The Client with Inflammatory Bowel Disease

The physician prescribes sulfasalazine for the client with ulcerative colitis. Which instruction should the nurse give the client about taking this medication? a) Avoid taking it with food. b) Take the total dose at bedtime. c) Take it with a full glass (240 mL) of water. d) Stop taking it if urine turns orange yellow.

C

A client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an exacerbation of the disease. Which of the following factors is most likely of greatest significance in causing an exacerbation of ulcerative colitis? a) A demanding and stressful job. b) Changing to a modified vegetarian diet. c) Beginning a weight-training program. d) Walking 2 miles (3.2 km) every day.

A

A client with ulcerative colitis is to take sulfasalazine. Which of the following instructions should the nurse provide for the client about taking this medication at home? Select all that apply. a) Drink enough fluids to maintain a urine output of at least 1,200 to 1,500 mL/day. b) Discontinue therapy if symptoms of acute intolerance develop and notify the health care provider. c) Stop taking the medication if the urine turns orange yellow. d) Avoid activities that require alertness. e) If dose is missed, skip and continue with the next dose.

A, B, D

A client has been placed on long-term sulfasalazine therapy for treatment of ulcerative colitis. The nurse should encourage the client to eat which of the following foods to help avoid the nutrient deficiencies that may develop as a result of this medication? a) Citrus fruits. b) Green, leafy vegetables. c) Eggs. d) Milk products.

B

A client newly diagnosed with ulcerative colitis who has been placed on steroids asks the nurse why steroids are prescribed. The nurse should tell the client: a) "Ulcerative colitis can be cured by the use of steroids." b) "Steroids are used in severe flare-ups because they can decrease the incidence of bleeding." c) "Long-term use of steroids will prolong periods of remission." d) "The side effects of steroids outweigh their benefits to clients with ulcerative colitis."

B

A client with Crohn's disease has concentrated urine; decreased urinary output; dry skin with decreased turgor; hypotension; and weak, thready pulses. The nurse should do which of the following first? a) Encourage the client to drink at least 1,000 mL/day. b) Provide parenteral rehydration therapy prescribed by the physician. c) Turn and reposition every 2 hours. d) Monitor vital signs every shift.

B

The client with ulcerative colitis is to be on bed rest with bathroom privileges. When evaluating the effectiveness of this level of activity, the nurse should determine if the client has: a) Conserved energy. b) Reduced intestinal peristalsis. c) Obtained needed rest. d) Minimized stress.

B

Which goal for the client's care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis? a) Promoting self-care and independence. b) Managing diarrhea. c) Maintaining adequate nutrition. d) Promoting rest and comfort.

B

Which of the following diets would be most appropriate for the client with ulcerative colitis? 1. High-calorie, low-protein. 2. High-protein, low-residue. 3. Low-fat, high fiber. 4. Low-sodium, high-carbohydrate.

B

Which of the following should be a priority focus of care for a client experiencing an exacerbation of Crohn's disease? a) Encouraging regular ambulation. b) Promoting bowel rest. c) Maintaining current weight. d) Decreasing episodes of rectal bleeding.

B

The nurse is developing a plan of care for a client with Crohn's disease who is receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include? Select all that apply. a) Monitoring vital signs once a shift. b) Weighing the client daily. c) Changing the central venous line dressing daily. d) Monitoring the IV infusion rate hourly. e) Taping all IV tubing connections securely.

B, D, E

When planning care for a client with ulcerative colitis who is experiencing an exacerbation of symptoms, which client care activities can the nurse appropriately delegate to an unlicensed assistant? Select all that apply. a) Assessing the client's bowel sounds. b) Providing skin care following bowel movements. c) Evaluating the client's response to antidiarrheal medications. d) Maintaining intake and output records. e) Obtaining the client's weight.

B, D, E

The nurse is assigning clients for the evening shift. Which of the following clients are appropriate for the nurse to assign to a licensed practical nurse to provide client care? Select all that apply. a) A client with Crohn's disease who is receiving total parenteral nutrition (TPN). b) A client who underwent inguinal hernia repair surgery 3 hours ago. c) A client with an intestinal obstruction who needs a Cantor tube inserted. d) A client with diverticulitis who needs teaching about take-home medications. e) A client who is experiencing an exacerbation of his ulcerative colitis.

B, E

A client has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which of the following complications? a) Heart failure. b) Deep vein thrombosis. c) Hypokalemia. d) Hypocalcemia.

C

A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for: a) Hyperalbuminemia. b) Thrombocytopenia. c) Hypokalemia. d) Hypercalcemia.

C

A client who has ulcerative colitis has persistent diarrhea, and has lost 12 lb (5.4 kg) since the exacerbation of the disease. Which of the following will be most effective in helping the client meet nutritional needs? a) Continuous enteral feedings. b) Following a high-calorie, high-protein diet. c) Total parenteral nutrition (TPN). d) Eating six small meals a day.

C

A client who has ulcerative colitis says to the nurse, "I can't take this anymore; I'm constantly in pain, and I can't leave my room because I need to stay by the toilet. I don't know how to deal with this." Based on these comments, the nurse should determine the client is experiencing: a) Extreme fatigue. b) Disturbed thought. c) A sense of isolation. d) Difficulty coping.

D