Chapter 48 med surge

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

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

A nursing instructor is discussing hemorrhoids with the nursing class. Which patients would the nursing instructor identify as most likely to develop hemorrhoids?

A pregnant woman at 28 weeks' gestation

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.

Acute Pain Related to Increased Peristalsis and GI Inflammation, Activity Intolerance Related to Generalized Weakness, Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea

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

Acyclovir Zovirax

A patient's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather that ulcerative colitis, as the cause of the patient's signs and symptoms?

An absence of blood in stool

The nurse is providing care for a patient whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the patient's medication regimen?

Anticholinergic medications 30 minutes before a meal

A patient has had an ileostomy created for the treatment of irritable bowel disease and the patient is now preparing for discharge. What should the patient be taught about changing this device in the home setting?

Apply a skin barrier to the peristomal skin prior to applying the pouch.

An older adult who resides in an assisted living facility has sought care from the nurse because of recurrent episodes of constipation. Which of the following actions should the nurse first perform?

Assess the patient's food and fluid intake.

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?

Change in bowel habits

A nurse is working with a patient who has chronic constipation. What should be included in patient teaching to promote normal bowel function?

Consume high-residue, high-fiber foods.

A nurse is assessing a patient's stoma on postoperative day 3. The nurse notes that the stoma has a shiny 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.

A nurse is providing care for a patient whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention best addresses this diagnosis?

Engage the patient in the care of the ostomy to the extent that the patient is willing.

A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite?

High levels of alcohol consumption

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?

Increased fiber intake, Reduced fat intake

During a patient's scheduled home visit, an older adult patient has stated to the community health nurse that she has been experiencing hemorrhoids of increasing severity in recent months. The nurse should recommend which of the following?

Increased fluid and fiber intake

Which of the following is the most plausible nursing diagnosis for a patient whose treatment for colon cancer has necessitated a colonostomy?

Ineffective Sexuality Patterns Related to Changes in Self-Concept

A patient is admitted to the medical unit with a diagnosis of intestinal obstruction. When planning this patient's care, which of the following nursing diagnoses should the nurse prioritize?

Ineffective Tissue Perfusion Related to Bowel Ischemia

A 35-year-old male patient 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 nasogastric tube

A patient 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 and electrolyte balance

A nurse is providing care for a patient who has a diagnosis of irritable bowel syndrome (IBS). When planning this patient's care, the nurse should collaborate with the patient and prioritize what goal?

Patient will accurately identify foods that trigger symptoms.

A nurse is caring for an older adult who has been experiencing severe Clostridium difficile-related diarrhea. When reviewing the patient's most recent laboratory tests, the nurse should prioritize which of the following?

Potassium level

A patient's large bowel obstruction has failed to resolve spontaneously and the patient's worsening condition has warranted admission to the medical unit. Which of the following aspects of nursing care is most appropriate for this patient?

Preparing the patient for surgical bowel resection

A teenage patient with a pilonidal cyst has been brought for care by her mother. The nurse who is contributing to the patient's care knows that treatment will be chosen based on what risk?

Risk for infection

A nurse at an outpatient surgery center is caring for a patient who had a hemorrhoidectomy. What discharge education topics should the nurse address with this patient?

The correct procedure for taking a sitz bath

A patient has been experiencing disconcerting GI symptoms that have been worsening in severity. Following medical assessment, the patient has been diagnosed with lactose intolerance.

The nurse should recognize an increased need for what form of health promotion? Frequent screening for osteoporosis

A nurse is working with a patient who is learning to care for a continent ileostomy (Kock pouch). Following the initial period of healing, the nurse is teaching the patient how to independently empty the ileostomy.

The nurse should teach the patient to do which of the following actions? Insert the catheter approximately 5 cm into the pouch.

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

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

A nurse caring for a patient with colorectal cancer is preparing the patient for upcoming surgery. The nurse administers cephalexin (Keflex) to the patient and explains what rationale?

To reduce intestinal bacteria levels

A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this patient?

Tofu

A patient with a diagnosis of colon cancer is 2 days postoperative following bowel resection and anastomosis. The nurse has planned the patient's care in the knowledge of potential complications.

What assessment should the nurse prioritize? Frequent abdominal auscultation

An older adult has a diagnosis of Alzheimer's disease and has recently been experiencing fecal incontinence. However, the nurse has observed no recent change in the character of the patient's stools.

What is the nurse's most appropriate intervention? Toilet the patient on a frequent, scheduled basis.

A patient's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the patient 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 patient's reluctance and initiate discussion of the factors underlying it.

A nurse caring for a patient with a newly created ileostomy assesses the patient and notes that the patient has had not ostomy output for the past 12 hours. The patient also complains of worsening nausea.

What is the nurse's priority action? Report signs and symptoms of obstruction to the physician.

A patient has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet.

What pharmacologic intervention should the nurse recommend to the patient for ongoing use? Psyllium hydrophilic mucilloid Metamucil

nurse is talking with a patient who is scheduled to have a hemicolectomy with the creation of a colostomy. patient admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes.

Which of the following nursing actions is most appropriate? Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse.

A patient admitted with acute diverticulitis has experienced a sudden increase in temperature and complains of a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the

patient'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 is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the

patient's stools will have what characteristics? Watery with blood and mucus

A 16-year-old presents at the emergency department complaining of right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this patient's nursing care,

the nurse should prioritize what nursing diagnosis? Risk for Infection Related to Possible Rupture of Appendix

The nurse is caring for a patient who is undergoing diagnostic testing for suspected malabsorption. When taking this patient's health history and performing the physical assessment,

the nurse should recognize what finding as most consistent with this diagnosis? Foul-smelling diarrhea that contains fat

A nurse is planning discharge teaching for a 21-year-old patient 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 patient's coping after discharge? The family's ability to provide emotional support