Irritable Bowel Syndrome (IBS)

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Questions and Answers

Irritable Bowel Syndrome (IBS) is characterized by:

  • Progressive weight gain and increased appetite
  • Acute, constant abdominal pain
  • Sudden onset of high fever and vomiting
  • Chronic or recurrent diarrhea, constipation, and/or abdominal pain and bloating (correct)

Which factor is NOT typically associated with the development or course of IBS?

  • Environmental factors like diet
  • Genetic predisposition
  • A single, identified bacterial infection (correct)
  • Immunologic responses

A patient with IBS primarily experiencing diarrhea is concerned about potential complications. Which concern is MOST directly associated with diarrhea-predominant IBS?

  • Anxiety related to the availability of bathroom facilities (correct)
  • Decreased risk of mental health disorders
  • Progressive weight gain due to increased nutrient absorption
  • Increased self-esteem from managing a chronic condition

When assessing a patient suspected of having IBS, which assessment finding is LEAST likely?

<p>Consistent weight loss (A)</p>
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A patient reports that caffeinated beverages worsen their IBS symptoms. What is the MOST likely explanation for this?

<p>Caffeine stimulates intestinal motility, potentially exacerbating diarrhea. (D)</p>
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Before a patient begins taking alosetron for IBS, what is the most important nursing action?

<p>Obtain a thorough drug history (B)</p>
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What dietary modification is MOST appropriate for a patient with IBS trying to manage their symptoms?

<p>Consuming regular meals (A)</p>
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What is the PRIMARY goal of using bulk-forming laxatives for patients with IBS-C (constipation)?

<p>To establish regular bowel elimination habits (C)</p>
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Why might a hydrogen breath test be ordered for a patient with suspected IBS?

<p>To assess for small-bowel bacterial overgrowth (B)</p>
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A patient with postprandial abdominal pain related to IBS is prescribed a tricyclic antidepressant. When should the patient be instructed to take this medication?

<p>30 to 45 minutes before mealtime (B)</p>
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What is the MOST common cause of gastroenteritis?

<p>Viral infection (C)</p>
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Which action is MOST important for preventing the spread of norovirus?

<p>Thorough handwashing (A)</p>
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A public health nurse is investigating a norovirus outbreak in a nursing home. What initial action should the nurse prioritize?

<p>Isolating infected residents and educating staff on proper hand hygiene (A)</p>
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What is the typical progression of symptoms in a patient with gastroenteritis?

<p>Nausea and vomiting first, followed by abdominal cramping and diarrhea (D)</p>
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An older adult patient with gastroenteritis is MOST at risk for:

<p>Fluid and electrolyte imbalance (B)</p>
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During the assessment of an older adult with suspected gastroenteritis, what would be an EARLY sign of dehydration?

<p>Acute confusion (A)</p>
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A patient with gastroenteritis is prescribed ciprofloxacin. What information should the nurse provide regarding this medication?

<p>The medication treats bacterial infections (B)</p>
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A patient with gastroenteritis is experiencing frequent stools and anal irritation. What measure should the nurse teach the patient?

<p>Clean the area gently with warm water (B)</p>
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The nurse is teaching a patient how to prevent the transmission of gastroenteritis. Which statement by the patient indicates a need for further teaching?

<p>&quot;It's okay to prepare food for others as long as I feel well enough to do so.&quot; (C)</p>
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A patient with ulcerative colitis reports frequent bloody stools, abdominal pain, and weight loss. What collaborative problem is of the HIGHEST priority based on this information?

<p>Potential for lower GI bleeding and resulting anemia (D)</p>
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What is a primary difference between ulcerative colitis and Crohn's disease?

<p>Ulcerative colitis only affects the colon, while Crohn's disease can affect any part of the GI tract (A)</p>
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A patient with ulcerative colitis is scheduled for a magnetic resonance enterography (MRE). What education is MOST important to give the patient before the procedure?

<p>You will need to drink a large amount of contrast medium (D)</p>
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The nurse is evaluating the effectiveness of drug therapy for a patient with ulcerative colitis. What assessment finding indicates that the therapy is achieving the desired outcome?

<p>Decreased frequency of bowel movements (C)</p>
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A patient with ulcerative colitis is prescribed sulfasalazine. What information should the nurse emphasize when teaching about this medication?

<p>Take a folic acid supplement (A)</p>
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A patient with ulcerative colitis has a history of toxic megacolon. Which sign or symptom would require the MOST immediate nursing intervention?

<p>Hypotension (C)</p>
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Why is it important to assess for extraintestinal manifestations in a patient with ulcerative colitis?

<p>To identify potential complications affecting other parts of the body (B)</p>
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A patient with ulcerative colitis is scheduled for a proctocolectomy with ileal pouch-anal anastomosis (IPAA). What should the nurse explain about this procedure?

<p>The procedure will eliminate the need for a stoma (C)</p>
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A patient with a new ileostomy expresses concern about their ability to maintain hydration. What should the nurse teach them?

<p>Include adequate sodium (A)</p>
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A nurse is assessing an ileostomy stoma and notes that it is pale. What is the nurse's PRIORITY action?

<p>Notify the surgeon immediately (C)</p>
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A patient with Crohn's disease develops a fever, abdominal pain, and signs of peritonitis. What is the PRIORITY nursing intervention?

<p>Prepare the patient for possible surgery (A)</p>
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A patient with Crohn's disease is experiencing frequent steatorrhea. What dietary teaching is MOST appropriate for this patient?

<p>Adhere to a low-residue diet (D)</p>
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To manage the ongoing nutritional needs and possible complications of Crohn's disease...

<p>Coordinate care with dietitian (B)</p>
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What is a potential complication specific to Crohn's disease, but not typically seen with ulcerative colitis?

<p>Fistula formation (D)</p>
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A patient is prescribed infliximab for Crohn's disease. What information is MOST important for the nurse to provide regarding this medication?

<p>Report signs of beginning infection (C)</p>
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A patient with Crohn's disease is being discharged. What statement indicates a need for further teaching regarding self-management?

<p>&quot;I should eat whatever I want, whenever I want.&quot; (B)</p>
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If perforated diverticulitis progresses to an intraabdominal perforation...

<p>Peritonitis (B)</p>
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A patient with diverticulosis has mild symptoms. Which dietary modification is MOST appropriate?

<p>Gradually increase dietary fiber intake. (B)</p>
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The home health nurse is visiting a patient recovering from diverticulitis. What nursing intervention is MOST important?

<p>Monitor for signs of peritonitis (A)</p>
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Flashcards

Irritable Bowel Syndrome (IBS)

A functional GI disorder causing chronic/recurrent diarrhea, constipation, abdominal pain, and bloating.

IBS Prevalence

Most common digestive disorder, affecting 10-15% worldwide. Causes GI motility changes leading to diarrhea (IBS-D), constipation (IBS-C), or mixed (IBS-M).

Environmental Factors in IBS

Foods (caffeine, carbonated drinks, dairy), infectious agents, bacterial overgrowth.

Small Bowel Bacterial Overgrowth in IBS

Bloating, abdominal distention from small-bowel bacterial overgrowth with normal flora such as Pseudomonas aeruginosa.

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Cytokines in IBS

Pro-inflammatory interleukins (IL-6, IL-1β) and tumor necrosis factor-alpha (TNF-α).

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IBS Assessment

History of fatigue, malaise, abdominal pain, bowel pattern changes, stool consistency, and mucus.

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Dietary Triggers for IBS

Caffeinated drinks, sorbitol, or fructose sweetened beverages, dairy, raw fruits, and grains.

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Common IBS Symptoms

Pain in left lower quadrant, nausea with mealtime, constipated stools followed by softer stools, watery diarrhea with mucus, belching, gas, anorexia, bloating.

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Hydrogen Breath Test

NPO for 12 hours, blowing into hydrogen analyzer for baseline, ingest lactulose, breath samples every 20 minutes for 1-2 hours.

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IBS Management Strategies

Maintain hydration, manage stress, self-management strategies, dietary fiber and bulk intake, regular meals, and slow chewing.

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Bulk-Forming Laxatives

Take with meals and a glass of water, aids in bowel elimination.

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Lubiprostone Action

Increases fluid in intestines to promote bowel elimination.

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Linaclotide Action

Stimulates guanylate cyclase receptors in intestines to increase fluid and transit time.

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Alosetron Monitoring

Report colitis or constipation early due to life-threatening risks.

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Rifaximin for IBS

Works locally with little systemic absorption, originally for "traveler's diarrhea."

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Tricyclic Antidepressants for IBS

May relieve postprandial pain if taken 30-45 minutes before meals.

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Probiotic Supplements for IBS

Shown to reduce bacteria and alleviate GI symptoms.

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Gastroenteritis Definiton

A very common helath problem worldwide that causes diarrhea and/or vomiting related to inflammation of the mucous membranes of the stomach and intestinal tract.

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Norovirus

Norovirus occurs between November and April due to resistance at low temperatures

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How is norovirus contracted?

norovirus is transmitted through the fecal-oral route from person to person and from contaminated food and water

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Gastroenteritis initial symptoms.

Nausea and vomiting, abdominal cramping, diarrhea.

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Symptoms of dehydration

Weight loss, poor skin turgor, fever, dry mucous membranes, hypotension.

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Patients care

Oral fluid replacement is encouraged for gastroenteritis patients.

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Drugs that suppress intestinal motility

Avoid them so organisms from being eliminated from the body are not supressed.

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Preventing transmission

Wash hands for 30 seconds with soap, use disposable items, prepare food carefully.

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Causes of ulcerative colitis

Medications or antibiotics.

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What the intestinal does

Hyperemic, reddened, small erosion and ulcers.

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The patients stools

Bloody and full of mucus, urgent sensation.

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Other conditions due to ulcerative colitis.

Fatigue, tenderness, anemia, dehydration and weight loss.

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What to drink.

Drink lots of water or liquids.

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Always assesss

Check the bloody stool level.

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Crohn's disease (CD)

Inflammation that causes a thickened bowel wall, strictures, and deep ulcerations.

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Injeciton type

Vitamin b12 injection.

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Risk of fistulas.

Fistulas is likely more to occur.

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Other risk factors in crohns.

Small bowel and ulcer formation.

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Symptoms and test.

Diarrhea, abdominal pain and fever.

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Antibiotics are used for.

Antibiotics are prescribed.

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Definition

Colon diverticulosis are abnormal pouch like herniations in the intestinal wall.

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Muscle Spasms

Diverticulitis has local muscle spasms and can develop abscesses.

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