NU144- Chapter 47: Management of Patients With Intestinal and Rectal Disorders

steatorrhea

excess of fatty wastes in the feces

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.

malabsorption

impaired transport across the mucosa

tenesmus

ineffective and sometimes painful straining and urge to eliminate either feces or urine

diverticulitis

inflammation of a diverticulum from obstruction by fecal matter resulting in abscess formation

ileostomy

surgical opening into the ileum by means of a stoma to allow drainage of bowel contents; one type of fecal diversion

peritonitis

inflammation of the lining of the abdominal cavity

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

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

fecal incontinence

involuntary passage of feces

inflammatory bowel disease (IBD)

group of chronic disorders (ulcerative colitis and Crohn's disease) that result in inflammation or ulceration (or both) of the bowel lining

The nurse is assessing a client for constipation. To identify the cause of constipation, the nurse should begin by reviewing the client's:

usual pattern of elimination.

constipation

fewer than three bowel movements weekly or bowel movements that are hard, dry, small, or difficult to pass

A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a:

fissure.

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."

The nurse is assisting a client to drain his continent ileostomy (Kock pouch). The nurse should insert the catheter how far through the nipple/valve?

2 in.

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

In women, which of the following types of cancer exceeds colorectal cancer?

Breast

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

A client reports constipation. Which nursing measure would be most effective in helping the client reduce constipation?

Assist client to increase dietary fiber.

The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider?

Change in bowel habits

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 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

Which of the following is the diagnostic of choice if the suspected diagnosis is diverticulitis?

Computed tomography scan

An older adult client seeks help for chronic constipation. What factor related to aging can cause constipation in elderly clients?

Decreased abdominal strength

A nurse is caring for a client with cardiac disease. The client asks the nurse which medication is best for help with regular bowel movements. What is the best response by the nurse?

Docusate

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.

The nurse is caring for a patient who has malabsorption syndrome with an undetermined cause. What procedure will the nurse assist with that is the best diagnostic test for this illness?

Endoscopy with mucosal biopsy

The nurse is caring for a patient who has had an appendectomy. What is the best position for the nurse to maintain the patient in after the surgery?

High Fowler's

A patient diagnosed with IBS is advised to eat a diet that is:

High in fiber.

An elderly client diagnosed with diarrhea is taking digoxin. Which electrolyte imbalance should the nurse be alert to?

Hypokalemia

Which of the following is considered a bulk-forming laxative?

Metamucil

The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder?

One part of the intestine telescopes into another portion of the intestine.

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

Osteoporosis

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 nurse is interviewing a client about past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?

Polyps

Which of the following is the most common symptom of a polyp?

Rectal bleeding

Which is a true statement regarding regional enteritis (Crohn's disease)?

The clusters of ulcers take on a cobblestone appearance.

A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?

The consistency of stool and comfort when passing stool

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition?

Ulcerative colitis

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

Ulcerative colitis

The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation?

Usual pattern of elimination

diarrhea

an increased frequency of bowel movements or an increased amount of stool with altered consistency (i.e., increased liquidity) of stool.

fistula

anatomically abnormal tract that arises between two internal organs or between an internal organ and the body surface

irritable bowel syndrome (IBS)

chronic functional disorder characterized by recurrent abdominal pain that affects frequency of defecation and consistency of stool is associated with no specific structural or biochemical alterations

hemorrhoids

dilated portions of the anal veins

A client has symptoms suggestive of peritonitis. Nursing management would not include:

limiting analgesics to avoid the formation of paralytic ileus.

abscess

localized collection of purulent material surrounded by inflamed tissues

A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate?

metabolic acidosis

fissure

normal or abnormal fold, groove, or crack in body tissue

gastrocolic reflex

peristaltic movements of the large bowel occurring five to six times daily that are triggered by distention of the stomach

diverticulosis

presence of several diverticula in the intestine

diverticulum

saclike out-pouching of the lining of the bowel protruding through the muscle of the intestinal wall

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

colostomy

surgical opening into the colon by means of a stoma to allow drainage of bowel contents one type of fecal diversion