Nursing Chapter 52: Inflammatory Intestinal Disorders
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Questions and Answers

What assessment findings would the nurse expect for a client with peritonitis? (Select all that apply)

  • Nausea and vomiting (correct)
  • Abdominal pain (correct)
  • Distended rigid abdomen
  • Decreased urinary output (correct)
  • Fever (correct)
  • Bradycardia (correct)
  • Which finding(s) would the nurse report immediately to the surgeon for a client post-exploratory laparotomy? (Select all that apply)

  • Passing flatus
  • Serosanguineous drainage
  • Fever and chills (correct)
  • Pain level 2 on a scale of 0 to 10
  • Increased abdominal distention (correct)
  • For a client experiencing exacerbation of ulcerative colitis, which complications should the nurse assess? (Select all that apply)

  • Anemia (correct)
  • Hyponatremia (correct)
  • Increased BUN (correct)
  • Hypokalemia (correct)
  • Leukocytosis (correct)
  • Which food should the client with diverticulosis avoid?

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

    Which abdominal assessment finding will the nurse most likely expect for a client with peritonitis from a perforated appendix?

    <p>Board-like abdomen</p> Signup and view all the answers

    Which assessment finding will the nurse report to the primary health care provider after a colectomy with creation of an ileo-anal pouch?

    <p>No drainage from the ileostomy</p> Signup and view all the answers

    The nurse assesses a client who has appendicitis. Which assessment finding would the nurse expect?

    <p>Severe, steady right lower quadrant pain</p> Signup and view all the answers

    The nurse reviews the laboratory results for a client who has possible appendicitis. Which laboratory test finding would the nurse expect?

    <p>Elevated leukocyte count</p> Signup and view all the answers

    The nurse teaches a client who has viral gastroenteritis. Which dietary instruction would the nurse include in the health teaching?

    <p>Drink plenty of fluids to prevent dehydration.</p> Signup and view all the answers

    The nurse assesses a client with gastroenteritis. What risk factor would the nurse consider as the most likely cause of this disorder?

    <p>Consuming raw seafood</p> Signup and view all the answers

    The nurse assesses a client who is hospitalized with an exacerbation of Crohn's disease. Which assessment finding would the nurse expect?

    <p>High-pitched, rushing bowel sounds in the right lower quadrant</p> Signup and view all the answers

    After teaching a patient with diverticular disease, a nurse assesses the client's understanding. Which menu selection indicates the client correctly understood the teaching?

    <p>Baked fish with steamed carrots and a glass of apple juice</p> Signup and view all the answers

    A nurse cares for a young client with a new ileostomy. The client states, 'I cannot go to prom with an ostomy.' How would the nurse respond?

    <p>Let's talk to the ostomy nurse about options for ostomy supplies and dress styles.</p> Signup and view all the answers

    The nurse teaches a client about how to prevent transmission of gastroenteritis. Which statement by the nurse indicates a need for further teaching?

    <p>I'll cook all the meals for my family.</p> Signup and view all the answers

    After teaching a client who is prescribed adalimumab for severe ulcerative colitis (UC), the nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching?

    <p>I will take this medication with my breakfast each morning.</p> Signup and view all the answers

    The nurse is caring for a client who is prescribed sulfasalazine. Which question would the nurse ask the client before starting this drug?

    <p>Do you have any allergy to sulfa drugs?</p> Signup and view all the answers

    A nurse assesses a client who has ulcerative colitis and severe diarrhea. Which assessment would the nurse complete first?

    <p>Heart rate and rhythm</p> Signup and view all the answers

    A nurse reviews the electronic health record of a client who has Crohn's disease and a draining fistula. Which documentation would alert the nurse to urgently contact the primary health care provider for additional prescriptions?

    <p>Serum potassium of 2.6 mEq/L (2.6 mmol/L)</p> Signup and view all the answers

    A client is preparing to have a laparoscopic restorative proctocolectomy with ileo pouch-anal anastomosis (RCA-IPAA). Which preoperative health teaching would the nurse include?

    <p>You should be able to have better bowel continence after healing occurs.</p> Signup and view all the answers

    After teaching a client who has diverticulitis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching?

    <p>I will take a laxative nightly at bedtime to avoid becoming constipated.</p> Signup and view all the answers

    The nurse plans care for a client with Crohn's disease who has a heavily draining fistula. Which intervention would be the nurse's priority action?

    <p>Skin protection</p> Signup and view all the answers

    The nurse assesses a patient who is recovering from an ileostomy placement. Which assessment finding would alert the nurse to immediately contact the primary health care provider?

    <p>Pale and bluish stoma</p> Signup and view all the answers

    A nurse cares for a client with a new ileostomy. The client states, 'I don't think my friends will accept me with this ostomy.' How would the nurse respond?

    <p>Tell me more about your concerns.</p> Signup and view all the answers

    The nurse teaches a community group ways to prevent Escherichia coli infection. Which statements would the nurse include in this group's teaching? (Select all that apply.)

    <p>Use separate cutting boards for meat and vegetables.</p> Signup and view all the answers

    The nurse assesses a client with ulcerative colitis. Which complications are paired correctly with their physiologic processes? (Select all that apply.)

    <p>Lower gastrointestinal bleeding—erosion of the bowel wall</p> Signup and view all the answers

    A nurse assesses a patient who has celiac disease. Which signs and symptoms would the nurse expect? (Select all that apply.)

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

    A nurse cares for an older adult who is admitted to the hospital with complications of diverticulitis. Which actions would the nurse include in the client's plan of care? (Select all that apply.)

    <p>Palpate the abdomen for distention.</p> Signup and view all the answers

    A nurse prepares to discharge a client who is newly diagnosed with a chronic inflammatory bowel disease. Which questions would the nurse ask in preparation for discharge? (Select all that apply.)

    <p>What do you plan to eat for dinner?</p> Signup and view all the answers

    After teaching a patient who has a permanent ileostomy, a nurse assesses the client's understanding. Which dietary items chosen for dinner indicate that the client needs further teaching? (Select all that apply.)

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

    A nurse cares for a patient who has a chronic inflammatory bowel disease. Which actions would the nurse take to prevent skin excoriation? (Select all that apply.)

    <p>Gently pat the perineum dry after cleansing.</p> Signup and view all the answers

    The nurse is caring for a client who is diagnosed with celiac disease and preparing to start natalizumab. Which health teaching would the nurse include in the teaching? (Select all that apply.)

    <p>Awareness of a rare but potentially fatal drug complication.</p> Signup and view all the answers

    Study Notes

    Appendicitis Assessment

    • Right lower quadrant pain, especially at McBurney's point, is indicative of appendicitis.
    • Initial nausea and vomiting are more characteristic of gastroenteritis rather than appendicitis.

    Laboratory Findings in Appendicitis

    • An elevated leukocyte count is a common laboratory finding in appendicitis, signaling inflammation.
    • Serum electrolytes are typically stable unless diarrhea is present.

    Gastroenteritis Management

    • Encouragement of fluid intake is critical to prevent dehydration during viral gastroenteritis.
    • Caffeinated drinks should be avoided to prevent increased intestinal motility.

    Gastroenteritis Risk Factors

    • Raw seafood is a leading cause of gastroenteritis due to potential contamination.

    Crohn's Disease Symptoms

    • High-pitched, rushing bowel sounds may indicate narrowing of bowel lumen associated with Crohn's disease.

    Diet for Diverticular Disease

    • A low-residue diet is crucial for clients with diverticular disease, avoiding high-fiber foods and opting for well-cooked or canned options.

    Ileostomy Concerns

    • Consultation with an ostomy nurse can help clients address concerns about appearance and supplies.
    • It’s impractical to remove the ostomy pouch during public events due to constant liquid output.

    Preventing Gastroenteritis Transmission

    • Clients should avoid preparing meals for others to limit the spread of gastroenteritis.

    Adalimumab for Ulcerative Colitis

    • Adalimumab should not necessarily be taken with food; understanding its side effects and signs of infection is vital.

    Safety Priorities in Diarrhea

    • Monitoring heart rate and rhythm is critical in clients with severe diarrhea due to risks of electrolyte loss.

    Fistula Management in Crohn’s Disease

    • A serum potassium level below 3.5 mEq/L necessitates urgent medical intervention due to the risk of dysrhythmias.

    Postoperative Teaching for RCA-IPAA

    • The procedure aims to improve bowel continence and does not result in a permanent ileostomy.

    Managing Diverticulitis

    • Regular exercise and adequate fiber intake are essential, while laxatives should be avoided to prevent exacerbating the condition.

    Skin Protection for Fistulas

    • Ensuring skin protection is essential for patients with draining fistulas due to the caustic nature of intestinal fluids.

    Ostomy Assessment

    • A pale or bluish stoma indicates possible perfusion issues and requires immediate medical attention.

    Supporting Clients with New Ileostomies

    • Open discussions about social concerns associated with ostomies allow clients to express their feelings and receive appropriate support.

    E. Coli Infection Prevention

    • Handwashing after animal contact and using separate cutting boards can significantly reduce the risk of E. coli transmission.

    Complications of Ulcerative Colitis

    • Recognizing lower GI bleeding and abscess formation are critical for proper diagnosis and treatment in ulcerative colitis.

    Symptoms of Celiac Disease

    • Celiac disease signs include anorexia, constipation, and abdominal pain, while anal fistulas are not associated.

    Diverticulitis Care in Older Adults

    • Assessment of mental status, abdominal distention, and stool occult blood are integral aspects of care for older clients with diverticulitis.

    Discharge Planning for IBD

    • Understanding the availability of bathroom facilities and discussing dietary needs are crucial aspects of discharge teaching for chronic IBD patients.

    Dietary Choices for Ileostomy Patients

    • High-fiber foods such as corn and string beans should be avoided in the diets of clients with an ileostomy.

    Preventing Skin Excoriation

    • Using medicated wipes and aloe cream can help protect skin integrity for patients with inflammatory bowel disease.

    Natalizumab Administration for Celiac Disease

    • Careful instruction on drug administration, avoiding crowds, and reporting potential side effects is important for clients starting natalizumab.

    Peritonitis Assessment Findings

    • Symptoms of peritonitis include nausea, rigid abdomen, abdominal pain, and potentially fever; bradycardia is atypical.

    Postoperative Monitoring

    • Increased abdominal distention and persistent fever after surgery warrant immediate communication with the surgical team.

    Complications in Ulcerative Colitis Exacerbations

    • Frequent assessments for increased BUN, hypokalemia, leukocytosis, anemia, and hyponatremia are necessary during exacerbations.

    Nutrition Guidance for Diverticulosis

    • Clients should avoid cucumbers, as they are difficult to digest and could exacerbate diverticulosis symptoms.

    Abdominal Assessment for Peritonitis

    • A board-like abdomen is a classic sign of peritonitis resulting from a perforated appendix.

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    Description

    This quiz covers essential assessment findings related to patients with inflammatory intestinal disorders, such as appendicitis. Test your knowledge on expected symptoms and nursing evaluations critical for effective patient care.

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