Nursing Management: Patients With Intestinal and Rectal Disorders
Which drug is considered a stimulant laxative?
Bisacodyl
The nurse is performing an abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse's notes?
Borborygmus
The nurse is performing and documenting the findings of an abdominal assessment. When the nurse hears intestinal rumbling and the client then experiences diarrhea, the nurse documents the presence of which condition?
Borborygmus
Which of the following is a term used to describe intestinal rumbling?
Borborygmus
An 81-year-old patient of a subacute geriatric medical unit has become incontinent of stool over the past several days. This development has coincided with a decline in the patient's cognition as a result of severe Alzheimer's disease. In light of the patient's fecal incontinence, what nursing diagnosis should the nurse prioritize when planning this patient's care?
Impaired skin integrity related to fecal incontinence
A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, what would the nurse stress the importance of?
Increasing fluid intake to prevent dehydration
The nurse is comparing Crohn's disease (regional enteritis) with ulcerative colitis. Which of the following describes Crohn's disease?
Its course is prolonged and variable
A client is scheduled to undergo rhinoplasty in the morning, and reports medications used on a daily basis, which the nurse records on the client's chart. Which daily medications have the potential to result in constipation?
Laxative
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?
Maintaining skin integrity
Vomiting results in which of the following acid-base imbalances?
Metabolic alkalosis
Which of the following is considered a bulk-forming laxative?
Metamucil
Celiac disease (celiac sprue) is an example of which category of malabsorption?
Mucosal disorders causing generalized malabsorption
A nurse is teaching an older adult client about good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required?
"I need to use laxatives regularly to prevent constipation."
Medical management of a patient with peritonitis includes fluid, electrolyte, and colloid replacement. The nurse knows to prepare the initial, most appropriate intravenous solution. Which of the following is the correct solution?
0.9% NS
The nurse is caring for a patient admitted with symptoms of an anorectal infection. Cultures obtained from a rectal swab indicate that the patient has a viral infection. What medication will the nurse anticipate the health care provider to order for this anorectal infection?
Acyclovir (Zovirax)
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
Which statement provides accurate information regarding cancer of the colon and rectum?
Colorectal cancer is the third most common site of cancer in the United States.
A nurse is applying an ostomy appliance to the ileostomy of a client with ulcerative colitis. Which action is appropriate?
Gently washing the area surrounding the stoma using a facecloth and mild soap
The nurse is caring for a 77-year-old patient diagnosed with Crohn's disease. What would be especially important to monitor this patient for?
Dehydration
Which is one of the primary symptoms of irritable bowel syndrome (IBS)?
Diarrhea
A client has been recently diagnosed with an anorectal condition. The nurse is reviewing interventions that will assist the client with managing the therapeutic regimen. What would not be included?
Encourage the client to avoid exercise.
A surgeon is discussing surgery with a client diagnosed with colon cancer. The client is visibly shaken over the possibility of a colostomy. Based on the client's response, the surgeon should collaborate with which health team member?
Enterostomal nurse
A client underwent a continent ileostomy. Within which time frame should the client expect to empty the reservoir?
Every 4 to 6 hours
When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?
Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
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 board-like. What complication does the nurse determine may be occurring at this time?
Peritonitis
Post appendectomy, a nurse should assess the patient for abdominal rigidity and tenderness, fever, loss of bowel sounds, and tachycardia, all clinical signs of:
Peritonitis
The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication?
Peritonitis
A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location?
Right lower quadrant
A client is diagnosed with Zollinger-Ellison syndrome. The nurse knows to assess the client for which characteristic clinical feature of this syndrome?
Steatorrhea
The nurse is reviewing the laboratory test results of a client with Crohn disease. Which of the following would the nurse most likely find?
Stool cultures negative for microorganisms or parasite
The nursing educator is teaching a group of nurses about constipation and the elderly. What recommendation for this population should a nurse can make about treating chronic constipation?
Take a stool softener, such as docusate sodium (Colace), daily.
A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which statement best indicates that the disease process is under control?
The client exhibits signs of adequate GI perfusion.
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.
Which is a true statement regarding regional enteritis (Crohn's disease)?
The clusters of ulcers take on a cobblestone appearance.
Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes:
high-fiber diet.
The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for:
hypokalemia.
A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client?
inflammatory bowel disease (IBD)
A resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. The client receives nutrition via a PEG tube, has adapted well to the tube feedings, and remains physically and socially active. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. What is the most likely cause of this client's constipation?
lack of free water intake
A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate?
metabolic acidosis
A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find?
severe abdominal pain with direct palpation or rebound tenderness
An older adult client in a long-term care facility is concerned about bowel regularity. During a client education session, the nurse reinforces the medically acceptable definition of "regularity." What is the actual measurement of "regular"?
stool consistency and client comfort
A client informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The client 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
The nurse is caring for a patient who is postoperative day 3 following bowel resection and the creation of a colostomy. While changing the dressing, the nurse notes the stoma is dusky in color. How should the nurse interpret this assessment finding?
Circulation to the stoma is compromised.
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?
Clamp the tubing and give the patient a rest period.
A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling?
Colonoscopy
A 16-year-old girl presents at the emergency department complaining of right lower quadrant pain and is diagnosed with appendicitis. When assessing this patient, what signs or symptoms should the nurse expect to find?
Rebound tenderness, McBurney's sign, low-grade fever
A client has been diagnosed with cancer in the descending colon. Which symptoms would the nurse expect the client to report? Select all that apply.
narrowing of stools constipation
A nurse is performing focused assessment on her clients. She expects to hear hypoactive bowel sounds in a client with:
paralytic ileus.
