Chapter 47: Intestinal and Rectal Disorders (SATA only)

b. Narrowing stools c. Constipation e. Abdominal distention Explanation: Melena and dull abdominal pain are associated with right-sided lesions. The other symptoms are found with left-sided lesions.

A client diagnosed with colon cancer presents with the characteristics symptoms of a left-sided lesion. Which symptoms are indicative of this disorder? Select all that apply. a. Black, tarry stools b. Narrowing stools c. Constipation d. Dull abdominal pain e. Abdominal distention

a) Drink at least 8 to 10 large glasses of fluid every day. c) Do not suppress the urge to defecate. Explanation: Avoid constipation. Do not suppress the urge to defecate. Consume at least 2 L/day (within limits of the client's cardiac and renal reserve) and include foods that are soft but have increased fiber, such as prepared cereals or soft-cooked vegetables, to increase the bulk of the stool and facilitate peristalsis, thereby promoting defecation. Avoid the use of laxatives or enemas except when recommended by the physician. Exercise regularly if the current lifestyle is somewhat inactive.

A client is being treated for diverticulosis. Which of the following points should the nurse include in this client's teaching plan? Select all that apply. a) Drink at least 8 to 10 large glasses of fluid every day. b) Avoid daily exercise; indulge only in mild activity. c) Do not suppress the urge to defecate. d) Use laxatives or enemas at least once a week.

A. Acute Pain Related to Increased Peristalsis and GI Inflammation B. Activity Intolerance Related to Generalized Weakness D. Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea Explanation: Patients with diverticulitis are likely to experience pain and decreased activity levels, and are at risk of fluid volume deficit. The patient is unlikely to experience fecal incontinence and urinary function is not directly influenced.

A nurse is caring for a patient who has been admitted to the hospital with diverticulitis. Which of the following would be appropriate nursing diagnoses for this patient? Select all that apply. A. Acute Pain Related to Increased Peristalsis and GI Inflammation B. Activity Intolerance Related to Generalized Weakness C. Bowel Incontinence Related to Increased Intestinal Peristalsis D. Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea E. Impaired Urinary Elimination Related to GI Pressure on the Bladder

B) Increased fiber intake D) Reduced fat intake Explanation: Patients whose diverticular disease does not warrant hospital treatment often benefit from a high-fiber, low-fat diet. Neither enemas nor anticholinergics are indicated, and fluid intake is encouraged.

An adult patient has been diagnosed with diverticular disease after ongoing challenges with constipation. The patient will be treated on an outpatient basis. What components of treatment should the nurse anticipate? Select all that apply. A. Anticholinergic medications B. Increased fiber intake C. Enemas on alternating days D. Reduced fat intake E. Fluid reduction

a. narrowing of stools b. constipation Explanation: Abdominal pain and cramping, narrowing of stools, constipation, abdominal distension, and bright red blood in stools are symptoms associated with cancer in the descending colon. Black, tarry stools and tenesmus are symptoms associated with cancer in the ascending colon.

Nurse expect the client to report? Select all that apply. a. narrowing of stools b. constipation c. black, tarry stools d. tenesmus

d. all of the above.

On assessment, the nurse should be looking for additional symptoms diagnostic of peritonitis, which include: a. abdominal rigidity. b. diminished peristalsis. c. leukocytosis. d. all of the above.

d. all of the above.

Preparation for an appendectomy includes: a. an intravenous infusion. b. prophylactic antibiotic therapy. c. salicylates to lower an elevated temperature. d. all of the above.

d. all of the above.

Remission of inflammation in ulcerative colitis is possible with: a. antidiarrheal medication. b. periods of rest after meals. c. steroid therapy. d. all of the above.

d. all of the above mechanisms.

The pathophysiology of constipation may be related to interference with: a. myoelectric activity of the colon. b. mucosal transport. c. processes involved in defecation. d. all of the above mechanisms.

a. sudden, sustained abdominal pain b. abdominal distention Explanation: Abdominal distention, fever, and sudden, sustained abdominal pain are the symptoms of perforation in a client with intestinal obstruction.

What symptoms of perforation might the nurse observe in a client with an intestinal obstruction? Select all that apply. a. sudden, sustained abdominal pain b. abdominal distention c. sudden drop in body temperature d. intermittent, severe pain