Chapter 52, Concepts of Care for Patients With Inflammatory Intestinal Disorders

Consume extra fluids to replace fluid losses

Which instruction would the nurse give to a patient who has viral gastroenteritis with vomiting and diarrhea and who cannot be seen in the clinic until the following day?

Take antibiotics as prescribed., Take opioid analgesics as prescribed.

Which instruction would the nurse provide to the patient with appendicitis who is scheduled for surgery? Select all that apply. One, some, or all responses may be correct.

Ciprofloxacin

Which medication would be prescribed to a patient who has severe diarrhea and an elevated temperature and who just returned from a trip South America?

Preparing the patient for emergency surgery

Which nursing intervention is the highest priority when caring for a patient who has diverticulitis with a suspected complication of a perforated bowel that is causing peritonitis?

Nurse: "When did the pain and vomiting begin?" Patient response: "The pain started 2 days ago, and yesterday I started vomiting."

A patient with suspected appendicitis reports having abdominal pain around the umbilicus for the past 2 days, associated with decreased hunger and episodes of vomiting. Which nursing statement and patient response helps confirm the diagnosis?

Notify the health care provider immediately of this potentially life-threatening situation

A patient was admitted to the hospital for evaluation of abdominal pain. The patient is unable to pass flatus, and the abdomen has become firm and distended. The nurse is unable to hear bowel sounds. The patient has a heart rate of 90 beats/min and a temperature of 39°C (102.2°F). Which action would the nurse take?

They may prolong exposure to the causative organism."

A patient who has viral gastroenteritis asks the nurse why the health care provider has not ordered a medication to reduce diarrhea. Which explanation would the nurse tell this patient about antidiarrheal medications?

Applying warm compresses to the abdomen

A patient with pain in the epigastric region has a white blood cell (WBC) count of 21,000 cells/mm3. The ultrasound report shows an enlarged appendix, and the CT reveals the presence of a fecalith. Which intervention performed by the nurse may worsen the patient's condition?

Diphenoxylate with atropine sulfate

A 68-year-old patient with severe abdominal pain, vomiting, and loose, watery-mucous stools for 3 days is receiving medication to treat the symptoms. The patient reports frequent dizziness and falls. Which medication may contribute to frequent falls in the patient?

Loperamide

A patient admitted with severe gastroenteritis has been started on an IV, but the patient continues having excessive diarrhea. Which medication would the nurse ask the health care provider about prescribing

Signs of wound dehiscence, Unusual or foul-smelling drainage, A temperature higher than 101°F (38.3°C)

A patient is being discharged after a laparotomy for treatment of peritonitis. Which sign or symptom would the nurse teach the patient to report to the primary health care provider immediately? Select all that apply. One, some, or all responses may be correct.

Loperamide

About which medication would the nurse teach the patient who is prescribed an antiperistaltic agent?

Start an IV solution of 5% dextrose in 0.45 normal saline at 125 mL/hr.

An 80-year-old patient with a 2-day history of myalgia, nausea, vomiting, and diarrhea is admitted to the medical-surgical unit with a diagnosis of gastroenteritis. Which health care provider prescription would the nurse implement first?

"I must keep my toothbrush and toothpaste separate from others."

The nurse is teaching a patient with gastroenteritis regarding self-management and hygiene. Which statement made by the patient indicates effective learning?

Peritonitis

The complications of gangrene of the bowel and sepsis are associated with which inflammatory bowel disorder?

Provide oral rehydration therapy (ORT)

The nurse is caring for a patient who reports vomiting and diarrhea for 2 days and has a serum potassium level of 3.0 mEq/L. Which nursing action would be the highest priority?

Maintaining sterile technique during peritoneal irrigation

The nurse is caring for a patient who underwent exploratory laparotomy for a ruptured appendix. Which nursing intervention in the postoperative care would promote wound healing?

Oral rehydration solution

The nurse is caring for an older patient who has had abdominal distention and loose stools for 3 days. The serum potassium is 3.0 mEq/L, and blood pressure is 94/60 mm Hg. Which treatment would be suitable for the patient at this time?

Shigella species

Which bacteria may cause gastroenteritis?

Cramping pain in the epigastric area

Which classic symptom is associated with appendicitis?

Abdominal wall rigidity

Which classic symptom is seen in a patient with peritonitis?

Blood cultures

Which clinical diagnostics may be performed to determine whether septicemia has occurred?

Using sitz baths three times daily

Which comfort measure would be included in the plan of care for a patient admitted with severe diarrhea who is experiencing skin breakdown from frequent stools?

Peritonitis, Appendicitis, Gastroenteritis

Which disorder would the nurse identify as acute inflammatory bowel disorders? Select all that apply. One, some, or all responses may be correct

Abdominal ultrasound

Which examination is used to identify an enlarged appendix in a patient?

Abdominal pain followed by nausea and vomiting

Which factors would the nurse inquire about when taking the medical history of a patient with suspected appendicitis?

Fever, Oliguria, Poor skin turgor

Which finding in a patient with gastroenteritis indicates dehydration? Select all that apply. One, some, or all responses may be correct.

Appendicitis

Which illness is associated with right lower quadrant pain?

Administer prescribed analgesics, Monitor output from wound drains., Maintain nasogastric tube to suction as prescribed, Administer prescribed IV antibiotics.

Which nursing intervention would be included in the care plan for a patient who had a laparotomy due to abscesses in the abdominal cavity? Select all that apply. One, some, or all responses may be correct.

Keeping the patient in a semi-Fowler position

Which nursing intervention would be included in the plan of care for a patient with appendicitis?

Irrigate peritoneal drain using sterile technique.

Which postoperative action would be implemented for a patient who just had abdominal surgery for peritonitis?

Report a temperature higher than 101°F (38.3°C).

Which postoperative instruction would be given to the patient after undergoing abdominal surgery for peritonitis?

To determine septicemia

Which rationale is accurate as to why blood cultures are obtained in a patient with peritonitis?

To prevent possible gastroenteritis

Which rationale would the community health nurse give to people in a senior citizen center regarding washing spinach and lettuce thoroughly before consuming it?

Acute confusion

Which sign of gastroenteritis may appear first in an older adult?

Pain that increases with coughing, Relief of pain with bending of the right knee, White blood cell count of 25,000/mm3

Which sign or symptom would the nurse assess in a patient with a perforated appendix? Select all that apply. One, some, or all responses may be correct.

The patient usually has less pain with this minimally invasive procedure.

Which statement about a laparoscopic procedure for an appendectomy is correct?

It occurs mostly in young adults

Which statement about appendicitis is accurate?

Patients with gastroenteritis will present with hypoactive bowel sounds

Which statement about gastroenteritis is accurate?

Humans are possible carriers for months.Ciprofloxacin may be used for treatment of gastroenteritis.Shigellosis is transmitted by direct fecal-oral routes

Which statement about shigellosis is accurate? Select all that apply. One, some, or all responses may be correct.

Exploratory laparotomy

Which surgical intervention is beneficial when a patient with abdominal pain has an indefinitive diagnosis?

Transluminal endoscopic surgery

Which surgical procedure for removing an inflamed appendix involves minimal intervention without an external incision?

Vomiting

Which symptom is usually seen first in gastroenteritis?

Fever, Acute confusion, Poor skin turgor

Which symptom would the nurse assess in a patient admitted for gastroenteritis? Select all that apply. One, some, or all responses may be correct.

To use medicated cleansing wipes, To apply a protective barrier cream to the skin, To take sitz baths for 10 minutes two or three times daily

Which teaching point would the nurse include in a plan of care for a patient with gastroenteritis? Select all that apply. One, some, or all responses may be correct.

Exploratory laparotomy

While assessing a patient with pain in the right lower quadrant, the nurse finds that the patient has a body temperature of 39°C (102.2°F) and a pulse rate of 100 beats/min. About which surgical intervention would the nurse anticipate teaching the patient that will control the patient's condition?

Diminishing bowel sounds

While assessing a patient with peritonitis, which finding would the nurse be concerned about that indicates that the inflammation has progressed?