Chapter 46- prep you (lower GI disorders)

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.

A nurse is working with a client experiencing chronic constipation. Which education will the nurse provide to promote normal bowel function for this client?

- consume high residue, high fiber foods - increase fluid intake unless contraindicated

A client is having symptoms suggestive of Crohn disease. Which assessment data obtained by the client support this diagnosis?

- cramps pain triggered by eating - secondary anemia - LRQ abdominal pain - cobblestone appearance of distal ileum

When providing care for a client who has a diagnosis of irritable bowel syndrome (IBS), the nurse should collaborate with the client and prioritize what goal?

Accurate identification of foods that trigger symptoms

A client's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the client has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse's most appropriate response to this observation?

Acknowledge the client's reluctance and initiate discussion of the factors underlying it.

A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?

Contact the primary care provider promptly and report these signs of perforation.

A nurse assessing a client on postoperative day 3 notes that their new stoma has a moist appearance and a bright red color. How should the nurse best respond to this assessment finding?

Document that the stoma appears healthy and well perfused.

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

Familial polyposis

The nurse is caring for a client who is undergoing diagnostic testing for a suspected gastrointestinal malabsorption issue. When taking this client's health history and performing the physical assessment, which finding is most consistent with this diagnosis?

Foul-smelling stool that contains fat & Stool with characteristics of diarrhea

A nurse is caring for a client with a subclavian central line who is receiving parenteral nutrition (PN). In preparing a care plan for this client, what nursing diagnosis should the nurse prioritize?

Risk for infection related to the presence of a subclavian catheter

A client's screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this client's health problem?

The client's polyps constitute a risk factor for cancer.

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?

Ulcerative colitis

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

Ulcerative colitis

A nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics?

Watery with blood and mucus

The nurse working in the emergency department is caring for a client with signs and symptoms of appendicitis. Which order from the health care provider should the nurse question?

administering an enema

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?

anal fissure

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 administering total parenteral nutrition (TPN) to a client who underwent surgery for gastric cancer. Which of the nurse's assessments most directly addresses a major complication of TPN?

checking the client's capillary blood glucose levels regularly

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 & give the patient a rest period

Which is one of the primary symptoms of irritable bowel syndrome (IBS)?

diarrhea

The nurse is assessing a client who had an ileostomy created three days ago for the treatment of irritable bowel disease. The nurse observes that the client's stoma is bright red and there are scant amounts of blood on the stoma. What is the nurse's best action?

document these expected assessment findings

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?

elevated WBC

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 w/ mucosal biopsy

Which characteristic is a risk factor for colorectal cancer?

familial polyposis

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

client experiencing disturbing gastrointestinal (GI) symptoms that have been worsening in severity has been diagnosed with lactose intolerance. The nurse should recognize an increased need for what form of health promotion?

frequent screening for osteoporosis

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

high fiber diet

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 nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client?

inflammatory bowel disease

A 35-year-old client presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize?

insertion of a NG tube

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?

keep a 1 to 2 week symptom & food diary to identify food triggers

A client has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurse's care should prioritize which of the following outcomes?

maintaining fluid & electrolyte balance

The nurse is caring for a client with diarrhea. For which finding will the nurse suspect the diarrhea is caused by pancreatic insufficiency?

oil droplets on the toilet water

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 with a cyst has been brought for care. The nurse who is contributing to the client's care knows that treatment will be chosen based on what risk?

risk for infection

A client presents to the ED with acute abdominal pain, fever, nausea, and vomiting. During the client's examination, the lower left abdominal quadrant is palpated, causing the client to report pain in the RLQ. This positive sign is referred to as ________ and suggests the client may be experiencing ________.

roving sign & acute appendicitis

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 w/ direct palpitation or rebound tenderness

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

suggest fluid intake of at least 2 L/day

Which outcome indicates effective client teaching to prevent constipation?

the client reports engaging in a regular exercise regimen

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

the clusters of ulcers take on a cobblestone appearance

A nurse is planning discharge teaching for a 21-year-old client with a new diagnosis of ulcerative colitis. When planning family assessment, the nurse should recognize that which of the following factors will likely have the greatest impact on the client's coping after discharge?

the family's ability to provide emotional support

An older adult has a diagnosis of Alzheimer disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the client's stools. What is the nurse's most appropriate intervention?

toilet the client on a frequent, scheduled basis

nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics?

watery w/ blood & mucus