Med Surg Intestinal and Rectal Disorders

Which of the following is the most common symptom of a polyp?

rectal bleeding

A nurse is caring for a client who had an ileo conduit 3 days earlier. The nurse examines the stoma site and determines that she should consult with the ostomy nurse. Which assessment finding indicates the need for further consultation?

red, sensitive skin around the stoma site

An older adult client seeks help for chronic constipation. What factor related to aging can cause constipation in elderly clients?

decrease abdominal strength

When interviewing a client with internal hemorrhoids, what would the nurse expect the client to report?

rectal bleeding

A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location?

right lower quadrant

Which term refers to a protrusion of the intestine through a weakened area in the abdominal wall?

hernia

A client describes being constipated, but also experiencing abdominal cramping, pain, and urgent diarrhea. These symptoms occur more often when the client is nearing a deadline or is under emotional stress. What would be recommended to treat these symptoms? Select all that apply.

high fiber diet psyllium

The nurse is caring for a patient who has had an appendectomy. What is the best position for the nurse to maintain the patient in after the surgery?

high fowlers

The nurse is irrigating a colostomy when the patient says, "You will have to stop, I am cramping so badly." What is the priority action by the nurse?

clamp the tubing and give the patient a rest period

The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for:

hypokalemia

A surgeon is discussing surgery with a client diagnosed with colon cancer. The client is visibly shaken over the possibility of a colostomy. Based on the client's response, the surgeon should collaborate with which health team member?

enterostomal nurse

A client underwent a continent ileostomy. Within which time frame should the client expect to empty the reservoir?

every 4-6 hours

The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching?

drink 8 to glass of fluid daily

A client has been recently diagnosed with an anorectal condition. The nurse is reviewing interventions that will assist the client with managing the therapeutic regimen. What would not be included?

encourage the client to avoid exercise

The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is the best diagnostic test for this illness?

endoscopy with mucosal biopsy

A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a:

fissure

A patient diagnosed with IBS is advised to eat a diet that is:

high in fiber

The nurse is caring for an older adult patient experiencing fecal incontinence. When planning the care of this patient, what should the nurse designate as a priority goal?

maintaining skin integrity

After undergoing a total cystectomy and urinary diversion, a client has a Kock pouch (continent internal reservoir) in place. Which statement by the client indicates a need for further teaching?

"Ill have to wear an external collection pouch for the rest of my life"

Medical management of a patient with peritonitis includes fluid, electrolyte, and colloid replacement. The nurse knows to prepare the initial, most appropriate intravenous solution. Which of the following is the correct solution?

0.9% NS

Which statement provides accurate information regarding cancer of the colon and rectum?

Colorectal cancer is the third most common site of cancer in the United States.

What information should the nurse include in the teaching plan for a client being treated for diverticulosis?

Drink at least 8 to 10 large glasses of fluid every day

A nurse is applying an ostomy appliance to the ileostomy of a client with ulcerative colitis. Which action is appropriate?

Gently washing the area surrounding the stoma using a facecloth and mild soap

Which of the following is considered a bulk-forming laxative?

Metamucil

When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder?

One part of the intestine telescopes into another portion of the intestine.

Which outcome indicates effective client teaching to prevent constipation?

The client reports engaging in a regular exercise regimen.

The presence of mucus and pus in the stools suggests which condition?

Ulcerative colitis

A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder?

a change in bowel habits

Which of the following would a nurse expect to assess in a client with peritonitis?

board-like abdomen

The nurse is performing and documenting the findings of an abdominal assessment. When the nurse hears intestinal rumbling and the client then experiences diarrhea, the nurse documents the presence of which condition?

borborygmus

Crohn's disease is a condition of malabsorption caused by which pathophysiological process?

inflammation of all layers of intestinal mucosa

A patient visited a nurse practitioner because he had diarrhea for 2 weeks. He described his stool as large and greasy. The nurse knows that this description is consistent with a diagnosis of:

intestinal malabsorption

A resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. The client receives nutrition via a PEG tube, has adapted well to the tube feedings, and remains physically and socially active. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. What is the most likely cause of this client's constipation?

lack of free water intake

After teaching a group of students about irritable bowel syndrome and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-related antidiarrheal agent?

loperamide

Vomiting results in which of the following acid-base imbalances?

metabolic alkalosis

The nurse is admitting a client with a diagnosis of diverticulitis and assesses that the client has a boardlike abdomen, no bowel sounds, and reports of severe abdominal pain. What is the nurse's first action?

notify the physician

A nurse is performing focused assessment on her clients. She expects to hear hypoactive bowel sounds in a client with:

paralytic ileus

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and boardlike. What complication does the nurse determine may be occurring at this time?

peritonitis

The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication?

peritonitis

A client is diagnosed with Zollinger-Ellison syndrome. The nurse knows to assess the client for which characteristic clinical feature of this syndrome?

steatorrhea

an older adult client in a long term care facility is concerned about bowel regularity. During a client education session, the nurse reinforces the medically acceptable definition of "regularity." What is the actual measurement of "regular"?

stool consistency and client comfort

Which is a true statement regarding regional enteritis (Crohn's disease)?

take on a cobblestone appearance

After assessing a client with peritonitis, how would the nurse most likely document the client's bowel sounds?

absent

A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem?

bowel perforation

The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider?

change in bowel habits

The nurse is preparing a client for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the client for?

defecography

The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening?

familial polyposis

The nurse in an extended-care facility reports that a resident has clinical manifestations of fecal incontinence. The health care provider orders a diagnostic study to rule out inflammation. Which study will the nurse prepare the client for?

flexible sigmoidoscopy

A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control?

the client exhibits adequate GI perfusion

A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?

the consistency of stool and comfort when passing stool

A client informs the nurse that he is taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about taking a stimulant laxative?

they can be habit forming and will require increasing doses to be effective.

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition?

ulverative colitis

The nurse is assessing a client for constipation. To identify the cause of constipation, the nurse should begin by reviewing the client's:

usual pattern of elimination

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of?

Crohns disease

A longitudinal tear or ulceration in the lining of the anal canal is termed a(n):

anal fissure

A client with anorexia reports constipation. Which nursing measure would be most effective in helping the client reduce constipation?

assist client to increase dietary fiber

A patient with IBD would be encouraged to increase fluids, use vitamins and iron supplements, and follow a diet designed to reduce inflammation. Select the meal choice that would be recommended for a low-residue diet.

broiled chicken with low fiber pasta

Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following?

low residue

A nurse is interviewing a client about past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?

polyps

Which type of diarrhea is caused by increased production of water and electrolytes by the intestinal mucosa and their secretion into the intestinal lumen?

secretory diarrhea

A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find?

severe abdominal pain with direct palpation or rebound tenderness.

diet therapy for clients diagnosed with irritable bowel syndrome includes:

high-fiber diet

The nurse is irrigating a client's colostomy when the client begins to report cramping. What is the appropriate action by the nurse?

clamp the tubing and allow the patients to rest

A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?

chronic constipation with sporadic bouts of diarrhea

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, what would the nurse stress the importance of?

increase fluid intake to prevent dehydration

The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation?

review the clients usual pattern of elimination