Chapter 51: MEDSURG 4

A nurse teaches a client who is at risk for colorectal cancer. Which dietary recommendation would the nurse teach the client?

"Add vegetables such as broccoli and cauliflower to your diet."

The nurse is caring for a client who has been prescribed lubiprostone for irritable bowel syndrome (IBS-C). What health teaching will the nurse include about taking this drug?

"Be sure to take this drug with food and water to help manage constipation."

A nurse assesses a client who is prescribed alosetron. Which assessment question would the nurse ask this client before starting the drug?

"Have you been experiencing any constipation?"

After teaching a client who is recovering from a colon resection to treat early-stage colorectal cancer (CRC), the nurse assesses the client's understanding. Which statements by the client indicate understanding of the teaching? (Select all that apply.)

"I might start bicycling and swimming again once my incision has healed." "I will make sure that I make lifestyle changes to prevent constipation." "I will be sure to have the recommended colonoscopies."

A nurse cares for a client with colorectal cancer who has a new colostomy. The client states, "I think it would be helpful to talk with someone who has had a similar experience." How would the nurse respond?

"I will make a referral to the United Ostomy Associations of America."

The nurse is caring for a client who is planning to have a laparoscopic colon resection for colorectal cancer tomorrow. Which statement by the client indicates a need for further teaching?

"I will probably be in the hospital for 3 to 4 days after surgery."

A nurse cares for a client who states, "My husband is repulsed by my colostomy and refuses to be intimate with me." How would the nurse respond?

"Let's talk to the ostomy nurse to help you and your husband work through this."

A nurse cares for a client who had a colostomy placed in the ascending colon 2 weeks ago.The client states, "The stool in my pouch is still liquid." How would the nurse respond?

"The stool will always be liquid with this type of colostomy."

A nurse assesses a client with irritable bowel syndrome (IBS). Which questions would the nurse include in this client's assessment? (Select all that apply.)

"Which food types cause an exacerbation of symptoms?" "Where is your pain or discomfort and what does it feel like?"

A client is preparing to have a fecal occult blood test (FOBT). What health teaching would the nurse include prior to the test?

"You need to avoid red meat and NSAIDs for 48 hours before the test."

A nurse cares for a client who has a family history of colorectal cancer. The client states, "My father and my brother had colon cancer. What is the chance that I will get cancer?" How would the nurse respond?

"You should have a colonoscopy more frequently to identify abnormal polyps early."

A nurse assesses clients at a community health center. Which client is at highest risk for developing colorectal cancer?

A 72-year-old who eats fast food frequently.

The nurse is caring for a client who has a postoperative paralytic ileus following abdominal surgery. What drug is appropriate to manage this nonmechanical bowel obstruction?

Alvimopan

The nurse is caring for a client who just had a minimally invasive inguinal hernia repair. Which nursing actions would the nurse implement? (Select all that apply.)

Apply ice to the surgical area for the first 24 hours after surgery. Encourage ambulation with assistance within the first few hours after surgery. Encourage deep breathing after surgery but teach the client to avoid coughing. Assess vital signs frequently for the first few hours after surgery. Teach the client to rest for several days after surgery when at home. Teach the client not to lift more than 10 lb (4.5 kg) until allowed by the surgeon.

The nurse is caring for a client who has a nasogastric tube (NGT). Which actions would the nurse take for client care? (Select all that apply.)

Assess for proper placement of the tube every 4 hours or per agency policy. Disconnect suction when auscultating bowel peristalsis. Monitor the client's skin around the tube site for irritation.

The nurse is caring for a client who has perineal surgical wound. Which actions would the nurse take to promote comfort and wound healing? (Select all that apply.)

Assist the client into a side-lying position. Apply warm compresses three to four times a day. Place an absorbent dressing over the wound.

After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client's understanding. Which menu selection indicates that the client correctly understands the dietary teaching?

Broiled chicken with brown rice, steamed broccoli, glass of apple juice

The nurse assists the wound care/ostomy nurse assess a client prior to ostomy surgery. Which assessments would the nurse complete before marking the placement for the ostomy? (Select all that apply.)

Contour of the abdomen when standing Location of the client's belt line Contour of the abdomen when lying Contour of the abdomen when sitting

The nurse is teaching a client how to avoid the formation of hemorrhoids. What lifestyle change would the nurse include?

Decreasing fluid intake

The nurse is caring for a client who is diagnosed with a complete small bowel obstruction. For what priority problem is this client most likely at risk?

Electrolyte imbalance

A nurse cares for a client who has a new colostomy. Which action would the nurse take?

Empty the pouch frequently to remove excess gas collection.

A nurse assessing a client with colorectal cancer auscultates high-pitched bowel sounds and notes the presence of visible peristaltic waves. Which action would the nurse take?

Recommend that the client have computed tomography.

The nurse is caring for a client with probable colorectal cancer (CRC). What assessment findings would the nurse expect? (Select all that apply.)

Rectal bleeding Anemia Change in stool shape Abdominal discomfort

The nurse is caring for a client with a large bowel obstruction due to fecal impaction. What position would be appropriate for the client while in bed?

Semi-Fowler

A client is admitted with a diagnosis of possible strangulated inguinal hernia. For which complication would the nurse monitor?

Sepsis

A nurse is caring for a client who has been diagnosed with a small bowel obstruction. Which assessment findings would the nurse correlate with this diagnosis? (Select all that apply.)

Serum potassium of 2.8 mEq/L (2.8 mmol/L) Abdominal pain in upper quadrants Serum sodium of 121 mEq/L (121 mmol/L)

The nurse is teaching a client who had a descending colostomy 2 days ago about the ostomy stoma. Which changes in the stoma would the nurse teach the client to report to the primary health care provider? (Select all that apply.)

Stoma becomes dark and dull. Skin around the stoma becomes excoriated. Skin around stoma becomes protruded. Stoma becomes retracted into the abdomen.