Exam 4 (Chapter 48) MGMT of Pt's w/Intestinal and Rectal Disorders

The nurse is irrigating a colostomy. The catheter should be advanced into the stoma __________to _________ inches.

2 to 3

A food to avoid for a patient with ileostomy

Celery

The most common bacteria found in antibiotic associated diarrhea is ______________ ______________.

Clostridium difficile

Another food to avoid for a patient with an ileostomy

Corn

Another name for regional enteritis

Crohn's disease

The most common bacteria associated with peritonitis

E. coli

Another term for fecal matter

Effluent

Dilated and atonic colon caused by a fecal mass

Megacolon

The most common complication of colon cancer

Peritonitis

The three most common causes of small bowel obstruction are ____________, _______________, and ___________.

adhesions, hernias, neoplasms

The most popular over-the-counter medication purchased in the United States

laxatives

A chemotherapeutic agent used to treat colon cancer

5-FU

10. A patient is expected to have diverticulitis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling? a. Colonoscopy b. Barium enema c. Flexible sigmoidoscopy d. CT scan

a. Colonoscopy

1. The nurse is assessing a patient with appendicitis. The nurse is attempting to elicit a Rovsing's sign. Where should the nurse palpate for this indicator of acute appendicitis? a. right lower quadrant b. left lower quadrant c. right upper quadrant d. left upper quadrant

b. left lower quadrant

The most common site for the presence of diverticulitis is the ________________________.

sigmoid

Malabsorption diseases may affect the ability of the digestive system to absorb the major water-soluble __________________________.

vitamin B 12

The recommended dietary intake of fiber is ________________ grams per day. This intake, along with 1.5 to 2L of fluids daily, should prevent constipation that occurs with fewer than _________ bowel movements per week.

25 to 30 g/day; three

A highly reliable blood study used to diagnose appendicitis

CEA

A tubular fibrous tract that extends from an opening beside the anus into the anal canal

Fistula

The two diseases of the colon that are commonly associated with constipation are ____________ and ___________.

Irritable bowel syndrome, diverticular disease

An ileal outlet on the abdomen

Stoma

Painful straining at stool

Tenesmus

Straining at stool

Valsalva maneuver

A disorder of malabsorption that inactivates pancreatic enzymes is ____________________ ___________________.

Zollinger-Ellison syndrome

The majority of large bowel obstructions are caused by ____________________.

adenocarcinoid tumors

4. The nurse is performing in abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the lower left quadrant. What will the nurse document this sound as on the nurse's notes? a. Loud bowel sounds b. Borborygmus c. Tenesmus d. Peristalsis

b. Borborygmus: a rumbling or gurgling sound caused by the movement of gas in the intestines.

15. The nurse is irrigating a colostomy when the patient says, "you will have to stop, I am cramping so badly". What is the priority action by the nurse? a. Inform the patient that it will only last a minute and continue with the procedure b. Clamp the tubing and give the patient a rest period c. Stop irrigation and remove the tube d. Replace the fluid with cooler water since it is probably too warm

b. Clamp the tubing and give the patient a rest period

Instestinal rumbling

borborygmus

9. Nurse is caring for a patient who has had an appendectomy. What is the best position for the nurse to maintain the patient and after the surgery? a. Prone b. Sims left lateral c. High Fowler's d. Supine with head of bed elevated 15 degrees

c. High Fowler's

Common clinical manifestations of Crohn's disease are ________________________ and ___________________.

Abdominal pain, diarrhea

Intravenous nutrition used for inflammatory bowel disease

TPN

13. A patient is having a diagnostic workup for complaints of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of string sign. What does the nurse understand that this is significant of? a. Crohn's disease b. Ulcerative colitis c. Irritable bowel syndrome d. Diverticulitis

a. Crohn's disease

5. The nurse is caring for an older adult patient experiencing fecal incontinence. When planning the care of this patient, what should the nurse designate as a priority goal? a. Maintaining skin integrity b. Beginning a bowel program to establish continence c. Instituting a diet high in fiber and increase fluid intake d. Determining the need for surgical intervention to correct the problem

a. Maintaining skin integrity

7. The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is best diagnostic test for this illness? a. Ultrasound b. Endoscopy with mucosal biopsy c. Stool specimen for OVA and parasites d. Pancreatic function test

b. Endoscopy with mucosal biopsy

11. The nurse is admitting a patient with a diagnosis of diverticulitis and assesses that the patient has a board like abdomen, no bowel sounds, and complains of severe abdominal pain. What is the nurses first action? a. Start an IV with lactated Ringer's solution b. Notify the physician c. Administer a retention enema d. Administer an opioid analgesic

b. Notify the physician

12. The nurse is assigned to care for a patient 2 days after an appendectomy due to a ruptured appendix with resultant peritonitis. The nurse has just assisted the patient with ambulation to the bedside commode when the patient points to the surgical site and informs the nurse that "something gave way". What does the nurse suspect may have occurred? a. A drain may have become dislodged b. Wound dehiscence has occurred c. Infection has developed d. The surgical wound has begun to bleed

b. Wound dehiscence has occurred

8. A patient arrives in the emergency department with complaints of right lower abdominal pain that begins four hours ago and is getting worse. The nurse assesses rebound tenderness at mcburney's Point. What does this assessment data indicate to the nurse? a. Crohn's disease b. Ulcerative colitis c. Appendicitis d. Diverticulitis

c. Appendicitis

3. A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem? a. Appendicitis b. Rectal fissures c. Bowel perforation d. Diverticulitis

c. Bowel perforation

2. A patient is not having daily bowel movements and has begun taking a laxative for this problem. What should the nurse educate the patient about regarding laxative use? a. When taking a laxative, plenty of fluids should be taken as well b. Laxatives should be taken no more than 3 times a week or laxative addiction will result c. Laxative should not be routinely taken due to destruction of nerve endings in the colon d. laxatives should never be the first response for the treatment of constipation; natural methods should be employed first

c. Laxative should not be routinely taken due to destruction of nerve endings in the colon

14. A patient is being seen in the clinic for complaints of painful hemorrhoids. The nurse assesses the patient and observes the hemorrhoids are prolapsed but able to be placed back in the rectum manually. The nurse documents the hemorrhoids as what degree? a. First degree b. Second degree c. Third degree d. 4th degree

c. Third degree

6. A patient with irritable bowel syndrome has been having more frequent symptoms lately and is not sure what Lifestyle Changes may have occurred. What suggestion can the nurse provide to identify a trigger for the symptoms? a. Document how much fluid is being taken to determine if the patient is over hydrating b discontinue the use of any medication presently being taken to determine if medication is a trigger. c. Begin an exercise regimen and biofeedback to determine if external stress is a trigger d. Keep a 1 to 2 weeks symptom and food diary to identify food triggers

d. Keep a 1 to 2 weeks symptom and food diary to identify food triggers