Nursing Care of Children: IBD Chapter 23
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Questions and Answers

What is a common cause of obstruction in appendicitis?

  • Appendix twisting on itself
  • Swelling of the intestinal lining
  • Fecaliths or hard pieces of stool (correct)
  • Presence of tumors in the appendix

    • Which group is at increased risk for developing appendicitis?

  • Children under 10 years old
  • Adolescents and young adults (correct)
  • Elderly individuals
  • Pregnant women

    • What are potential complications of inflammatory bowel disease (IBD)?

  • Decreased risk of infections
  • Improved bowel function
  • Nutritional deficits and electrolyte imbalances (correct)
  • Increased appetite

    • Inflammatory bowel disease includes which of the following?

    <p>Both acute and chronic disorders</p> Signup and view all the answers

    Which of these statements is true regarding the responsibilities of a nurse in managing IBD?

    <p>Knowledge about IBD is crucial for collaborating with the multidisciplinary team</p> Signup and view all the answers

    What is a potential cause of peritonitis?

    <p>Rupture of part of the gastrointestinal tract</p> Signup and view all the answers

    Which symptom is most associated with gastroenteritis?

    <p>Frequent, watery stools</p> Signup and view all the answers

    What condition could potentially result from continuous ambulatory peritoneal dialysis?

    <p>Peritonitis</p> Signup and view all the answers

    What is a significant risk associated with gastroenteritis?

    <p>Dehydration and electrolyte imbalance</p> Signup and view all the answers

    Which of the following is NOT a trigger for gastroenteritis?

    <p>Inflammation of the peritoneum</p> Signup and view all the answers

    Which statement best describes the characteristics of ulcerative colitis?

    <p>It is associated with hyperemia of the mucosa and submucosa.</p> Signup and view all the answers

    What potential complication is associated with chronic ulcerative colitis?

    <p>Development of colon cancer.</p> Signup and view all the answers

    In what way can edema and thickening of bowel mucosa due to ulcerative colitis present?

    <p>It can cause a partial bowel obstruction.</p> Signup and view all the answers

    Which classification level indicates the most severe form of ulcerative colitis?

    <p>Fulminant</p> Signup and view all the answers

    What symptom is most commonly associated with ulcerative colitis exacerbations?

    <p>Frequent stools</p> Signup and view all the answers

    What is a key feature of Crohn’s disease regarding the lesions it causes?

    <p>Lesions are sporadic and can affect all bowel layers.</p> Signup and view all the answers

    Which of the following is a common complication of diverticulitis?

    <p>Perforation of diverticula causing peritonitis.</p> Signup and view all the answers

    In Crohn’s disease, what nutritional issue may arise if the jejunum and ileum are involved?

    <p>Malnutrition and possible vitamin B12 deficiencies.</p> Signup and view all the answers

    What differentiates diverticulitis from diverticulosis?

    <p>Diverticulitis involves inflammation and infection.</p> Signup and view all the answers

    Which statement about malabsorption in inflammatory bowel diseases is correct?

    <p>It may require supplemental vitamins and minerals.</p> Signup and view all the answers

    What is a significant risk factor for Crohn’s disease?

    <p>Tobacco use</p> Signup and view all the answers

    Which demographic is most likely to develop ulcerative colitis?

    <p>Caucasian females in adolescence to young adulthood</p> Signup and view all the answers

    What is the common age range for the onset of Crohn’s disease?

    <p>Adolescents to young adults</p> Signup and view all the answers

    Which group is at a higher risk for diverticular disease?

    <p>African Americans</p> Signup and view all the answers

    Which of the following statements about the sex and age incidence for ulcerative colitis is accurate?

    <p>It peaks in females during adolescence to young adulthood.</p> Signup and view all the answers

    What is the most characteristic location of abdominal pain in ulcerative colitis?

    <p>Left-lower quadrant</p> Signup and view all the answers

    What stool characteristic is commonly associated with Crohn's disease?

    <p>Stools with pus and steatorrhea</p> Signup and view all the answers

    Which physical assessment finding is indicative of ulcerative colitis?

    <p>High-pitched bowel sounds</p> Signup and view all the answers

    How many liquid stools per day are typically experienced by a patient with ulcerative colitis?

    <p>Up to 15 to 20</p> Signup and view all the answers

    Which symptom is often reported in both ulcerative colitis and Crohn’s disease?

    <p>Fever</p> Signup and view all the answers

    What is a common symptom associated with diverticulitis?

    <p>Acute onset of abdominal pain in left-lower quadrant</p> Signup and view all the answers

    What is a physical assessment finding commonly observed in patients with diverticulitis?

    <p>Fever</p> Signup and view all the answers

    Which of the following is a possible gastrointestinal symptom of diverticulitis?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What vital sign change may indicate the physiological response to diverticulitis?

    <p>Tachycardia</p> Signup and view all the answers

    Which of the following might a nurse observe in a patient with diverticulitis during a physical examination?

    <p>Abdominal distention</p> Signup and view all the answers

    What laboratory test result is typically increased in patients with both Crohn's disease and ulcerative colitis?

    <p>C-reactive protein</p> Signup and view all the answers

    Which nutrient deficiency is specifically noted in Crohn's disease but not in ulcerative colitis?

    <p>Folic acid</p> Signup and view all the answers

    Which laboratory test result is likely to be decreased in all three conditions: Crohn's disease, ulcerative colitis, and diverticulitis?

    <p>Hematocrit and hemoglobin</p> Signup and view all the answers

    Which of the following findings is specific to Crohn's disease diagnosis?

    <p>Increased anti-glycan antibodies</p> Signup and view all the answers

    What is a common laboratory finding in diverticulitis?

    <p>Decreased potassium levels</p> Signup and view all the answers

    Which laboratory test result is common to both ulcerative colitis and Crohn's disease?

    <p>Erythrocyte sedimentation rate (ESR)</p> Signup and view all the answers

    Which nutrient deficiency is specifically associated with Crohn’s disease?

    <p>Folic acid and B12</p> Signup and view all the answers

    What is a laboratory finding that is typically decreased in patients with diverticulitis?

    <p>Hemoglobin levels</p> Signup and view all the answers

    Which of the following is a distinguishing laboratory test finding of Crohn's disease compared to ulcerative colitis?

    <p>Increased anti-glycan antibodies</p> Signup and view all the answers

    Which electrolyte is typically decreased in patients with inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis?

    <p>Sodium (Na)</p> Signup and view all the answers

    What diagnostic procedure is specifically used to distinguish ulcerative colitis from other conditions?

    <p>Barium enema</p> Signup and view all the answers

    What is the correct pre-examination instruction for a patient undergoing magnetic resonance enterography for IBD?

    <p>Maintain NPO for 4 to 6 hours prior to the exam</p> Signup and view all the answers

    Which diagnostic tool is effective in identifying abscesses in patients with ulcerative colitis?

    <p>MRI or CT scan</p> Signup and view all the answers

    Which of the following procedures specifically diagnoses ulcerative colitis?

    <p>Sigmoidoscopy</p> Signup and view all the answers

    Which gastrointestinal examination is indicated for checking the presence of parasites or microbes?

    <p>Stool examination</p> Signup and view all the answers

    What contraindication should be considered before performing a barium enema?

    <p>Presence of diverticulitis</p> Signup and view all the answers

    Which procedure allows for the visualization of the rectum and large intestine using a lighted, flexible scope?

    <p>Proctosigmoidoscopy</p> Signup and view all the answers

    Which finding is consistent with Crohn's disease during diagnostic procedures?

    <p>Narrowing of small intestine</p> Signup and view all the answers

    What should clients be advised regarding post-procedure monitoring after a barium enema?

    <p>To monitor for signs of bowel perforation</p> Signup and view all the answers

    What is a common symptom experienced during a barium enema procedure?

    <p>Abdominal discomfort and cramping</p> Signup and view all the answers

    What is a recommended dietary practice for patients with ulcerative colitis?

    <p>Eat high-protein, high-calorie, low-fiber foods</p> Signup and view all the answers

    Which of the following symptoms would warrant seeking emergency care in a patient with bowel disease?

    <p>Severe abdominal pain and vomiting</p> Signup and view all the answers

    What adverse effect is important to monitor in patients with ulcerative colitis due to potential medication side effects?

    <p>Electrolyte imbalance, particularly potassium</p> Signup and view all the answers

    What is a crucial aspect of patient education regarding medication management in ulcerative colitis?

    <p>Follow the prescribed medication therapy consistently</p> Signup and view all the answers

    What approach may be taken during extreme exacerbations of ulcerative colitis?

    <p>Initiate total parenteral nutrition and NPO status</p> Signup and view all the answers

    What dietary progression is recommended for a client recovering from mild diverticulitis?

    <p>Clear liquid diet, to low-fiber diet, then high-fiber diet as tolerated</p> Signup and view all the answers

    Which medication used for ulcerative colitis should be avoided by clients with a specific allergy?

    <p>Sulfasalazine</p> Signup and view all the answers

    What is an essential nursing action when administering sulfasalazine?

    <p>Administer with a full glass of water</p> Signup and view all the answers

    Which fluid intake is advised for clients taking sulfasalazine?

    <p>2 L/day</p> Signup and view all the answers

    What potential side effect of sulfasalazine might indicate a serious condition that requires immediate medical attention?

    <p>Sore throat</p> Signup and view all the answers

    Which food or drink should be avoided during the management of diverticulitis?

    <p>Alcohol</p> Signup and view all the answers

    What is a recommended self-care practice for a client managing mild diverticulitis at home?

    <p>Drinking adequate fluids</p> Signup and view all the answers

    What does sulfasalazine do in the treatment of ulcerative colitis?

    <p>Inhibits prostaglandins and reduces intestinal inflammation</p> Signup and view all the answers

    What is a common nursing action when administering immunosuppressants for the treatment of inflammatory bowel disease?

    <p>Monitor for pancreatitis and neutropenia.</p> Signup and view all the answers

    Which of the following medications is NOT typically used as monotherapy in the treatment of inflammatory bowel disease?

    <p>Methotrexate</p> Signup and view all the answers

    Which statement accurately describes a characteristic of immunosuppressive medications used for inflammatory bowel disease treatment?

    <p>They can take up to 6 months to show therapeutic effects.</p> Signup and view all the answers

    What is an important aspect of client education regarding the use of immunosuppressants in IBD treatment?

    <p>They need to monitor for indications of bleeding and infection.</p> Signup and view all the answers

    Which of the following is a reason immunosuppressants are reserved for refractory disease in inflammatory bowel disease treatment?

    <p>They can cause toxicity requiring careful monitoring.</p> Signup and view all the answers

    Which medication is known to cause a risk of progressive multi-focal leukoencephalopathy?

    <p>Natalizumab</p> Signup and view all the answers

    What is a common adverse effect associated with immunomodulator use in treating inflammatory bowel disease?

    <p>Fever and chills</p> Signup and view all the answers

    Which of the following precautions should a patient on immunomodulators take regarding infections?

    <p>Limit attendance in communal settings</p> Signup and view all the answers

    What must be monitored regularly in patients receiving immunomodulator therapy?

    <p>Liver enzymes and complete blood count</p> Signup and view all the answers

    In what way might immunomodulators impact a patient with a history of tuberculosis?

    <p>Increased risk for development or reactivation of TB</p> Signup and view all the answers

    What is a significant risk when using antidiarrheals?

    <p>Toxic megacolon</p> Signup and view all the answers

    What medication combination is used in the treatment of diarrhea?

    <p>Diphenoxylate and atropine</p> Signup and view all the answers

    Which symptom should be monitored to assess for toxic megacolon?

    <p>Abdominal distention</p> Signup and view all the answers

    Which of the following actions is important for patient education regarding antidiarrheals?

    <p>Avoid hazardous activities until the medication response is established</p> Signup and view all the answers

    What vital sign change should be observed in older adults when using antidiarrheals?

    <p>Respiratory depression</p> Signup and view all the answers

    What is a significant side effect associated with the use of ciprofloxacin?

    <p>Tendon rupture</p> Signup and view all the answers

    Which medication would require a dosage adjustment in patients with impaired kidney function?

    <p>Ciprofloxacin</p> Signup and view all the answers

    Which symptom should prompt immediate notification of the healthcare provider when a patient is on specific antimicrobials?

    <p>Numbness of extremities</p> Signup and view all the answers

    What should a patient be educated about regarding the expected side effects of ongoing antimicrobial therapy?

    <p>Darkening of urine</p> Signup and view all the answers

    What potential complication is associated with the use of antimicrobials for treating inflammatory bowel disease?

    <p>Superinfection</p> Signup and view all the answers

    What surgical procedure is commonly performed for patients with ulcerative colitis who require surgery?

    <p>Colectomy with or without ileostomy</p> Signup and view all the answers

    Which condition would necessitate a colon resection in diverticulitis?

    <p>Obstruction or bleeding due to diverticulum rupture</p> Signup and view all the answers

    In the postoperative care of a patient who has undergone surgery for an ostomy, which of the following interventions is essential?

    <p>Maintaining the patient NPO and checking for bowel sounds</p> Signup and view all the answers

    What is the primary purpose of collaborating with an enterostomal therapy nurse before ostomy surgery?

    <p>Understanding care related to the stoma after surgery</p> Signup and view all the answers

    What is a common complication that may prompt laparoscopic stricturoplasty in patients with Crohn's disease?

    <p>Bowel strictures</p> Signup and view all the answers

    What position should a client be placed in to promote drainage of peritoneal fluid?

    <p>Fowler's or semi-Fowler's position</p> Signup and view all the answers

    Which of the following is a hallmark symptom of peritonitis?

    <p>Rigid, board-like abdomen</p> Signup and view all the answers

    What should be monitored closely in a client post-surgery for inflammatory bowel disease?

    <p>Fluid intake every hour</p> Signup and view all the answers

    Which intervention is essential for a patient diagnosed with peritonitis?

    <p>Maintain NPO status</p> Signup and view all the answers

    Which complication might arise from diverticular disease?

    <p>Abscess formation</p> Signup and view all the answers

    What is a critical nursing action to monitor in a patient with inflammatory bowel disease experiencing rectal bleeding?

    <p>Check laboratory values related to coagulation.</p> Signup and view all the answers

    What client education should be provided regarding the management of fluid and electrolyte imbalance in patients with inflammatory bowel disease?

    <p>Monitor laboratory values regularly.</p> Signup and view all the answers

    Which action should a patient take to manage their recovery after bowel surgery related to inflammatory bowel disease?

    <p>Rest adequately and gradually resume home activity.</p> Signup and view all the answers

    Which sign indicates a potential fluid volume deficit in a patient with inflammatory bowel disease?

    <p>Loss of skin turgor.</p> Signup and view all the answers

    What is the importance of clients reporting the number of loose stools during recovery from inflammatory bowel disease?

    <p>It helps assess the effectiveness of the treatment.</p> Signup and view all the answers

    What dietary recommendation is advised for a patient with Inflammatory Bowel Disease?

    <p>High in protein and low in fiber</p> Signup and view all the answers

    Which observation indicates a potential dehydration issue in a patient with Inflammatory Bowel Disease?

    <p>Dizziness accompanied by hypotension</p> Signup and view all the answers

    Which nursing action is essential for preventing skin breakdown in patients with Inflammatory Bowel Disease?

    <p>Consulting with an enterostomal therapist</p> Signup and view all the answers

    What is a significant nursing responsibility regarding a patient at risk of infection due to Inflammatory Bowel Disease?

    <p>Regularly checking for evidence of infection</p> Signup and view all the answers

    Which of the following actions should a nurse take when caring for a patient with an abdominal abscess related to Inflammatory Bowel Disease?

    <p>Ensure the function of any drainage devices used</p> Signup and view all the answers

    What is the primary cause of toxic megacolon?

    <p>Inactivity of the colon</p> Signup and view all the answers

    Which nursing action is essential for a patient with toxic megacolon?

    <p>Administering IV fluids and electrolytes</p> Signup and view all the answers

    What can happen if a patient with toxic megacolon does not show improvement within 72 hours?

    <p>They will require an ileostomy</p> Signup and view all the answers

    What is a major risk associated with toxic megacolon?

    <p>Perforation of the colon</p> Signup and view all the answers

    Which medication category is typically administered to a patient with toxic megacolon?

    <p>Antibiotics and corticosteroids</p> Signup and view all the answers

    Study Notes

    Inflammatory Bowel Disease (IBD)

    • IBD affects parts of the GI tract, with acute and chronic forms.
    • IBD can lead to nutritional deficiencies, altered bowel habits, infections, pain, and fluid/electrolyte imbalances.
    • Nurses need IBD knowledge to work with patients and other healthcare professionals.

    Acute Inflammatory Bowel Disease

    • Includes appendicitis.
    • Appendicitis is appendix inflammation.
    • Obstruction of the appendix opening is a cause.
    • Fecaliths (hard stool) can start the obstruction.
    • Risk is higher for adolescents and young adults.
    • Refer to the Nursing Care of Children Review Module, Chapter 23.

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    Description

    This quiz explores Inflammatory Bowel Disease (IBD) and its implications for nursing care. It focuses on both acute forms, including appendicitis, and the essential knowledge nurses must possess to effectively manage patients with IBD. Understand common risks, nutritional deficiencies, and symptoms associated with this condition.

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