Gastrointestinal Disorders Ch. 47 Hinkle PrepU

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Which client would be at greatest risk for the development of an anorectal fistula?

A 35-year-old female with Crohn's disease

The American Cancer Society recommends routine screening to detect colorectal cancer. Which screening test for colorectal cancer should a nurse recommend?

Annual digital examination after age 40

A positive Rovsing's sign is indicative of appendicitis. A nurse knows to assess for this indicator by palpating the:

Left lower quadrant.

Clients with inflammatory bowel disease (IBD) are at significantly increased risk for which condition?

Osteoporosis

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.

The presence of mucus and pus in the stools suggests which condition?

Ulcerative colitis

A client has a 10-year history of Crohn's disease and is seeing the physician due to increased diarrhea and fatigue. What is the recommended dietary approach to treat Crohn's disease?

dietary approach varies.

A typical sign/symptom of appendicitis is:

nausea

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 In functional obstruction, the intestine can become a dynamic from an absence of normal nerve stimulation to intestinal muscle fibers. For example, abdominal surgery can lead to paralytic ileus. Mechanical obstructions result from a narrowing of the bowel lumen with or without a space-occupying mass. A mass may include a tumor, adhesions (fibrous bands that constrict tissue), incarcerated or strangulated hernias, volvulus (kinking of a portion of intestine), intussusception (telescoping of one part of the intestine into an adjacent part), or impacted feces or barium.

The nurse caring for a client with diverticulitis is preparing to administer the client's medications. The nurse anticipates administration of which category of medication because of the client's diverticulitis?

Antispasmodic The nurse anticipates administration of antispasmodic medication to decrease intestinal spasm associated with diverticulitis. The client may also be ordered an opioid analgesic to relieve the associated pain.

A client presents with an infection in the area between the internal and external sphincters. In which chronic disease is this condition commonly seen

Crohn's disease

The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching?

Drink 8 to 10 glasses of fluid daily.

Which is the most prominent sign of inflammatory bowel disease?

Intermittent pain and diarrhea

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

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 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 Considered first-line treatment for inflammatory bowel disease, 5-ASA drugs contain salicylate, which is bonded to a carrying agent that allows the drug to be absorbed in the intestine. These drugs work by decreasing the inflammatory response. Methotrexate or azathioprine are used when failure to maintain remission necessitates the use of an immune-modulating agent. Ciprofloxacin is used as an effective adjunct to treat the disease.

A client describes being constipated, but also experiencing abdominal cramping, pain, and urgent diarrhea. These symptoms occur more often when the client is nearing a deadline or is under emotional stress. What would be recommended to treat these symptoms? Select all that apply.

high-fiber diet psyllium

A nurse is reviewing lab results for a client with an intestinal obstruction, and infection is suspected. What would be an expected finding?

leukocytosis; elevated hematocrit; low sodium, potassium, and chloride The hematocrit level is elevated if dehydration develops.---

What symptoms of perforation might the nurse observe in a client with an intestinal obstruction? Select all that apply.

sudden, sustained abdominal pain abdominal distention


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