

Multiple seizures without recovery of consciousness lasting 30 minutes. Signup and view all the answers

What is an early symptom of Huntington's disease?

Severe mood swings and emotional disturbances. Signup and view all the answers

Which condition is characterized by flaccidity?

Lack of muscle tone. Signup and view all the answers

What is the primary intervention in managing muscle weakness in amyotrophic lateral sclerosis (ALS)?

Physical therapy to maintain function. Signup and view all the answers

What adverse reaction is associated with long-term use of Sinemet in Parkinson's disease?

Dyskinesia. Signup and view all the answers

Which of the following is a characteristic feature of apraxia?

Impairment of purposeful movements. Signup and view all the answers

What dietary modification is recommended for individuals with Huntington's disease?

Soft or pureed diets to prevent aspiration. Signup and view all the answers

Which medication is commonly used for seizure management?

Valproic acid. Signup and view all the answers

Study Notes

Inflammatory Bowel Disease (IBD)

IBD involves inflammation and ulceration of the intestinal lining, encompassing Crohn's disease and ulcerative colitis.
Nursing priorities for IBD include managing diarrhea, pain, fluid and electrolyte balance, nutrition (potentially parenteral nutrition), activity tolerance, anxiety, and coping mechanisms. Skin integrity is also crucial.
Crohn's disease symptoms that may confirm the presence of the disease include ulceration in areas besides the rectum, such as the colon, inflammation affecting various tissues, and inflammation in the mouth.

Ostomies

Ileostomy/colostomy procedures can be temporary or permanent to reroute the intestine.
Nurses specializing in wound ostomy and continence (NSWOC) provide crucial support.
Pre-operative support is important.
Stool characteristics vary depending on the ostomy location. New ostomy color is typically bright red; if damaged, it might become dusty and then black.
Post-operative nursing care focuses on stoma blood supply, skin integrity, body image, patient education and fluid balance.

Gallbladder

Cholecystitis is gallbladder inflammation often caused by gallstones.
Post-operative nursing priorities include pain management, maintaining adequate gas exchange, skin care, and nutritional support, along with patient education.

Pancreatitis

Pancreatitis is autodigestion of the pancreas.
Nursing priorities for pancreatitis include pain management, managing nasogastric (NG) tubes, ensuring adequate oxygenation, and managing fluid and electrolyte balance, and providing nutritional support.
An x-ray may be used to determine the placement of a feeding tube (G-tube).
A physician may recommend NPO (nothing by mouth) and TPN (total parenteral nutrition) to prevent complications.

Diabetes Mellitus (DM)

DM is categorized by insulin resistance (Type 2) or insulin deficiency (Type 1).
Priorities for newly diagnosed patients include nutrition, preventing fluid volume deficit, education regarding self-management, managing anxiety, monitoring for complications like hyperglycemia and hypoglycemia, and recognizing symptoms like those associated with diabetic ketoacidosis (DKA).
Advanced hypoglycemia symptoms can include loss of concentration, confusion, seizures, and abdominal pain. Nausea might also occur.
For a 16-year-old with Type 1 DM experiencing low body weight despite regular eating, emphasizing the body's use of protein and fat for energy instead of glucose would be the best nursing response.
Ben's insulin replacement method, using rapid-onset insulin in an insulin pump with half the daily dose for basal needs and the remaining used for meal coverage, signifies adjusting for daily insulin needs.
Stress, intravenous (IV) dextrose, total parenteral nutrition (TPN), steroids, infection, decreased activity, and the timing of insulin administration can contribute to hyperglycemia in a hospitalized patient with diabetes undergoing surgery.

Thyroid

Goiter is an enlarged thyroid gland.
Symptoms of hypothyroidism include fatigue and slowed function; hyperthyroidism symptoms require further specification.
Post-thyroidectomy care focuses on maintaining airway, breathing, and circulation and placing the patient in a semi-Fowler's position.

Pneumonia/Tuberculosis (TB)

TB typically affects the lungs but can spread to other organs.
TB nursing priorities include preventing transmission through education, medication, nutrition, and oxygenation support.
Pneumonia nursing priorities are airway management, improving oxygenation, pain management, nutrition support, fatigue management, and patient education.
TB medication can lead to resistance if not taken correctly and consistently.

Urinary Issues

Urinary incontinence types include stress, urge, functional, overflow, and neurogenic incontinence.
Strategies to address these issues include behavioral modifications.
Urinary tract infections (UTIs) risk factors and management also require further specification.
Regarding calculus or urinary stones, pain management and improving elimination are crucial components of care.

Heart Failure

Heart failure means the heart cannot meet the body's metabolic demands.
Left-sided failure leads to pulmonary edema.
Treatments involve medications and fluid/sodium restrictions.
Nursing care prioritizes oxygenation, activities, fluid balance, patient education, and medication management.

Parkinson's Disease

Parkinson's disease symptoms include tremors, slow movement (bradykinesia), small handwriting (micrographia), shuffling gait, and postural instability.
Dopamine is the significantly decreased neurotransmitter in Parkinson's disease.
Levodopa/carbidopa (Sinemet) is a commonly used treatment, but long-term use can cause dyskinesia (involuntary movements.)
Nursing care for individuals with Parkinson's disease prioritizes mobility, self-care, constipation management, nutritional support, communication, and coping mechanisms.

Amyotrophic Lateral Sclerosis (ALS)

ALS affects speech, but not cognition or dementia.
Average survival is 3-5 years.
The primary cause of death is respiratory insufficiency.

Guillain-Barré Syndrome

Guillain-Barré is an autoimmune response to a viral infection, commonly starting in the lower extremities and progressing upward.
Full recovery is typical for most patients.
Nursing priorities include oxygenation, preventing aspiration, mobility, nutrition, communication support, and addressing potential fear and anxiety.

HIV/AIDS

HIV transmission occurs through body fluids: blood, semen, vaginal fluids, amniotic fluid, and breast milk.
Needle sharing, unprotected sex, and blood transfusions (now rare) are major transmission routes.
Early HIV symptoms may include fever, fatigue, and rash.
Prolonged infection stages often have few symptoms; CD4+ T-cell counts diminish over time.
AIDS is diagnosed when CD4+ counts drop below 200 cells/mm³.
Nursing priorities for HIV/AIDS patients include managing complications, preventing infection, supporting nutrition and airway management, and addressing psychosocial needs like social isolation or bereavement.

Spinal Cord Injury

A completely severed spinal cord at T4 requires mechanical ventilation.
Spinal shock occurs immediately after spinal cord injury.
Autonomic dysreflexia signs include tachycardia, hypotension, and altered sweating.

Brain Injury - General

Brain injury encompasses damage to the scalp, skull, or brain, often a result of falls, accidents, or violence.
Primary brain injury is the initial damage, while secondary injury results afterwards from complications like edema or ischemia.
Intracranial pressure increases due to swelling; this leads to oxygen and blood flow issues.

Brain Injury - Types

Closed injuries (e.g., concussion, contusions) : Acceleration/deceleration injuries are common;
Open injuries penetrate the skull;
Concussion is a temporary loss of consciousness without structural damage. Symptoms include headaches, dizziness, fatigue, and emotional changes; repeated concussions may lead to chronic traumatic encephalopathy (CTE).
Contusion: Bruising, hemorrhage, or edema. Recovery depends on the amount of damage.
Diffuse axonal injury: widespread axon damage causing immediate coma.
Intracranial hemorrhage: Types include epidural, subdural, and intracerebral, which requires emergent treatment and monitoring of intracranial pressure.

Brain Injury Management

Assume cervical spine injury until ruled out.
Treat cerebral edema and maintain cerebral perfusion.
Support respiration.
Prevent and manage seizures.

Spinal Cord Injuries — Management

Assess for spinal shock and autonomic dysreflexia.
Manage potential complications like venous thromboembolism, orthostatic hypotension, and pressure injuries.
Implement strategies to enhance mobility gradually and safely.
Note risk of autonomic dysreflexia.

Meningitis

Meningitis is inflammation of the brain and spinal cord membranes.
Types include bacterial (septic, transmission via secretions/aerosol) and aseptic (viral). Septic meningitis is typically caused by Streptococcus pneumoniae, Neisseria meningitides, or Haemophilus influenzae.
Key symptoms include headache, fever, altered mental status, stiff neck (nuchal rigidity), and sensitivity to light (photophobia). Positive Kernig and Brudzinski signs indicate meningeal irritation. Increased intracranial pressure (ICP) is a possible complication.

Seizures

Seizures are abnormal electrical discharges from cerebral neurons.
Partial seizures affect one brain region (simple = conscious, complex = impaired).
Generalized seizures affect the whole brain (tonic-clonic, absence, myoclonic).
Assessment during a seizure includes duration, symptoms, and level of awareness before, during, and after.
Treatment primarily relies on anticonvulsants, including medications like valproic acid, phenobarbital, carbamazepine, and phenytoin.

Status Epilepticus

Status epilepticus is a prolonged seizure state lasting at least 30 minutes.
It's a medical emergency needing immediate intervention to stop seizures, maintain oxygenation, and prevent further complications.

Other

Other conditions explored include cardiovascular issues (angina, MI, aneurysms), cerebrovascular disorders (strokes), various neurological conditions (Huntington's disease, muscular dystrophy), and more. Each condition and its associated care focuses on symptoms assessment, management and potential complications.

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Description

This quiz explores the nursing priorities related to Inflammatory Bowel Disease (IBD), including symptoms and care management. It also covers the essential knowledge needed for ostomy procedures and post-operative nursing considerations. Test your understanding of these crucial nursing topics!