chapter 41 prep-u

"I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."

A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult?

Crohn's disease

A client presents with an infection in the area between the internal and external sphincters. In which chronic disease is this condition commonly seen?

peritonitis

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 board-like. What complication does the nurse determine may be occurring at this time?

stool consistency and client comfort

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"?

Usual pattern of elimination

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

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

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

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

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

nausea

A typical sign/symptom of appendicitis is:

Dry skin thoroughly after washing

The nurse is teaching a client with an ostomy how to change the pouching system. Which information should the nurse include when teaching a client with no peristomal skin irritation?

elevated WBC count

A client is admitted to the emergency department with reports right lower quadrant pain. Blood specimens are drawn and sent to the laboratory. Which laboratory finding should be reported to the health care provider immediately?

Increasing fluid intake to prevent dehydration

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?

Assist client to increase dietary fiber.

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

fissure

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:

The consistency of stool and comfort when passing stool

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?

Suggest fluid intake of at least 2 L/day

A client who has undergone colostomy surgery is experiencing constipation. Which intervention should a nurse consider for such a client?

Crohn's disease

A client with a 10-year history of Crohn's disease is seeing the physician due to increased diarrhea and fatigue. Additionally, the client has developed arthritis and conjunctivitis. What is the most likely cause of the latest symptoms?

anal fissure

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

lack of free water intake

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?

usual pattern if elimination

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

usual pattern of elimination

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

Clamp the tubing and allow client to rest.

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

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?

anal fissure

The nurse is performing a rectal assessment and notices a longitudinal tear or ulceration in the lining of the anal canal. The nurse documents the finding as which condition?

Borborygmus

The nurse is performing an abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse's notes?

Borborygmus

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?

breast

In women, which of the following types of cancer exceeds colorectal cancer?

polyps

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?

change in bowel habits

A nurse is teaching a group of adults about screening and prevention of colorectal cancer. The nurse should describe which of the following as the most common sign of possible colon cancer?

severe abdominal pain with direct palpation or rebound tenderness

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?

Intestinal malabsorption.

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:

Broiled chicken with low-fiber pasta

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.

Keep a 1- to 2-week symptom and food diary to identify food triggers.

A patient with irritable bowel syndrome has been having more frequent symptoms lately and is not sure what lifestyle changes may have occurred. What suggestion can the nurse provide to identify a trigger for the symptoms?

acylovir

A nurse is caring for a client admitted with symptoms of an anorectal infection; cultures indicate that the client has a viral infection. The nurse should anticipate the administration of what drug?

"Avoid taking the drug on a long-term basis."

A nurse is caring for a client with constipation whose primary provider has recommended senna for the management of this condition. The nurse should provide which of the following education points?

narrowing of stools constipation

A client has been diagnosed with cancer in the descending colon. Which symptoms would the nurse expect the client to report? Select all that apply.

Chronic constipation with sporadic bouts of diarrhea

A client informs the nurse of having abdominal pain that is relieved when having a bowel movement. The health care provider diagnosed the client with irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?

Test all stools for occult blood.

A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer. Which intervention should the nurse include on the plan of care?

Mucosal disorders causing generalized malabsorption

Celiac disease (celiac sprue) is an example of which category of malabsorption?

high fiber diet

Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes:

hypokalemia.

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:

deficient fluid volume

What is the primary nursing diagnosis for a client with a bowel obstruction?

presents with a rigid, board-like abdomen.

Which client requires immediate nursing intervention? The client who:

rectal bleeding

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

Board-like abdomen

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