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 (C)</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 (D)</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 (C)</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 (B)</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 (A)</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. (D)</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 (B)</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 (B)</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 (C)</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. (B)</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. (B)</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. (C)</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? (C)</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 (B)</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) (D)</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. (A)</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. (A)</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 (B)</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 (D)</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. (C)</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. (C), Wash your hands after any contact with animals. (E)</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 (C), Nonmechanical bowel obstruction—paralysis of colon resulting from colorectal cancer (D), Abscess formation—localized pockets of infection develop in the ulcerated bowel lining (E)</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 (A), Anorexia (B), Constipation (D)</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. (A), Assess for sudden changes in mental status. (B), Administer pain medications as prescribed. (C), Evaluate stools for occult blood. (E)</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? (A), When should you contact your provider? (B), How many bathrooms are in your home? (D), Does your gym provide yoga classes? (E)</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 (B), Wheat rice (C), String beans (D)</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. (A), Apply a thin coat of aloe cream to the perineum. (D), Use medicated wipes instead of toilet paper. (E)</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. (A), Need to report any signs and symptoms of infection immediately. (B), Need to avoid crowds and individuals who have infection. (C), Need to have drug administered by a primary health care provider. (D)</p> Signup and view all the answers

Flashcards

Appendicitis pain location

Pain in the lower right abdomen, often around McBurney's point

Appendicitis initial symptoms

Often nausea and vomiting, but less common than in gastroenteritis.

Appendicitis lab finding

Elevated white blood cell count (leukocyte count).

Gastroenteritis fluid intake

Crucial to prevent dehydration, especially with viral gastroenteritis.

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Gastroenteritis drink avoidance

Avoid caffeinated drinks to prevent increased bowel movements.

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Gastroenteritis risk food

Raw seafood is a significant cause due to contamination possibilities.

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Crohn's disease bowel sound

High-pitched, rushing sounds, indicating narrowed bowel lumen.

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Diverticular disease diet

Low-residue diet: Avoid high-fiber foods; eat well-cooked or canned options.

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Ileostomy nursing care

Ostomy nurses provide support regarding appearance and supplies.

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Ileostomy pouch removal

Removing a pouch during public events is difficult due to continuous output.

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Gastroenteritis prevention

Avoid preparing meals for others when experiencing gastroenteritis to limit transmission.

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Adalimumab and food

Adalimumab doesn't need to be taken with food, but be mindful of its side effects and watch for signs of infection.

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Diarrhea's safety priority

Monitor heart rate and rhythm carefully in clients with severe diarrhea due to electrolyte loss risk.

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Crohn's fistula potassium

Low potassium (below 3.5 mEq/L) in Crohn's disease fistulas requires urgent medical care.

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RCA-IPAA procedure outcome

RCA-IPAA aims to improve bowel control; it doesn't lead to a permanent ileostomy.

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Diverticulitis and exercise

Regular exercise is beneficial, but avoid laxatives; focus on fiber intake.

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Fistula skin care

Protect the skin around fistulas because intestinal fluids can be irritating.

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Pale/blue stoma

Indicates potential blood flow problems, requiring immediate medical attention.

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Ileostomy support

Open communication about social concerns of ostomies helps support individuals.

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E. coli prevention

Handwashing after animal contact and using separate cutting boards reduces E. coli risk.

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Ulcerative colitis complications

Watch for signs of lower GI bleeding and abscesses for proper treatment.

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Celiac disease symptoms

Includes anorexia, constipation, and abdominal pain; not anal fistulas.

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Diverticulitis in older adults

Mental status, abdominal distention, and stool occult blood are important assessments.

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IBD discharge planning

Thoroughly assess bathroom facilities and discuss dietary needs during IBD discharge.

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Ileostomy diet restrictions

Avoid high-fiber foods like corn and string beans to prevent digestive problems.

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Skin excoriation prevention

Use medicated wipes and aloe cream to protect skin integrity for IBD.

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Natalizumab guidelines

Carefully teach clients, avoid crowds, and emphasize reporting any side effects.

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Peritonitis symptoms

Symptoms include nausea, rigid abdomen, abdominal pain, and possibly fever; bradycardia is not typical.

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Postoperative monitoring concerns

Increased abdominal distension, persistent fever, and worsening situations warrant immediate surgical team action.

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Ulcerative colitis exacerbation monitoring

Frequent monitoring for BUN increase, hypokalemia, leukocytosis, anemia and hyponatremia during flares.

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Diverticulosis diet avoidance

Avoid cucumbers due to potential difficulties in digestion and symptoms aggravation.

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Peritonitis assessment (abdomen)

A rigid, board-like abdomen is a typical assessment finding for peritonitis, especially when it comes from a perforated appendix.

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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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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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