Med Surg. Chapter 48 Management of Patients With Intestinal and Rectal Disorders
A nurse is helping to plan a teaching session for a client who will be discharged with a colostomy. Which statement describes a healthy stoma?
"At first, the stoma may bleed slightly when touched."
A client is readmitted with an exacerbation of celiac disease 2 weeks after discharge. Which statement by the client indicates the need for a dietary consult?
"I didn't eat anything I shouldn't have; I just ate roast beef on rye bread."
A nurse is caring for a client immediately following an appendectomy. The nurse should assign which nursing diagnosis the highest priority?
Acute pain
Which of the following terms is used to refer to intestinal rumbling?
Borborygmus
In women, which of the following types of cancer exceeds colorectal cancer?
Breast
Which of the follow statements provide accurate information regarding cancer of the colon and rectum?
Cancer of the colon and rectum is the second most common type of internal cancer in the United States.
The nurse is preparing a patient for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the patient for?
Defecography
A patient with an ileostomy should avoid which of the following?
Enteric-coated products
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
A patient who has undergone colostomy surgery is experiencing constipation. Which of the following interventions should a nurse consider for such a patient?
Suggest fluid intake of at least 2 L per day
An elderly client asks the nurse how to treat chronic constipation. What is the best recommendation the nurse can make?
Take a stool softener such as docusate sodium (Colace) daily.
The nurse is assessing a patient for constipation. Which of the following is the first review that the nurse should conduct in order to identify the cause of constipation?
Usual pattern of elimination
A nurse is preparing a presentation for a local community group of older adults about colon cancer. Which of the following would the nurse include as the primary characteristic associated with this disorder?
A change in bowel habits
A client with anorexia complains of constipation. Which of the following nursing measures would be most effective in helping the client reduce constipation?
Assist client to increase dietary fiber.
Which of the following would a nurse expect to assess in a client with peritonitis?
Board-like abdomen
A patient informs the nurse that he has been having abdominal pain that is relieved when having a bowel movement. The patient 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
A client is being seen in the gastroenterology office where you practice nursing. He presents with an infection in the area between the internal and external sphincters. In which of the following chronic diseases is this condition commonly seen?
Crohn's disease
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?
Crohn's disease
A patient is being treated for diverticulosis. Which of the following information should the nurse include in this patient's teaching plan?
Drink at least 8 to 10 large glasses of fluid every day
The nurse is teaching a patient with an ostomy how to change the pouching system. Which of the following should the nurse include in the teaching of a patient with no peristomal skin irritation?
Dry skin thoroughly after washing
A young woman has been brought into the ED via ambulance, complaining of acute generalized abdominal pain, nausea, fever, and constipation. The healthcare provider suspects appendicitis, but testing has not been performed yet to make a definitive diagnosis. You are the nurse caring for this client. Which of the following will you most likely do while initially caring for this client?
Explain to the client why analgesics are being withheld.
An elderly patient diagnosed with diarrhea is taking digoxin (Lanoxin). Which of the following electrolyte imbalances should the nurse be alert to?
Hypokalemia
Crohn's disease is a condition of malabsorption caused by which of the following pathophysiological processes?
Inflammation of all layers of intestinal mucosa
The nurse is conducting a community education program on colorectal cancer. Which of the following statements should the nurse include in the program?
It is the third most common cancer in the United States.
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?
Keep a 1- to 2-week symptom and food diary to identify food triggers.
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?
Left lower quadrant
A client comes to the clinic complaining of not having a bowel movement in several days, abdominal cramping, and nausea. When the nurse puts the client on the stretcher, he vomits a large amount of fecal material. What should the first action by the nurse be?
Notify the physician.
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 has noticed increased incidence of constipation since he broke his ankle and cannot complete his daily 3-mile walk. As his home care nurse, you complete your assessment and discuss the potential causes. During your client education session, what do you explain as the mechanical cause of his constipation?
Stool remaining in the large intestine too long
Which of the following will the nurse observe as symptoms of perforation in a patient with intestinal obstruction?
Sudden, sustained abdominal pain
A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer. Which intervention should the nurse include on the plan of care?
Test all stools for occult blood.
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.
A client informs the nurse that he is taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about the taking a stimulant laxative?
They can be habit forming and will require increasing doses to be effective.
The nurse is assessing a patient for constipation. Which of the following is the first factor the nurse should review to identify the cause of constipation?
Usual pattern of elimination
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?
Wound dehiscence has occurred.
Which client requires immediate nursing intervention? The client who:
presents with a rigid, boardlike abdomen.
Nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. The nurse also expects to find:
severe abdominal pain with direct palpation or rebound tenderness.
A client is being treated for diverticulosis. Which of the following points should the nurse include in this client's teaching plan? Select all that apply.
• Drink at least 8 to 10 large glasses of fluid every day. • Do not suppress the urge to defecate.
Common clinical manifestations of Crohn's disease include:
Abdominal pain and diarrhea.
