MedSurg Chapter 46

The nurse is assessing a client for fecal impaction, and when inserting a lubricated, gloved finger, the stool feels like small rocks. What does the nurse document this finding as?

Scybala

A client with Crohn's disease informs the nurse that he is allergic to aspirin. What medication ordered for the treatment of Crohn's does the nurse know is contraindicated when a client is allergic to aspirin?

Sulfasalazine (Pentasa)

28. A client is being discharged from the outpatient care center after having an inguinal hernia reduced nonsurgically. What can the nurse instruct the client to do to decrease the incidence of recurrence? Select all that apply. A) Avoid heavy lifting and strenuous exercise. B) Avoid constipation. C) How to wear a truss. D) Take analgesics for pain. E) Bend at the waist.

A, B, C

After assessing a client with peritonitis, the nurse likely would document the client's bowel sounds as?

Absent

A client comes to the clinic complaining of not having a bowel movement in several days, abdominal cramping, and nausea. When the nurse puts the client on the stretcher, he vomits a large amount of fecal material. What should the first action by the nurse be?

Notify the physician.

A client realizes that regular use of laxatives has greatly improved his bowel pattern. However, the nurse cautions this client against the prolonged use of laxatives for which reason?

The client's natural bowel function may become sluggish.

The nurse is caring for four clients with diarrhea. Which client is most likely to be diagnosed with Crohn's disease?

A 24 year-old Caucasian eastern European Jewish female

A client with a hernia decides to manage the herniation with a truss. The nurse would emphasize which of the following?

Using cornstarch to absorb moisture in the area

In addition to teaching a client with constipation to increase dietary fiber intake to 25 g/day, which of the following would the nurse include as important?

Adding fiber-rich foods to the diet gradually

A nurse is preparing a client with a long history of ulcerative colitis for first stage surgery to remove the colon. which of the client's statements indicates that the client requires more preoperative education?

"I will have an ileostomy for the rest of my life."

The nurse is reviewing the laboratory test results of a client with Crohn's disease. Which of the following would the nurse most likely find?

Stool cultures negative for microorganisms or parasite

The nurse is preparing discharge instructions for the client with diverticulosis. When instructing the client to increase dietary fiber, what should the nurse inform the patient is the amount that should be taken in daily?

20 to 35 g

The nurse who was caring for a client with constipation is correct and recommending that the client slowly increase the intake of dietary fiber to which of the following amounts per day?

25 g/day

A nurse is preparing a presentation for a local community group of older adults about colon cancer. Which of the following would the nurse include as the primary characteristic associated with this disorder?

A change in bowel habits

A client has developed an anorectal abscess. Which client is at most risk for the development of this type of abscess?

A client with Crohn's disease

Which of the following signs with the nurse expect when assessing a client with suspected peritonitis? SATA A) abdomen feels rigid B) pulse rate is elevated C) rectal bleeding is present D) respirations are slow and labored E) stools appear maroon

A) abdomen feels rigid B) pulse rate is elevated

What does the nurse recognize as important assessments on a 24-year-old client seen in the emergency room with complaints of abdominal pain? the diagnosis is "rule out appendicitis". SATA A) abdominal pain currently localized in RLQ B) generalized abdominal pain for 24 hours C) indigestion after eating meals D) stools with high fat content E)WBC of 16,500 cells/mm³

A) abdominal pain currently localized in RLQ B) generalized abdominal pain for 24 hours E) WBC of 26,500 cells/mm³

After teaching a group of students about intestinal obstruction, the instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction?

Abdominal surgery

A client is diagnosed with colon cancer, located in the lower third of the rectum. What does the nurse understand will be the surgical treatment option for this client?

Abdominoperineal resection

18. The nurse is caring for a patient who has had diarrhea for 3 days. What major problems associated with severe or prolonged diarrhea should the nurse monitor for when caring for this patient? Select all that apply. A) Oral candidiasis B) Dehydration C) Electrolyte imbalances D) Vitamin deficiencies E) Rectal fissures

B, C, D

A client is admitted with a diagnosis of diverticulitis. the client has nausea, vomiting, and dehydration. which sign requires immediate attention by the nurse?

Board-like abdomen

The nurse is talking with a group of clients that are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider?

Change in bowel habits

A patient informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The patient states that the physician told him he has irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?

Chronic constipation with sporadic bouts of diarrhea

A client at a long-term care facility informs the nurse that he is having cramping when trying to have a bowel movement, and all that is coming out is liquid. When the nurse reviews the client's last bowel movement history, it is determined that the client has not had a bowel movement in 7 days. What does the nurse understand is most likely occurring with this client?

Encopresis

The nurse is preparing a patient for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the patient for?

Defecography

The nurse would instruct a client who has an appendectomy to avoid which of the following?

Heavy lifting

A client is complaining of problems with constipation. What dietary suggestion can the nurse inform the client may help facilitate the passage of stool?

Increase dietary fiber.

A nurse enters the room of a client who is experiencing cramping, bloating, and flatus, as well as diarrhea and/or constipation, with or without the present of mucus. what condition do the client symptoms suggest?

Irritable Bowel Syndrome

After teaching a group of students about irritable bowel syndrome and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-related antidiarrheal agent?

Loperamide (Imodium)

The nurse is following an order to collect a stool specimen from a patient who is having diarrhea for ova and parasites. What does the nurse understand may be required when obtaining this specimen?

The nurse may have to obtain several samples.

The nurse is obtaining data from an older adult client who is being seen in the clinic for a checkup. The client informs the nurse that he is taking a daily dose of Epsom salts to have a daily bowel movement. What priority intervention should the nurse anticipate doing to detect the changes that can occur from prolonged use?

Obtaining an ECG

The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder?

One part of the intestine telescopes into another portion of the intestine.

The nurse is observing the mucous membranes of a client's mouth and notices that they are darkly discolored. The client has been taking medication for diarrhea. What medication should the nurse ask the client if he has been taking?

Pepto-Bismol

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and boardlike. What complication does the nurse determine may be occurring at this time?

Peritonitis

When interviewing a client with internal hemorrhoids, which of the following would the nurse expect the client to report?

Rectal bleeding

The nurse is admitting a client to the acute care facility with abdominal pain related to an umbilical hernia. The nurse is palpating the protrusion, and the client states that it suddenly feels better. What type of hernia does the nurse understand this client has?

Reducible

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to?

Rovsing's sign

A client is recently diagnosed with Crohn's disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response?

Sulfasalazine (Azulfidine)

A client informs the nurse that he is taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about the taking a stimulant laxative?

They can be habit forming and will require increasing doses to be effective.

An older client comes to the clinic for a physical examination period which of the following screening tests would the nurse recommend the client have beginning at the age of 50 years, and every 10 years after?

colonoscopy

A client is admitted to the hospital for a hemorrhoidectomy period post-operatively, which of the following would a client's nurse be most concerned about?

excessive bloody drainage on the gauze dressing

A client with ulcerative colitis who experiences severe diarrhea is prescribed a cleansing enema to relieve the symptoms period which of the following interventions should the nurse consider at this stage?

question the physician about the use of the cleansing enema

When monitoring the food intake of a client with crohn's disease, the nurse observes that the client does not eat most of the food served. the nurse learns that the client finds the food on appetizing period which of the following steps should the nurse take to address this issue?

request the dietitian to suggest more acceptable food

A client is assessed for surgery for herniation period why is it important that the nurse ask whether the client smokes?

sneezing and coughing due to smoking may increase intra-abdominal pressure

Which of the following teaching strategies with the nurse plan for a client with an anal fissure?

teach the client how to insert a suppository.

Which of the following outcomes demonstrates the client's understanding of methods to relieve constipation?

the client exercises regularly four to six times a week

The nurse expects to find which of the following symptoms for a client with severe diarrhea?

the client's stool has mucus and blood

Which of the following instructions should the nurse provide to a client who is asymptomatic of colon cancer, but whose stool test results are positive for blood?

undergo a colonoscopy

A client tells the nurse, ìI am not having normal bowel movements.î When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?

The consistency of stool and comfort when passing stool