CHAPTER 57 Care of Patients With Inflammatory Intestinal Disorders
Which surgical intervention is beneficial when a patient with abdominal pain has an indefinitive diagnosis? -Appendectomy -Exploratory laparotomy -Natural orifice transluminal endoscopic surgery -Restorative proctocolectomy with ileo pouch-anal anastomosis
-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 oC and a pulse rate of 100 beats per minute. Which surgical intervention does the nurse anticipate will control the patient's condition? -Ileostomy -Total proctocolectomy -Exploratory laparotomy -Uncomplicated appendectomy
-Exploratory laparotomy
A patient with ulcerative colitis (UC) has stage 1 of a restorative proctocolectomy with ileo-anal anastomosis (RPC-IPAA) procedure performed. The patient asks the nurse, "How long do people with this procedure usually have a temporary ileostomy?" How does the nurse respond? -"It is usually ready to be closed in about 1 to 2 months." -"The period of time is indefinite—I am sorry that I cannot say." -"You will probably have it for 6 months or longer, until things heal." -"This is something that you will have to discuss with your health care provider."
-"It is usually ready to be closed in about 1 to 2 months."
A nurse is teaching a patient with Crohn's disease about managing the disease with the drug adalimumab. Which instruction does the nurse emphasize to the patient? -'Avoid large crowds and anyone who is sick.' -'Expect difficulty with wound healing while you are taking this drug.' -'Monitor your blood pressure and report any significant decrease in it.' -'Do not take the medication if you are allergic to foods with fatty acids.'
-'Avoid large crowds and anyone who is sick.'
The nurse is counseling a patient with gastroenteritis regarding self-management and hygiene. Which statement made by the patient indicates effective learning? -'It is safe to cook meals for my family.' -'It is necessary to clean my bathroom once a month.' -'I should wash hands for 30 minutes with an antibacterial soap.' -'I can keep my toothbrush and toothpaste separate from others.'
-'I can keep my toothbrush and toothpaste separate from others.'
The nurse is providing instructions to a patient with gastroenteritis regarding personal hygiene. Which statement made by the patient indicates a need for further teaching? -'I can use incontinent pads at night.' -'I should use toilet paper and soaps after each defecation.' -'I can take a sitz bath for 10 minutes twice daily.' -'I should apply creams or oils on a damp cloth to remove stools.'
-'I should use toilet paper and soaps after each defecation.'
A patient with an exacerbation of ulcerative colitis (UC) has been prescribed Vivonex PLUS. The patient asks the nurse how this is helpful for improving symptoms. How does the nurse reply? -'It is bland and reduces the secretion of gastric acids.' -'It does not contain caffeine or other gastrointestinal (GI) tract stimulants.' -'It provides key nutrients and extra calories to promote healing.' -'It is absorbed quickly and allows the affected part of the GI tract to rest and heal.'
-'It is absorbed quickly and allows the affected part of the GI tract to rest and heal.'
The nurse is teaching a nursing student about care of the patient with gastroenteritis. Which statement by the student indicates a need for further instruction? -'Fluid replacement is a priority in the patient with gastroenteritis.' -'Most causes of gastroenteritis are transmitted by the fecal-oral route.' -'Patients with gastroenteritis will present with hypoactive bowel sounds.' -'Handwashing is an effective intervention for the prevention of gastroenteritis.'
-'Patients with gastroenteritis will present with hypoactive bowel sounds.'
A patient who has viral gastroenteritis asks the nurse why the provider has not ordered a medication to reduce diarrhea. What does the nurse tell this patient about antidiarrheal medications? -'They do not eliminate the need for antibiotics.' -'They will be used only if a bacterial infection develops.' -'They may prolong exposure to the causative organism.' -'They cause severe side effects that may be life-threatening.'
-'They may prolong exposure to the causative organism.'
Which question should the nurse ask while assessing a patient with ulcerative colitis (UC)? -'Did you eat street food in the last couple of days?' -'Have you undergone any surgeries in the past year?' -'Does anyone from your family have similar complaints?' -'Were you on antibiotic treatments in the past three months?'
-'Were you on antibiotic treatments in the past three months?'
The RN receives a change-of-shift report about four patients. Which patient does the nurse assess first? -20-year-old with ulcerative colitis (UC) who had six liquid stools during the previous shift -25-year-old who has just been admitted with possible appendicitis and has a temperature of 102°F -56-year-old who had a colon resection earlier in the day and whose colostomy bag does not have any stool in it -60-year-old admitted with acute gastroenteritis who is reporting severe cramping and nausea
-25-year-old who has just been admitted with possible appendicitis and has a temperature of 102°F
A patient with ulcerative colitis is scheduled to undergo restorative proctocolectomy with ileo pouch-anal anastomosis (RPC-IPAA). What statements about the procedure are accurate? Select all that apply. -A temporary loop ileostomy is created. -Metronidazole is avoided after the surgery. -The colon, rectum, and anus are removed by RPC-IPAA. -Parenteral antibiotics are given within 1 hour before the surgery. -An internal pouch is created with the distal part of the small intestine.
-A temporary loop ileostomy is created. -Parenteral antibiotics are given within 1 hour before the surgery. -An internal pouch is created with the distal part of the small intestine.
What is a clinical manifestation of Crohn's disease? -Nausea -Vomiting -Abdominal pain -Dryness of mucous membranes
-Abdominal pain
Which factors should the nurse inquire about when taking the medical history of a patient with suspected appendicitis? -Abdominal pain that increases with cough -Abdominal pain before nausea and vomiting -Polyphagia followed by nausea and vomiting -Abdominal pain followed by nausea and vomiting
-Abdominal pain followed by nausea and vomiting
Which examination is used first to identify an enlarged appendix in a patient? -X-ray study -Abdominal ultrasound -Computed tomography -Palpation of the abdomen
-Abdominal ultrasound
Which findings are likely in a patient with peritonitis? -Hematuria -Bradycardia -Severe diarrhea -Abdominal wall rigidity
-Abdominal wall rigidity
A patient is admitted to the hospital with appendicitis. What signs/symptoms are consistent with this diagnosis? Select all that apply. -Anorexia -Nausea and vomiting -Rebound tenderness -Decreased white blood cell count -Abdominal pain relieved by coughing
-Anorexia -Nausea and vomiting -Rebound tenderness
A patient presents to the emergency department with complaints of severe abdominal pain near the right anterior iliac crest that later led to nausea and vomiting. Which acute inflammatory bowel disorder does the nurse suspect is the most likely cause? -Peritonitis -Appendicitis -Viral gastroenteritis -Bacterial gastroenteritis
-Appendicitis
While assessing a patient with pain in the epigastric region, the student nurse observes the white blood cell (WBC) count is 21,000 cells/mm 3. The ultrasound report shows an enlarged appendix, and the computed tomography reveals the presence of a fecalith. Which intervention performed by the student nurse may worsen the patient's condition? -Infusing intravenous fluids -Positioning the patient at 45° -Applying warm compresses to the abdomen -Administering opioids as per the prescription
-Applying warm compresses to the abdomen
The nurse is assessing a 70-year-old patient with abdominal distention, hyperactive bowel sounds, and poor skin turgor. The nurse suspects that the patient has gastroenteritis. What are the other findings that support the nurse's suspicion? Select all that apply. -Hemoglobin of 9.8 g/dL -Hematocrit of 25 percent -Body temperature of 101°F -Blood pressure of 100/70 mm Hg -Serum potassium level of 3.0 mEq/L
-Body temperature of 101°F -Blood pressure of 100/70 mm Hg -Serum potassium level of 3.0 mEq/L
A pathology report indicates a patient who has impaired digestion and bowel function is infected with Trypanosoma cruzi. The nurse notes the patient has cardiac dysrhythmia. Which condition does the nurse suspect? -Giardiasis -Chagas disease -Celiac disease (CD) -Intestinal amebiasis
-Chagas disease
A home health patient has had severe diarrhea for the past 24 hours. Which nursing action does the RN delegate to the home health aide (unlicensed assistive personnel [UAP]) who assists the patient with self-care? -Administering loperamide 4 mg from the patient's medicine cabinet -Teaching the patient how to clean the perineal area after each loose stool -Checking and reporting the patient's heart rate and blood pressure in lying, sitting, and standing positions -Instructing the patient about the use of electrolyte-containing oral rehydration products
-Checking and reporting the patient's heart rate and blood pressure in lying, sitting, and standing positions
A patient has vague symptoms that indicate an inflammatory bowel disorder. Which symptom is most indicative of Crohn's disease (CD)? -Epigastric cramping -Hypotension with vomiting -Chronic diarrhea, abdominal pain, and fever -Abdominal pain relieved by bending the knees
-Chronic diarrhea, abdominal pain, and fever
The nurse is providing instructions to a patient with an Ileostomy. Which action of the patient indicates a need for further learning? -Drinking hot tea -Using ostomy skin creams -Consuming tomatoes, nuts, and peas -Emptying the pouch when it is half full
-Consuming tomatoes, nuts, and peas
The student nurse is caring for a patient who underwent open abdominal surgery for peritonitis. Which intervention made by the student nurse indicates a need for further teaching? -Positioning the patient at a 45° angle in bed -Monitoring the level of patient's consciousness -Supplying oxygen to the patient through facial mask -Encouraging the patient to lift 20 pound weights daily
-Encouraging the patient to lift 20 pound weights daily
What term is used to describe a fistula that is present between the bowel and the bladder? -Enteroenteric fistula -Enterovesical fistula -Enterovaginal fistula -Enterocutaneous fistula
-Enterovesical fistula
Which findings in a patient indicate dehydration? Select all that apply. -Fever -Oliguria -Hypertension -Poor skin turgor -Right lower quadrant pain
-Fever -Oliguria -Poor skin turgor
A patient with ulcerative colitis complains of severe diarrhea with exacerbations. What is the drug of choice in this condition? -Glucocorticoids -Aminosalicylates -Immunomodulators -Antidiarrheal drugs
-Glucocorticoids
A patient with a history of osteoarthritis has a 10-inch incision following a colon resection. The incision has become infected, and the wound requires extensive irrigation and packing. What aspect of the patient's care does the nurse make certain to discuss with the health care provider before the patient's discharge? -Requesting an antianxiety medication -Having a home health consultation for wound care -Requesting pain medication for the patient's osteoarthritis -Placing the patient in a skilled nursing facility for rehabilitation
-Having a home health consultation for wound care
Which laboratory parameters should the nurse assess in the patient who presents with symptoms of diverticulitis? Select all that apply. -Hematocrit -Hemoglobin -Serum albumin -Serum potassium -White blood cell (WBC) count
-Hematocrit -Hemoglobin -White blood cell (WBC) count
A patient reports an increased frequency of bloody stools. After reviewing the laboratory reports, the nurse suspects the patient has ulcerative colitis (UC). Which findings support the nurse's suspicion? Select all that apply. -Hematocrit value of 25 percent -Serum albumin of 2.5 g/dL -Hemoglobin value of 8 g/dL -White blood cell (WBC) count of 8000 cells/mcL -Erythrocyte sedimentation rate (ESR) of 18 mm/hr
-Hematocrit value of 25 percent -Serum albumin of 2.5 g/dL -Hemoglobin value of 8 g/dL
Which statements about shigellosis are accurate? Select all that apply. -Antibiotics are not typically ordered. -Humans are possible carriers for months. -Cipro may be used for treatment of gastroenteritis -Shigellosis is transmitted by direct fecal-oral routes. -Shigellosis carries an incubation period of 10 days or more.
-Humans are possible carriers for months. -Cipro may be used for treatment of gastroenteritis -Shigellosis is transmitted by direct fecal-oral routes.
A patient has developed gastroenteritis while traveling outside the country. What is the likely cause of the patient's symptoms? -Overcooked food -Insufficient vaccinations -Bacteria on the patient's hands -Ingestion of parasites in the water
-Ingestion of parasites in the water
A laparotomy performed on patient revealed abscesses in the abdominal cavity. What treatment strategies might be included in the care plan? Select all that apply. -Avoiding analgesics -Inserting wound drains -Inserting a nasogastric tube -Encouraging complete bed rest -Administering intravenous (IV) antibiotics
-Inserting wound drains -Inserting a nasogastric tube -Administering intravenous (IV) antibiotics
The nurse is caring for a patient who has had abdominal distention and loose stools for 3 days due to gastroenteritis. The serum potassium is 3.0 mEq/L and blood pressure is 94/60 mm Hg. Which treatment may be best suitable for the patient in this situation? -Loperamide -Sulfasalazine -Oral rehydration solution -Diphenoxylate hydrochloride
-Oral rehydration solution
The nurse is performing discharge teaching with a patient who has been diagnosed with a parasitic infection. Which instructions does the nurse include in the teaching plan? Select all that apply. -Drink plenty of water. -Keep toilet areas clean. -Avoid contact with cat feces. -All household members should be tested for parasites. -Wash hands with antimicrobial soap after bowel movements.
-Keep toilet areas clean. -All household members should be tested for parasites. -Wash hands with antimicrobial soap after bowel movements.
Which statement about the procedure for an appendectomy is correct? -The patient can likely be discharged the day after the surgery. -The patient can return to usual activities in 2 to 3 days after the surgery. -Natural orifice transluminal endoscopic surgery (NOTES) creates an incision near the umbilicus. -Laparoscopy is an invasive procedure used to remove the inflamed appendix.
-Laparoscopy is an invasive procedure used to remove the inflamed appendix.
The nurse is caring for a patient who underwent exploratory laparotomy for a ruptured appendix. Which is the most important nursing intervention in the postoperative care to promote wound healing? -Assessing fluid retention -Measuring intake and output of fluids -Identifying infection at the site of incision -Maintaining sterile technique during peritoneal irrigation
-Maintaining sterile technique during peritoneal irrigation
A patient reports pain midway between the anterior iliac crest and the umbilicus in the right lower quadrant. The nurse documents that the patient is experiencing pain in which location? -Rebound point -Appendix point -McBurney's point -Right lower quadrant point
-McBurney's point
A patient is admitted with peritonitis due to a perforated appendix. Which intervention can be delegated to unlicensed assistive personnel (UAP)? -Measuring intake and output -Assessing for signs of sepsis -Administering pain medication -Performing nasogastric tube suctioning
-Measuring intake and output
The nurse is discharging a patient diagnosed with a parasitic intestinal infection. Which intervention does the nurse review with the patient before discharge? -Abdominal splinting -Abdominal massage -Meticulous hand washing -Coughing and deep breathing
-Meticulous hand washing
A patient had emergency surgery for peritonitis. Which nursing interventions are appropriate immediately after surgery? Select all that apply. -Monitoring the vital signs -Monitoring the level of consciousness -Encouraging the patient to consume food -Maintaining the patient in a semi-Fowler's position -Encouraging the patient to take fluids up to 2 liters
-Monitoring the vital signs -Monitoring the level of consciousness -Maintaining the patient in a semi-Fowler's position
What are the common signs and symptoms of gastroenteritis? -Fecaliths -Polyphagia -Nausea and vomiting -Abdominal pain that increases with cough
-Nausea and vomiting
Which organism causes gastroenteritis and is possibly transmitted through the respiratory route? -Shigella -Norovirus -Escherichia coli -Campylobacter enteritis
-Norovirus
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 in confirming the diagnosis? -Nurse: "Have you eaten in restaurants within the past two days?" Patient response: "Yes, once at a fast-food restaurant." -Nurse: "Do you have an allergy toward milk and milk products?" Patient response: "Yes." -Nurse: "Were you traveling recently?" Patient response: "Yes, two week ago." -Nurse: "When did the pain and vomiting begin?" Patient response: "The pain started 2 days ago, and yesterday I started vomiting."
-Nurse: "When did the pain and vomiting begin?" Patient response: "The pain started 2 days ago, and yesterday I started vomiting."
Which interventions will be beneficial for a patient with diarrhea who has developed skin irritation? Select all that apply. -Using a tissue to wipe -Patting the area gently -Taking antidiarrheal medication -Refraining from taking sitz baths -Using mild soap to wash the skin
-Patting the area gently -Taking antidiarrheal medication -Using mild soap to wash the skin
An older patient is being evaluated for abdominal pain. After 2 days of pain, the patient began vomiting and now reports increased pain with coughing. The patient prefers to lie in a fetal position with the right hip and knee bent. The patient's white blood cell count is 25,000/mm 3. What does the nurse suspect in this patient? -Ulcerative colitis -Viral gastroenteritis -Appendicitis with a fecalith -Perforation of the appendix
-Perforation of the appendix
Which clinical findings in a patient indicate ulcerative colitis? -Bowel fistulas -Thickened bowel wall -Inflammation of the ileum and colon -Presence of blood and mucus in the stool
-Presence of blood and mucus in the stool
The nurse is caring for a patient who reports vomiting and diarrhea for 2 days. The laboratory report reveals serum sodium levels of 130 mEq/L. Which nursing intervention will reduce the patient's symptoms? -Applying A+D ointment or aloe gel -Providing oral rehydration therapy (ORT) -Supplying oxygen through a nasal mask -Inserting a nasogastric tube into the stomach
-Providing oral rehydration therapy (ORT)
Which information is important to collect from a patient who is admitted to the hospital with diarrhea to determine the risk for gastroenteritis? Select all that apply. -Age -Family -Recent travel -Recent restaurant meals -Food items purchased recently
-Recent travel -Recent restaurant meals -Food items purchased recently
What postoperative measure must the patient take after undergoing abdominal surgery for peritonitis? -Avoid drugs such as docusate sodium. -Report a temperature higher than 38°C. -Avoid lifting anything for at least 4 weeks. -Stop taking antibiotics once the incision begins to heal.
-Report a temperature higher than 38°C.
Which bacteria may cause gastroenteritis? -Shigella species -Gonococcal species -Pneumococcal species -Staphylococcal species
-Shigella species
A patient is being discharged following a laparotomy for treatment of peritonitis. What complications should the patient report to the primary health care provider immediately? Select all that apply. -Incisional tenderness -Active bowel sounds -Signs of wound dehiscence -Unusual or foul-smelling drainage -A temperature higher than 101°F (38.3°C)
-Signs of wound dehiscence -Unusual or foul-smelling drainage -A temperature higher than 101°F (38.3°C)
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 request does the nurse implement first? -Administer acetaminophen 650 mg rectally. -Obtain a stool specimen for culture and sensitivity. -Draw blood for a complete blood count and serum electrolytes. -Start an IV solution of 5% dextrose in 0.45 normal saline at 125 mL/hr.
-Start an IV solution of 5% dextrose in 0.45 normal saline at 125 mL/hr.
An obese patient is discharged 10 days after being hospitalized for peritonitis, which resulted in an exploratory laparotomy. Which assessment finding by the patient's home health nurse requires immediate action? -Pain when coughing -Temperature of 100.8°F (38.2°C). -States, 'I am too tired to walk very much' -States, 'I feel like the incision is splitting open'
-States, 'I feel like the incision is splitting open'
What changes take place in a patient after a total proctocolectomy with a permanent ileostomy? -The effluent has a foul odor. -The stool becomes reddish in color. -Stool volume increases and becomes thin. -Stool volume decreases and becomes thick.
-Stool volume decreases and becomes thick.
Which instructions should the nurse provide to the patient with appendicitis that is scheduled for surgery? Select all that apply. -Take laxatives as prescribed. -Take antibiotics as prescribed. -Apply heat to the abdomen often. -Take opioid analgesics as prescribed. -Use enemas a day before the surgery.
-Take antibiotics as prescribed. -Take opioid analgesics as prescribed.
A patient is being treated for an anal fissure. During a follow-up visit, the nurse finds improvement in the patient's condition. Which actions made by the patient are responsible for this positive finding? Select all that apply. -Limiting fluid intake -Taking warm sitz baths -Taking olsalazine regularly -Using hydrocortisone cream -Using psyllium hydrophilic mucilloid
-Taking warm sitz baths -Using hydrocortisone cream -Using psyllium hydrophilic mucilloid
Which patient requires infliximab treatment? -The patient with heart disease -The patient with Crohn's disease -The patient with multiple sclerosis -The patient with diverticular disease
-The patient with Crohn's disease
The registered nurse is supervising a student nurse providing preoperative care to a patient with ulcerative colitis who is scheduled for surgery. Which action of the student indicates effective learning? -The student nurse administers antidiarrheal drugs as prescribed. -The student nurse explains the procedure of a laparoscopy to the patient. -The student nurse explains what an ileostomy is to the patient and family. -The student nurse administers parenteral antibiotics 30 minutes before surgery.
-The student nurse explains what an ileostomy is to the patient and family.
What is the rationale for a nurse to obtain blood cultures in a patient with peritonitis? -To assess renal function -To determine septicemia -To assess respiratory status -To determine acid-base balance
-To determine septicemia
The community health nurse educates people in a senior citizen center about consuming spinach and lettuce. What is the reason behind this instruction? -To prevent possible viral infection -To prevent possible gastroenteritis -To reduce the risk for acute kidney failure -To reduce the frequency of bowel movements
-To prevent possible gastroenteritis
Which surgical procedure for removal of an inflamed appendix involves minimal intervention? -Laparotomy -Laparoscopy -Exploratory laparotomy -Transluminal endoscopic surgery
-Transluminal endoscopic surgery
A patient with abdominal distention reports sharp, cramping abdominal pain. The abdominal x-ray shows free air and fluid in the abdominal cavity, and the blood reports reveal a white blood cell (WBC) count of 20,000/ mm 3 with a neutrophil count of 90 percent. Which parameters should the nurse monitor in the patient? Select all that apply. -Urine output -Pulse oximetry -Body temperature -Oral cavity for lesions -Leaking of stools at night
-Urine output -Pulse oximetry -Body temperature
A patient admitted with severe diarrhea is experiencing skin breakdown from frequent stools. What is an important comfort measure for this patient? -Applying hydrocortisone cream -Using sitz baths three times daily -Wearing absorbent cotton underwear -Cleaning the area with soap and hot water
-Using sitz baths three times daily
What is the common symptom associated with anorexia? -Vomiting -Diarrhea -Abdominal cramping -Temperature greater than 101°F
-Vomiting
What diagnostic test is preferred to differentiate between ulcerative colitis and Crohn's disease? -Computed tomography (CT) scan -Colonoscopy -Magnetic resonance enterography -X-ray examination with barium enema
-X-ray examination with barium enema
What is the typical incubation period of the Norwalk virus in a person with a normal immune system? 48 hours 72-96 hours 7 days 2-7 weeks
48 hours
The emergency room nurse is caring for a patient with an acute anal fissure. What time frame is expected for the fissure to heal? 6 days 6 years 6 weeks 6 months
6 weeks
A patient has a low-grade body temperature of 99 oF, tachycardia, and lesions in the mouth. The laboratory results reveal a hemoglobin level of 8.7 g/dL and the erythrocyte sedimentation rate (ESR) as 38 mm per hour. Which treatment strategy may benefit the patient? Opioids Aminosalicylates Antiperistaltic agents Bulk-producing agents
Aminosalicylates
The nurse is caring for a patient with peritonitis. What assessment findings will the nurse observe? Select all that apply. Diarrhea Anorexia Low-grade fever Distended abdomen Increased urine output
Anorexia Distended abdomen
What is the most common cause of right lower quadrant pain? Sepsis Peritonitis Appendicitis Gastroenteritis
Appendicitis
Which condition is suspected in a patient who presents with right quadrant abdominal pain followed by anorexia, nausea, and vomiting? Peritonitis Appendicitis Gastroenteritis Crohn's disease
Appendicitis
A patient has undergone a restorative proctocolectomy with ileal pouch-anal anastomosis. What should the nurse instruct the patient to avoid? Corn Wheat Asparagus Fiber-rich foods
Asparagus
A patient reports pain and a boardlike abdomen. What other findings would indicate peritonitis? Select all that apply. Diarrhea High fever Dehydration Inability to pass feces Increase in urine output
High fever Dehydration Inability to pass feces
Which drug is often used to treat gastroenteritis caused by Shigella? Tinidazole Loperamide Ciprofloxacin Diloxanide furoate
Ciprofloxacin
Which medication is most likely to be prescribed by the primary health care provider for the condition depicted in the figure below? Infliximab Tinidazole Adalimumab Ciprofloxacin
Ciprofloxacin
Which complication is seen exclusively in patients with ulcerative colitis? Cholelithiasis Malabsorption Colorectal cancer Abscess formation
Colorectal cancer
Which sign of peritonitis appears first in an older adult? Chills Fever Confusion Abdominal pain
Confusion
Which findings support the nurse's conclusion that a patient has gastroenteritis and may require hospitalization? Select all that apply. Hyperkalemia Dehydration Septicemia Hypovolemia Cardiac dysrhythmias
Dehydration Hypovolemia Cardiac dysrhythmias
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? -Oxycodone -Loperamide -Azithromycin -Diphenoxylate with atropine sulfate
Diphenoxylate with atropine sulfate
The nurse is caring for a patient with a low grade fever of 101°F, chills, and a heart rate of 98 beats per minute. The abdominal ultrasonography reveals bowel thickening. The blood test reports reveal a white blood cell (WBC) count of 19,000cells/ mm 3 and hemoglobin levels of 9.8 g/dL. Which condition does the nurse suspect in the patient? Peritonitis Diverticulitis Gastroenteritis Crohn's disease
Diverticulitis
The nurse is caring for a patient admitted for gastroenteritis. What symptoms does the nurse expect to see in the patient? Select all that apply. Fever Hypertension Acute confusion Poor skin turgor Excessive urination
Fever Acute confusion Poor skin turgor
Which complication is associated with Crohn's disease? Fistula Hemorrhage Hypovolemia Colorectal cancer
Fistula
What is a common complication of Crohn's disease? Fistulas Tenesmus Liquid stools Bloody stools
Fistulas
A patient with 10 to 13 liquid, bloody stools per day has a body temperature of 100 oF, decreased skin turgor, and a hemoglobin level of 8g/dL. What other conditions does the nurse expect to find in the patient? Select all that apply. Atelectasis Hemorrhage Chagas disease Acute kidney failure Nutritional deficiency
Hemorrhage Nutritional deficiency
A patient admitted with severe gastroenteritis has been started on an IV, but the patient continues having excessive diarrhea. Which medication does the nurse ask the health care provider about prescribing? Balsalazide Loperamide Mesalamine Milk of Magnesia (MOM)
Loperamide
What would be the drug of choice for a patient with gastroenteritis who is prescribed antiperistaltic agents? Loperamide Ciprofloxacin Acetaminophen Docusate sodium
Loperamide
Which medication would be beneficial to the patient with gastroenteritis who has increased peristaltic movements? Loperamide Ciprofloxacin Trimethoprim Acetaminophen
Loperamide
Which medication is helpful in patients who have fistulas associated with Crohn's disease? Mesalamine Sulfasalazine Azithromycin Metronidazole
Metronidazole
A patient reports daily passage of several foul-smelling stools with mucus accompanied by abdominal cramping, gas, fatigue, and weight loss. Which medications does the nurse anticipate will be prescribed? Select all that apply. Methotrexate Azathioprine Metronidazole Mercaptopurine Diloxanide furoate
Metronidazole Diloxanide furoate
The laboratory report of a patient with appendicitis indicates a white blood count (WBC) of 23,000/mm 3. Which condition does the nurse suspect from this finding? Fecalith Anal fissure Gastroenteritis Perforated appendix
Perforated appendix
A patient reports abdominal pain. Upon assessment, the nurse finds that the patient has poor skin turgor, a body temperature of 101 oF, and a distended abdomen with rebound tenderness. The blood culture reports show the presence of Streptococcus. Which condition does the nurse suspect in the patient? Peritonitis Appendicitis Gastroenteritis Ulcerative colitis (UC)
Peritonitis
Gangrene of the bowel and sepsis are some of the most common indications for emergency surgery. With which inflammatory bowel disorder are these complications associated? Peritonitis Appendicitis Gastroenteritis Ulcerative colitis
Peritonitis
What disorders does the nurse identify as acute inflammatory bowel disorders? Select all that apply. Peritonitis Appendicitis Gastroenteritis Crohn's disease Ulcerative colitis
Peritonitis Appendicitis Gastroenteritis
A patient returns to the unit after having an exploratory abdominal laparotomy. How does the nurse position this patient after the patient is situated in bed? Supine High Fowler's Semi-Fowler's Lateral Sims' (side-lying)
Semi-Fowler's
A patient reports having seven to nine bloody stools per day. The nurse finds that the patient has fever, tachycardia, anemia, and abdominal pain. The patient's laboratory reports indicate elevated C-reactive protein. Which classification of ulcerative colitis should the nurse suspect? Mild Severe Moderate Fulminant
Severe
A patient has had abdominal surgery for peritonitis and is being discharged home with antibiotics and opioid analgesics. The primary health care provider prescribes docusate sodium. What is the rationale for the use of docusate sodium? To relieve pain To relieve fever To fight infections To soften the stools
To soften the stools
Which medication prevents the migration of white blood cells (WBCs) to inflamed bowel tissue? Prednisone Vedolizumab Azathioprine Metronidazole
Vedolizumab
A patient with Crohn's disease is learning about nutrition. Which type of food should the nurse teach the patient to avoid? Wheat Spinach Lettuce Bananas
Wheat
