IBD

which goal for the clients 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 diarrhea is the primary symptoms in an exacerbation of ulcerative colitis and decreasing the frequency of stools is the first goal of treatment

the client dx with inflammatory bowel disease has a serum potassium level of 3.4. which action should the nurse implement first a. notify the HCP b. assess the client for muscle weakness c. request telemetry for the client d. prepare to administer potassium IV

b muscle weakness may be a sign of hypokalemia; this can lead to cardiac dysrythmias and can be life threatening

the client with type 2 diabetes is prescribed predisone a steroid or an acute exacerbation of inflammatory bowel disease. which intervention should the nurse discuss with the client a. take the medication on an empty stomach b. notify the HCP if experiencing a moon face c. take the steroid as prescribed d. notify the HCP if the blood glucose is over 100

c this medication must be tapered off to prevent adrenal insufficiency; therefore the client must take as ordered

Which sign/symptom should the nurse expect to find in a client diagnosed with ulcerative colitis? 1. Twenty bloody stools a day. 2. Oral temperature of 102˚F. 3. Hard, rigid abdomen. 4. Urinary stress incontinence.

the colon is ulcerated and unable to absorb water, resulting in bloody diarrhea. ten to twenty bloody diarrhea stools is the main common symptoms of ulcerative collitis

The client diagnosed with ulcerative colitis has an ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy? 1. My stoma should be pink and moist 2. I will irrigate my ileostomy every morning 3. If I get a red, bumpy, itchy rash I will call my HCP 4. I will change my pouch if it starts leaking

2 an ilestomy will drain liquid all the time and should not be routinely irrigated. a sigmoid colostomy may need daily irrigation to evacuate feces

The client with ulcerative colitis is following orders for bed rest with bathroom privileges. When evaluating the effectiveness of this level of activity, the nurse should determine if the client has: 1. Conserved energy. 2. Reduced intestinal peristalsis. 3. Obtained needed rest. 4. Minimized stress.

2.Although modified bed rest does help conserve energy and promotes comfort, its primary purpose in this case is to help reduce the hypermotility of the colon. Remaining on bed rest does not by itself reduce stress, and if the client is having stress, the nurse can plan with the client to use strategies that will help the client manage the stress.

The client diagnosed with ulcerative colitis is prescribed a low residue diet. Which meal selection indicates the client understands the diet teaching? a. grilled hamburger on a wheat bun and fried potatoes b. a chicken salad sandwich and lettuce and tomato salad c. roast pork, white rice, and plain custard d. fried fish, whole grain pasta and fruit salad

3 a low residue diet is low in fiber; products made of refined flour or finely milled grains, along with roasted, baked, or broiled meats are recommended

The client is diagnosed with an acute exacerbation of IBD. Which priority intervention should the nurse implement first? 1. Weigh the client daily and document in the clients chart 2. Teach coping strategies such as dietary modifications 3. Record the frequency, amount, and color of stools 4. Monitor the clients oral fluid intake every shift

3. The severity of the diarrhea helps determine the need for fluid replacement. The liquid stool should be measured as part of the total output

The client diagnosed with IBD is prescribed sulfasalazine (Asulfidine), a sulfonamide antibiotic. Which statement best describes the rationale for administering this medication? 1. It is administered re tally to help decrease colon inflammation. 2. The medications Slows gastrointestinal motility and reduces diarrhea 3. This medication kills the bacteria causing the exacerbation 4. It acts topically on the colon mucosa to decrease inflammation

4 sulfidine is poorly absorbed from the gastrointestinal tract and acts topically on the colonic mucosa to inhibit the inflammatory process

Select ALL of the following that are complications associated with Crohn's Disease: A. Cobble-stone appearance of GI lining B. Lead-pipe sign C. Toxic megacolon D. Fistula E. Abscess F. Anal Fissure

A D E F

A patient with Crohn's Disease is taking corticosteroids. The patient is complaining of extreme thirst, polyuria, and blurred vision. What is your next nursing action? A. Check the patient's blood glucose B. Give the patient a food containing sugar (ex: orange juice) C. Administer oxygen via nasal cannula D. Assess bowel sounds

a

the client is dx with crohns disease. which statement by the client supports this diagnosis a. my pain goes away when i have a bowel movement b. i have bright red blood in my stool all the time c. i have episodes of diarrhea and constipation d. my abdomen is hard and rigid and i have a fever

a the terminal ileum is the most common site for crohns disease. which causes right lower quadrant pain that is relieved by defecation

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 was most likely of greatest significance in causing an exacerbation of ulcerative colitis? a. demanding and stressful job b. changing to a modified vegetarian diet c. beginning a weight training program d. walking 2 miles every day

a stressful and emotional events have been clearly linked to exacerbations of ulcerative colitis although theier role in the etiology of the disease has been disproved. a modified vegetarian diet or exercise program is unlikely

the client diagnosed with IBD is prescribed TPN. which intervention should the nurse implement a. check the clients glucose level b. administer an oral hypoglycemic c. assess the peripheral intravenous site d. monitor the clients oral food intake

a TPN is high in dextrose, which is glucose; therefore, the clients blood glucose level must be monitored closely.

the cleint with ulcerative colitis is scheduled for an ileostomy. the nurse is aware the clients stoma will be located in which area of the abdomen a. right lower quadrant b. left lower quadrant c. transverse colon d. right upper quadrant

a The cure for ulcerative colitis is a total colectomy, which is removing he entire large colon and bringing the terminal end of the ileum up to the abdomen in the right lower quadrant. This is an ileostomy.

which of the following diets would be most appropriate for the client with ulcerative colitis a. high calorie low protein b. high protein low residue c. low fat high fiber d. low sodium high carbohydrate

b Clients with ulcerative colitis should follow a well-balanced high-protein, high-calorie, low-residue diet, avoiding such high-residue foods as whole-wheat grains, nuts, and raw fruits and vegetables. Clients with ulcerative colitis need more protein for tissue healing and should avoid excess roughage. There is no need for clients with ulcerative colitis to follow low-sodium diets.

the client is dx with acute exacerbation of ulcerative colitis. which intervention should the nurse implement a. provide a low residue diet b. rest the clients bowels c. assess vital signs daily d. administer antacids orally

b Whenever a client has an acute exacerbation of gastrointestinal disorder, the first intervention is to place the bowel on rest. The client should be NPO with intravenous fluids to prevent dehydration.

a client has been placed on long term sulfasalazine therapy for tx of his ulcerative colitis. the nurse should encourage the client to eat which of the following foods to help avoid nutrient deficiencies that occur while taking this medication a. citrus fruits b. green leafy vegetables c. eggs d. milk products

b in long term sulfasalazine therapy the client may develop folic acid deficiency. the client can take folic acid supplements, but the nurse should also encourage the client to increase intake of folic acid in his diet

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 atleast 1000 ml per day b. provide parenteral re hydration therapy ordered by the physician c. turn and reposition every 2 hrs d. monitor vital signs every shift

b initially the extracellular fluid volume with isotonic IV fluids until adequate circulating blood volume and renal perfusion are achieved. vital signs should be monitored as parenteral and oral rehydration are achieved. oral fluid intake should be greater than 1000 ml /day. turning and reposition the client at regular intervals aids in prevention skin breakdown but it is first necessary to rehydrate the client

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 clients bowel sounds b. providing skin care following bowel movements c. evaluating clients response to antidiarrheal medications d.maintaining intake and output records e. obtaining the clients weight

b d e the nurse can delegate basic care activities to the unlicensed assistant.

the nurse is developing a plan of care for a client with crohns disease who is receiving total parenteral nutrition (TPN). which of the following interventions should the nurse include? SATA 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 caring for a client who is receiving TPN the nurse should plan to weigh the client daily, monitor the IV fluid infusion rate hourly (even when using an IV fluid pump) and securely tape all IV tubing connections to prevent disconnections. vital signs should be monitored every 4 hrs to facilitate early detection of complications. it is recommended that the IV dressing be changed once or twice per week

which of the following should be a priority focus of care for a client experiencing an exacerbation of crohns disease a. encouraging regular ambulation b. promoting bowel rest c. maintaining current weight d. decreasing episodes of rectal bleeding

b priority goal of care during an acute exacerbation of Crohn's disease is to promote bowel rest. This is accomplished through decreasing activity, encouraging rest, and initially placing client on nothing-by-mouth status while maintaining nutritional needs parenterally. Regular ambulation is important, but the priority is bowel rest. The client will probably lose some weight during the acute phase of the illness. Diarrhea is nonbloody in Crohn's disease, and episodes of rectal bleeding are not expected.

A physician has prescribed a patient with a severe case of Crohn's Disease to take a drug that works by suppressing the immune system. This medication achieves this by blocking a protein that plays a role the inflammatory process. Which drug does this describe? A. Azathioprine B. Sulfasalazine C. Infliximab D. Prednisone

c

a patient with crohns disease is most likely to have the disease in what part of the GI tract a. rectum b. duodenum of the small intestine c. terminal illeum d. descending colon

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 hypokalemia is the most expected laboratory finding owing to the diarrhea. hypoalbuminemia can also occur in crohns disease; however the clients potassium level is of greater importance at this time because a low potassium level can cause cardiac arrest. anemia is an expected development but thrombocytopenia is not. calcium levels are not affected

in planning care for the pt with crohns disease, the nurse recognizes that a major difference between ulcerative colitis and crohns disease is that crohns disease a. frequently results in toxic megacolon b. causes fewer nutritional deficiencies than ulcerative colitis c. often recurs after surgery, where as ulcerative colitis is curable with a colectomy d. is manifested by rectal bleeding and anemia more frequently than is ulcerative colitis

c ulcerative colitis affects only the colon and rectum, it can cause megacolon and rectal bleeding, but not nutrient malabsorption. surgical removal of the colon and rectum cures it. crohns disease usually involves the ileum where bile salts and vitamin cobalamin are absorbed. after surgical treatment, disease recurrence at the site is common

A patient experiencing a flare-up with Crohn's Disease is ordered complete bowel rest by the physician. You are administering TPN (total parental nutrition) per physician order. When developing the patient's nursing plan of care, which nursing diagnosis is MOST important to include in the care plan? A. Risk for allergy response B. Risk for unstable blood glucose level C. Risk for imbalance nutrition: more than body requirements D. Risk for imbalanced nutrition: less than body requirements

d

you are providing teaching to patient who has been newly diagnosed with crohns disease. which statement by the patients spouse requires re education? a. crohns disease can be scattered throughout the GI tract in patches with some areas appearing healthy while others are diseased b. there is no cure for crohns disease c. strictures are a common complication with crohns disease d. crohns disease can cause the haustra of the large intestine to lose its form

d