Nursing Care for Inflammatory Bowel Disorders

Questions and Answers

Which interventions should be taught to the patient to avoid skin irritation and infections? (Select all that apply)

To apply a protective barrier cream to the skin (correct)

To use toilet paper and harsh soaps

To clean the genital area with cool water

To use medicated cleansing wipes (correct)

To take sitz baths for 10 minutes two or three times daily (correct)

Which intervention would be included in the care plan for a patient with diarrhea who has developed skin irritation? (Select all that apply)

Using mild soap to wash the skin (correct)

Patting the area gently (correct)

Taking antidiarrheal medication (correct)

Refraining from taking sitz baths

Using a tissue to wipe

Which postoperative instruction would be given to a patient after abdominal surgery for peritonitis?

Report a temperature higher than 101°F (38.3°C). (correct)

Avoid lifting anything for at least 4 weeks.

Avoid drugs such as docusate sodium.

Stop taking antibiotics once the incision begins to heal.

Which postoperative action would be implemented for a patient who just had abdominal surgery for peritonitis?

Irrigate peritoneal drain using sterile technique. Signup and view all the answers

While assessing a patient with peritonitis, which finding would indicate that inflammation has progressed?

Diminishing bowel sounds Signup and view all the answers

Which symptoms would the nurse assess in a patient admitted for gastroenteritis? (Select all that apply)

Acute confusion Signup and view all the answers

Which nursing intervention is the highest priority when caring for a patient who has diverticulitis with a suspected complication of perforated bowel?

Preparing the patient for emergency surgery Signup and view all the answers

Which statement made by the patient indicates effective learning regarding self-management of gastroenteritis?

I must keep my toothbrush and toothpaste separate from others. Signup and view all the answers

About which surgical intervention would the nurse anticipate teaching the patient with pain in the right lower quadrant?

Exploratory laparotomy Signup and view all the answers

Which condition would be most likely in a patient when there is bacterial contamination of the peritoneal cavity?

Gangrenous gallbladder Signup and view all the answers

In which position would the nurse place a patient after having an exploratory abdominal laparotomy?

Semi-Fowler Signup and view all the answers

Which medication would be prescribed to a patient who has severe diarrhea and an elevated temperature after returning from South America?

Ciprofloxacin Signup and view all the answers

Which treatment would be suitable for an older patient with abdominal distention and low blood pressure?

Oral rehydration solution Signup and view all the answers

Which assessment finding would the nurse observe in a patient with peritonitis? (Select all that apply)

Distended abdomen Signup and view all the answers

Which assessment finding would the nurse observe in a patient with peritonitis? (Select all that apply)

Distended abdomen Signup and view all the answers

Which sign of gastroenteritis may appear first in an older adult?

Acute confusion Signup and view all the answers

About which medication would the nurse teach a patient who is newly diagnosed with moderate ulcerative colitis (UC)?

Sulfasalazine Signup and view all the answers

Which medication prevents the migration of white blood cells (WBCs) to inflamed bowel tissue?

Vedolizumab Signup and view all the answers

Which disorder is associated with inflammation of the small intestine?

Crohn disease Signup and view all the answers

Which patient requires infliximab treatment?

The patient with Crohn disease Signup and view all the answers

Which potential complication is associated with Crohn disease? (Select all that apply)

Malabsorption Signup and view all the answers

The nurse is teaching a patient with ulcerative colitis about different medication regimens. Which drug would the nurse explain has a complication of hemolytic anemia if taken in higher doses?

Sulfasalazine Signup and view all the answers

About which medication would the nurse teach the patient who is prescribed an antiperistaltic agent?

Loperamide Signup and view all the answers

Which medication would be helpful in a patient who has a fistula associated with Crohn disease?

Metronidazole Signup and view all the answers

Which statement about a laparoscopic procedure for an appendectomy is correct?

The patient usually has less pain with this minimally invasive procedure. Signup and view all the answers

Which classic symptom is seen in celiac disease? (Select all that apply)

Abdominal pain Signup and view all the answers

Which rationale is accurate as to why blood cultures are obtained in a patient with peritonitis?

To determine septicemia Signup and view all the answers

Which complication is seen exclusively in patients with ulcerative colitis?

Colorectal cancer Signup and view all the answers

Which clinical findings in a patient indicate ulcerative colitis?

Presence of blood and mucus in the stool Signup and view all the answers

Which statement about appendicitis is accurate?

It occurs mostly in young adults. Signup and view all the answers

Which drug is often used to treat gastroenteritis caused by Shigella?

Ciprofloxacin Signup and view all the answers

A patient has been diagnosed with ulcerative colitis (UC) and reports having between four and five bloody stools per day. How would the nurse classify the intensity of this patient's UC?

Moderate Signup and view all the answers

Which complication is associated with Crohn disease?

Fistula Signup and view all the answers

Which classic symptom is seen in a patient with peritonitis?

Abdominal wall rigidity Signup and view all the answers

Which clinical manifestation is seen in Crohn disease?

Abdominal pain Signup and view all the answers

Which physiological change is seen in a patient with ulcerative colitis?

Leukocytosis Signup and view all the answers

Which patient is at risk for celiac disease?

The patient with diabetes mellitus type I Signup and view all the answers

Which surgical procedure for removing an inflamed appendix involves minimal intervention without an external incision?

Transluminal endoscopic surgery Signup and view all the answers

Which medication would a patient with ulcerative colitis who complains of severe diarrhea with exacerbations be taught to take for flare-ups?

Glucocorticoids Signup and view all the answers

A patient reports pain midway between the anterior iliac crest and the umbilicus in the right lower quadrant. The nurse would document that the patient is experiencing pain in which location?

McBurney point Signup and view all the answers

Which organism causes gastroenteritis and is possibly transmitted through the respiratory route in addition to the fecal-oral route?

Norovirus Signup and view all the answers

Which source of gastroenteritis is the likely cause for a patient who has traveled outside the country?

Ingestion of food from a farmer's market Signup and view all the answers

Which surgical techniques are involved in the treatment of Crohn disease?

Minimal invasive surgery and stricturoplasty Signup and view all the answers

Which sign/symptom is consistent with the diagnosis of appendicitis? (Select all that apply)

Rebound tenderness Signup and view all the answers

Which physiological changes take place in a patient about a week after having a total proctocolectomy with a permanent ileostomy?

Stool volume decreases and becomes thick. Signup and view all the answers

Which illness is associated with right lower quadrant pain?

Appendicitis Signup and view all the answers

Which medication would be used as the first-line treatment for mild ulcerative colitis?

Sulfasalazine Signup and view all the answers

Which surgical intervention is beneficial when a patient with abdominal pain has an indefinitive diagnosis?

Exploratory laparotomy Signup and view all the answers

A patient has a low-grade fever and tenesmus. Which other clinical manifestation may indicate ulcerative colitis?

Inflammation of the joints Signup and view all the answers

Which incubation period is seen in a person with a normal immune system who has the Norwalk virus?

24 to 48 hours Signup and view all the answers

Which medication would be beneficial to the patient with gastroenteritis who has increased peristaltic movements?

Loperamide Signup and view all the answers

Which term is used to describe a fistula that is present between the bowel and the bladder?

Enterovesical fistula Signup and view all the answers

Which classic symptom is associated with appendicitis?

Cramping pain in the epigastric area Signup and view all the answers

Which disorder would the nurse identify as acute inflammatory bowel disorders? (Select all that apply)

Peritonitis Signup and view all the answers

A patient reports having seven to nine bloody stools per day. The nurse finds that the patient has fever, tachycardia, anemia, and abdominal pain. The patient's laboratory reports indicate elevated C-reactive protein. Which classification of ulcerative colitis (UC) do these findings support?

Severe Signup and view all the answers

Which examination is used to identify an enlarged appendix in a patient?

Abdominal ultrasound Signup and view all the answers

Which kind of diet would be provided to a patient to promote the healing of a fistula?

High-protein meals Signup and view all the answers

Which bacteria may cause gastroenteritis?

Shigella species Signup and view all the answers

Which symptom is most indicative of Crohn disease (CD)?

Chronic diarrhea, abdominal pain, and fever Signup and view all the answers

Which cause of peritonitis is less common? (Select all that apply)

Perforating tumors Signup and view all the answers

Which diagnostic test is preferred to differentiate between ulcerative colitis and Crohn disease?

Colonoscopy Signup and view all the answers

Which symptom is usually seen first in gastroenteritis?

Vomiting Signup and view all the answers

An 80-year-old patient with a 2-day history of myalgia, nausea, vomiting, and diarrhea is admitted to the medical-surgical unit with a diagnosis of gastroenteritis. Which health care provider prescription would the nurse implement first?

Start an IV solution of 5% dextrose in 0.45 normal saline at 125 mL/hr. Signup and view all the answers

Which statement about gastroenteritis is accurate?

Fluid replacement is a priority in the patient with gastroenteritis. Signup and view all the answers

A patient is being discharged after a laparotomy for treatment of peritonitis. Which sign or symptom would the nurse teach the patient to report to the primary health care provider immediately? (Select all that apply)

Unusual or foul-smelling drainage Signup and view all the answers

Which nursing intervention would be included in the plan of care for a patient with appendicitis?

Keeping the patient in a semi-Fowler position Signup and view all the answers

Which finding in a patient with gastroenteritis indicates dehydration? (Select all that apply)

Fever Signup and view all the answers

Which teaching point would the nurse include in a plan of care for a patient with gastroenteritis? (Select all that apply)

Increase fluid intake to prevent dehydration. Signup and view all the answers

Study Notes

Assessment Findings for Peritonitis

Common observations include anorexia and a distended abdomen.
Symptoms may also include low-grade fever.

Gastroenteritis in Older Adults

Acute confusion may be the first sign of gastroenteritis in older adults.

Ulcerative Colitis Medication

Sulfasalazine is a key medication taught to newly diagnosed patients with moderate ulcerative colitis.

White Blood Cell Migration

Vedolizumab prevents the migration of white blood cells to inflamed bowel tissue.

Small Intestine Inflammation

Crohn disease is specifically associated with inflammation of the small intestine.

Infliximab Treatment

Patients with Crohn disease may require infliximab treatment.

Complications of Crohn Disease

Potential complications include fistulas, osteoporosis, malabsorption, and abscess formation.

Hemolytic Anemia and Medication

Sulfasalazine may cause hemolytic anemia if taken in high doses.

Antiperistaltic Agents

Loperamide is an antiperistaltic medication used for managing diarrhea.

Treatment for Fistulas

Metronidazole is beneficial for patients with fistulas associated with Crohn disease.

Laparoscopic Appendectomy

This minimally invasive procedure often results in less pain and quicker recovery.

Celiac Disease Symptoms

Classic symptoms include steatorrhea, abdominal pain, and diarrhea/constipation.

Blood Cultures in Peritonitis

Blood cultures are essential to determine the presence of septicemia.

Colorectal Cancer and Ulcerative Colitis

Colorectal cancer is a complication exclusive to ulcerative colitis.

Clinical Findings of Ulcerative Colitis

Presence of blood and mucus in stool indicates ulcerative colitis.

Appendicitis Facts

Appendicitis primarily occurs in young adults, causing pain in the right lower quadrant.

Gastroenteritis Treatment

Ciprofloxacin is commonly used to treat gastroenteritis caused by Shigella.

Classification of Ulcerative Colitis

Patients reporting four to five bloody stools daily are classified as having moderate ulcerative colitis.

Complications of Crohn Disease

Fistulas are a significant complication associated with Crohn disease.

Diagnostic Tools

Abdominal ultrasound is preferred for identifying an enlarged appendix; colonoscopy is commonly used for differentiating between ulcerative colitis and Crohn disease.

Diet for Fistula Healing

A high-protein diet aids in the healing of a fistula.

Gastroenteritis Pathogens

Shigella species are a known cause of gastroenteritis.

Symptomatology of Crohn Disease

Chronic diarrhea, abdominal pain, and fever are indicative of Crohn disease.

Causes of Peritonitis

Less common causes include perforating tumors and leakage during surgery.

Treatment for Severe Gastroenteritis

Fluid replacement is prioritized in patients with gastroenteritis.

Dehydration Indicators in Gastroenteritis

Indicators include fever, oliguria, and poor skin turgor.

Postoperative Instructions for Peritonitis

Patients should report temperatures exceeding 101°F (38.3°C) to healthcare providers.### Antibiotics and Postoperative Care
Complete antibiotic courses as prescribed to combat infections effectively.
Avoid lifting heavy objects post-surgery; restrictions last for at least 6 weeks.

Postoperative Actions for Abdominal Surgery

For peritonitis patients, irrigating the peritoneal drain per orders is crucial.
Maintain a semi-Fowler position to enhance drainage after abdominal surgery.
Monitor respiratory rates intermittently, especially during the immediate postoperative period.

Signs of Complications in Peritonitis

Diminishing bowel sounds indicate progression of peritonitis, while bowel sounds typically reduce as inflammation escalates.
Increased heart rate is common due to inflammation, whereas bradycardia is not expected.
Patients may experience abdominal distention due to reduced intestinal activity.

Gastroenteritis Symptoms to Monitor

Key indicators include fever, acute confusion, and poor skin turgor, suggesting dehydration.
Gastroenteritis often leads to hypotension due to fluid loss rather than hypertension.

Prioritizing Nursing Interventions

In suspected perforated bowel with peritonitis, preparing for emergency surgery is the highest priority.
Expect changes in vital signs due to pain and infection; pain management is important but secondary.

Self-Management Education for Gastroenteritis

Keeping tooth and personal hygiene items separate prevents disease transmission.
Patients should wash hands for 30 seconds post bowel movements.
Avoid food handling for others during illness to reduce contamination risk.

Anticipated Surgical Interventions

Appendicitis with associated symptoms may require an exploratory laparotomy to manage peritonitis.
Surgical procedures differ in purpose: ileostomy for ulcerative colitis, total proctocolectomy for severe cases without ileo-anal pouch.

Bacterial Contamination Risks

Gangrenous gallbladder is a significant concern in cases of bacterial peritoneal contamination.
Chemical peritonitis can arise from bile leakage; less common causes include tumors.

Patient Positioning Post-Surgery

Place patients in a semi-Fowler position post-exploratory laparotomy to facilitate drainage and lung expansion.
Supine positioning may hinder drainage and lung expansion, increasing complication risks.

Appropriate Medications for Gastroenteritis

Ciprofloxacin may be prescribed for bacterial gastroenteritis, especially after travel to areas with known contamination.
Loperamide and diphenoxylate are contraindicated in bacterial infections as they may worsen the condition.

Treatment for Gastroenteritis in Older Patients

Oral rehydration solutions are essential for patients experiencing dehydration, indicated by low serum potassium and low blood pressure.
Avoid anti-diarrheal medications which can prevent necessary elimination of the organism.

Peritonitis Assessment Findings

Common observations include distended abdomen and anorexia, indicating inflammation severity.
Patients may experience high fever and decreased urine output due to fluid shifts associated with the condition.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on nursing care for patients with inflammatory intestinal disorders. This quiz includes assessment findings and signs to watch for in conditions like peritonitis and gastroenteritis. Perfect for nursing students and professionals looking to refresh their knowledge.