AH1 EX4
A nurse is assessing a client with the diagnosis of hemorrhoids. Which factors in the client's history most likely played a role in the development of the client's hemorrhoids? Select all that apply.
Constipation Hypertension Eating spicy foods Bowel incontinence Numerous pregnancies
A client has a new colostomy. The nurse has provided teaching related to when the client should irrigate the colostomy. Which client statement indicates correct understanding of the teaching?
"After it gets done healing in a few weeks, I will begin irrigating it just before going to bed each day." "It will need to be irrigated each morning before I can eat any food." "I plan to irrigate it in the late morning, the same time I had a bowel movement every day before I had my surgery." "I can wait to start irrigating it until after I have gotten used to this bag and change in lifestyle."
The nurse provides dietary teaching for a client with a colostomy. Which response by the client is indicative of successful learning?
"I will eat food low in fiber so that there is less stool." "I will eat bland foods so that my intestines do not become irritated." "I will eat everything I ate before the operation and avoid foods that cause gas." "I will eat soft foods that are more easily digested and absorbed by my large intestine."
Which information would the nurse include regarding appliance care and maintenance, when teaching a client with a new colostomy? Select all that apply.
Change the ostomy pouch on a routine basis. Replace the ostomy wafer weekly or sooner as needed. Remove the ostomy pouch when showering. Empty the ostomy pouch when three-quarters full of stool or gas. Empty the ostomy pouch before exercise and at bedtime.
A client with cancer of the pancreas has a pancreaticoduodenectomy (Whipple procedure). The nurse expects that the client will have which tube after surgery?
Chest Intestinal Nasogastric Gastrostomy
A client appears depressed since the surgical creation of a colostomy five days ago. The nurse determines that there is some movement toward adaptation to the change in body image when the client exhibits which behavior?
Discusses the necessity of the colostomy Requests the nurse to change the dressing Looks at the face of the nurse during care Stares at the stoma during dressing changes
A client with Crohn disease is admitted to the hospital with a history of chronic, bloody diarrhea, weight loss, and signs of general malnutrition. The client has anemia, a low serum albumin level, and signs of negative nitrogen balance. The nurse concludes that the client's health status is related to what major deficiency?
Ferrous sulfate Protein Ascorbic acid Linoleic acid
A client has a diagnosis of hemorrhoids. Which signs and symptoms does the nurse expect the client to report? Select all that apply.
Flatulence Anal itching Blood in stool Rectal bulging Pain when defecating
A client was admitted to the hospital with blunt trauma as a result of a collision with the steering wheel during a motor vehicle accident. The client was treated for a lacerated liver and abdominal hemorrhage. Which clinical findings should the nurse be alert for when assessing the client for peritonitis during the recovery period? Select all that apply.
Jaundice Boardlike abdomen Abdominal tenderness Decreased bowel sounds Rapid decrease in coagulation ability
A client who has cancer of the sigmoid colon is to have an abdominoperineal resection with a permanent colostomy. Before surgery a low-residue diet is prescribed. What is the nurse's explanation for the necessity of this diet?
Limit production of flatus in the intestine Prevent irritation of the intestinal mucosa Reduce the amount of stool in the large bowel Lower the bacterial count in the gastrointestinal tract
A client is diagnosed with Crohn disease, and parenteral vitamins are prescribed. The client asks why the vitamins have to be given intravenously (IV) rather than by mouth. What rationales for this route should the nurse include in a response to the question? Select all that apply.
More rapid action results. They decrease colon irritability. Oral vitamins are less effective. Intestinal absorption may be inadequate. Allergic responses are less likely to occur.
A client is diagnosed with gastroenteritis. What does the nurse determine is the basic intention underlying the unique dietary management for this client?
Provide optimal amounts of all important nutrients. Increase the amount of bulk and roughage in the diet. Eliminate chemical, mechanical, and thermal irritation. Promote psychological support by offering a wide variety of foods.
The postoperative diet prescription for a client who had a colostomy states, "Diet as tolerated." Which principle should the nurse include in the teaching plan to help guide the client with food choices?
Specific foods will cause most clients the same discomfort. A low-residue diet should be followed to avoid overstimulating the intestine. More rigid dietary rules limiting food choices are needed to provide security. A return to a regular diet as soon as possible promotes physical rehabilitation.
A client with ulcerative colitis has experienced frequent severe exacerbations over the past several years. The client is admitted to the hospital with intense pain, severe diarrhea, and cachexia. Which therapeutic course should the nurse expect the primary healthcare provider to explore with this client?
ntensive psychotherapy Continued medical therapy Surgical therapy (colectomy) Diet therapy (low-residue, high-protein diet)
