AQ 57

A patient who develops viral gastroenteritis with vomiting and diarrhea is scheduled to be seen in the clinic the following day. What will the nurse teach the patient to do in the meantime?

"Consume extra fluids to replace fluid losses."

The nurse is teaching a nursing student about care of the patient with gastroenteritis. Which statement by the student indicates a need for further instruction?

"Patients with gastroenteritis will present with hypoactive bowel sounds."

A patient newly diagnosed with ulcerative colitis (UC) is started on sulfasalazine. Which explanation will the nurse give the patient about the reason for use of this drug?

"This medication causes intestinal inflammation to be reduced."

Which sign of peritonitis appears first in an older adult?

Confusion

Which disorder is associated with inflammation of the small intestine?

Crohn's disease

A patient reports pain and a boardlike abdomen. What other findings would indicate peritonitis? Select all that apply.

High fever Dehydration Inability to pass feces

The patient requires a large amount of calories daily to promote the healing of a fistula. Which kind of diet should the nurse provide to the patient?

High-protein food

Which statement about appendicitis is accurate?

It occurs mostly in young adults.

A patient reports pain midway between the anterior iliac crest and the umbilicus in the right lower quadrant. The nurse documents that the patient is experiencing pain in which location?

McBurney's point

Which medication is the drug of choice for the treatment of giardiasis?

Metronidazole

Which organism causes gastroenteritis and is possibly transmitted through the respiratory route?

Norovirus

Which of the following are classic symptoms of celiac disease? Select all that apply.

Steatorrhea Abdominal pain Diarrhea and/or constipation

What instruction should the nurse give to a patient with inflammatory bowel disease regarding skin care?

Tell the patient to apply a thin coat of A+D ointment or aloe cream.

A nurse is teaching a patient about dietary methods to help manage exacerbations ("flare-ups") of diverticulitis. What does the nurse advise the patient?

"Consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet."

A patient has been newly diagnosed with ulcerative colitis. Which statement by the patient indicates a need for further teaching about the complications of the disease?

"I may have an increased risk of bladder infections caused by fistulas."

A parent of a patient suffering from chronic inflammatory bowel disease informs the nurse, "My son leaks stools while he is sleeping." The nurse teaches the parent necessary steps to manage the child's nocturnal stool leakage. Which statement made by the parent indicates a need for further teaching?

"I should encourage my son to drink more milk."

The nurse is teaching a patient about caring for an ileostomy at home. Which statement by the patient indicates a correct understanding of the teaching?

"I should use skin sealants and ostomy skin creams as needed to prevent irritation."

The nurse is instructing a patient with recently diagnosed diverticular disease about diet. What food does the nurse suggest the patient include?

A slice of 5-grain bread

A patient has vague symptoms that indicate an inflammatory bowel disorder. Which symptom is most indicative of Crohn's disease (CD)?

Chronic diarrhea, abdominal pain, and fever

Which drug is often used to treat gastroenteritis caused by Shigella?

Ciprofloxacin

Which complication is seen exclusively in patients with ulcerative colitis?

Colorectal cancer

A patient with ulcerative colitis (UC) is prescribed sulfasalazine and corticosteroid therapy. As the disease improves, what change does the nurse expect in the patient's medication regimen?

Corticosteroid therapy will be tapered.

A patient with ulcerative colitis complains of severe diarrhea with exacerbations. What is the drug of choice in this condition?

Glucocorticoids

A patient with a recent surgically created ileostomy refuses to look at the stoma and asks the nurse to perform all required stoma care. What does the nurse do next?

Has another patient with a stoma who performs self-care talk with the patient

A patient with a history of osteoarthritis has a 10-inch incision following a colon resection. The incision has become infected, and the wound requires extensive irrigation and packing. What aspect of the patient's care does the nurse make certain to discuss with the health care provider before the patient's discharge?

Having a home health consultation for wound care

Which statements about shigellosis are accurate? Select all that apply.

Humans are possible carriers for months. Cipro may be used for treatment of gastroenteritis Shigellosis is transmitted by direct fecal-oral routes.

What physiological change is seen in a patient with ulcerative colitis?

Increase in white blood cell levels

A patient has a low-grade fever and tenesmus. Which other clinical manifestations may indicate ulcerative colitis?

Inflammation of the joints

A patient has developed gastroenteritis while traveling outside the country. What is the likely cause of the patient's symptoms?

Ingestion of parasites in the water

A laparotomy performed on patient revealed abscesses in the abdominal cavity. What treatment strategies might be included in the care plan? Select all that apply.

Inserting wound drains Inserting a nasogastric tube Administering intravenous (IV) antibiotics

What instructions should the nurse give to a patient with Crohn's disease to manage his or her condition? Select all that apply.

Instruct the patient to take monthly vitamin B 12 injections. Teach the patient about drug therapy and the side effects Teach the patient about the usual course of the disease and symptoms.

A patient complains of severe diarrhea and abdominal pain. Which information collected from the patient would indicate an increased risk for inflammatory bowel disease? Select all that apply.

Intolerance to milk Exposure to antibiotics Travel to a tropical area

The nurse is performing discharge teaching with a patient who has been diagnosed with a parasitic infection. Which instructions does the nurse include in the teaching plan? Select all that apply.

Keep toilet areas clean. All household members should be tested for parasites. Wash hands with antimicrobial soap after bowel movements.

Which statement about the procedure for an appendectomy is correct?

Laparoscopy is an invasive procedure used to remove the inflamed appendix.

What would be the drug of choice for a patient with gastroenteritis who is prescribed antiperistaltic agents?

Loperamide

What measures should be taken by a patient who has gastroenteritis to prevent transmission of the infection?

Maintain clean bathroom facilities.

The nurse is caring for a patient who underwent exploratory laparotomy for a ruptured appendix. Which is the most important nursing intervention in the postoperative care to promote wound healing?

Maintaining sterile technique during peritoneal irrigation

What surgical techniques are involved in the treatment of Crohn's disease?

Minimal invasive surgery (MIS) and stricturoplasty

A patient has been diagnosed with ulcerative colitis (UC) and reports having between four and five bloody stools per day. How does the nurse classify the intensity of the patient's UC?

Moderate

What are the common signs and symptoms of gastroenteritis?

Nausea and vomiting

A patient was admitted to the hospital for evaluation of abdominal pain. The patient is unable to pass flatus and the abdomen has become firm and distended. The nurse is unable to hear bowel sounds. The patient has a heart rate of 90 beats/min and a temperature of 39° C. Which nursing action is correct?

Notify the provider immediately of this potentially life-threatening situation.

What interventions should the nurse provide to a patient with inflammatory bowel disease who complains of abdominal pain?

Observe for signs and symptoms of peritonitis

A patient with Crohn's disease has been admitted to the hospital with the development of a fistula between the bowel and bladder. What is the nursing priority for this patient?

Providing adequate nutrition and fluid and electrolytes

What changes take place in a patient after a total proctocolectomy with a permanent ileostomy?

Stool volume decreases and becomes thick.

A nurse is caring for a patient with a new diagnosis of moderate ulcerative colitis (UC). The nurse anticipates an order for which medication?

Sulfasalazine

What drug has a complication of hemolytic anemia in a patient with ulcerative colitis if taken in higher doses?

Sulfasalazine

The registered nurse is supervising a student nurse providing preoperative care to a patient with ulcerative colitis who is scheduled for surgery. Which action of the student indicates effective learning?

The student nurse explains what an ileostomy is to the patient and family.

Which surgical procedure for removal of an inflamed appendix involves minimal intervention?

Transluminal endoscopic surgery

The nurse is teaching a patient who recently began taking sulfasalazine about the drug. What side effects does the nurse tell the patient to report to the health care provider? Select all that apply.

Vomiting Anorexia Headache

What diagnostic test is preferred to differentiate between ulcerative colitis and Crohn's disease?

X-ray examination with barium enema

The primary health care provider prescribes natalizumab to a patient with Crohn's disease. Which health teaching is most important before beginning the medication?

"Cognitive, motor, and sensory changes have very lethal effects."

What is the common symptom associated with anorexia?

Vomiting

A nurse is teaching a patient with Crohn's disease about managing the disease with the drug adalimumab. Which instruction does the nurse emphasize to the patient?

"Avoid large crowds and anyone who is sick."

The nurse is teaching a patient with ulcerative colitis about ileostomy care. Which information does the nurse include in the plan of care?

"Avoid taking enteric-coated medications."

A patient diagnosed with ulcerative colitis (UC) is to be discharged on loperamide for symptomatic management of diarrhea. What does the nurse include in the teaching about this medication?

"Be aware of the symptoms of toxic megacolon that we discussed."

A certified Wound, Ostomy, and Continence Nurse is teaching a patient about caring for a new ileostomy. What information is most important to include?

"Call the health care provider if your stoma has a bluish or pale look."

The nurse is caring for a patient with ileo-anal pouch anastomosis who has undergone a restorative proctocolectomy. What pouch care advice given by the nurse will provide effective treatment?

"Change the entire pouch system every 3 to 7 days."

A patient with an exacerbation of ulcerative colitis (UC) has been prescribed Vivonex PLUS. The patient asks the nurse how this is helpful for improving symptoms. How does the nurse reply?

"It is absorbed quickly and allows the affected part of the GI tract to rest and heal."

A patient has been newly diagnosed with ulcerative colitis (UC). What does the nurse teach the patient about diet and lifestyle choices?

"Lactose-containing foods should be reduced or eliminated from your diet."

Which patient does the charge nurse assign to an experienced LPN/LVN?

30-year-old who must receive neomycin sulfate before a colectomy

What is the typical incubation period of the Norwalk virus in a person with a normal immune system? Correct

48 hours

What is a clinical manifestation of Crohn's disease?

Abdominal pain

Which factors should the nurse inquire about when taking the medical history of a patient with suspected appendicitis?

Abdominal pain followed by nausea and vomiting

Which examination is used first to identify an enlarged appendix in a patient?

Abdominal ultrasound

A patient who has undergone a restorative proctocolectomy with ileo pouch-anal anastomosis complains of severe bowel irritation and leakage of stool at night. What interventions should the nurse perform to help the patient manage the condition? Select all that apply.

Administer antidiarrheal drugs Instruct the patient to take flax seeds and vitamin C Prepare the patient for a total proctocolectomy with a permanent ileostomy.

The nurse is caring for a patient with peritonitis. What assessment findings will the nurse observe? Select all that apply.

Anorexia Distended abdomen

A patient is admitted to the hospital with appendicitis. What signs/symptoms are consistent with this diagnosis? Select all that apply.

Anorexia Nausea and vomiting Rebound tenderness

What term is used to describe a fistula that is present between the bowel and the bladder?

Enterovesical fistula

The nurse is caring for a patient admitted for gastroenteritis. What symptoms does the nurse expect to see in the patient? Select all that apply.

Fever Acute confusion Poor skin turgor

Which findings does the nurse expect with a diagnosis of acute peritonitis? Select all that apply.

Fever Vomiting Tachycardia Rigid abdomen

What is a common complication of Crohn's disease?

Fistulas

What are potential complications of Crohn's disease? Select all that apply.

Fistulas Osteoporosis Malabsorption Abscess formation

A patient with peritonitis has developed bacterial contamination of the peritoneal cavity. What could be the most probable cause of the contamination?

Gangrenous gallbladder

What are the less-common causes for peritonitis? Select all that apply.

Perforating tumors Leakage during surgery Contamination during surgery

What disorders does the nurse identify as acute inflammatory bowel disorders? Select all that apply.

Peritonitis Appendicitis Gastroenteritis

A patient demonstrates the manifestations of diverticulitis with a suspected complication of peritonitis. What is the priority nursing intervention?

Preparing the patient for emergency surgery

Which clinical findings in a patient indicate ulcerative colitis?

Presence of blood and mucus in the stool

After reviewing the case sheet of a patient experiencing severe abdominal pain and diarrhea, the nurse suspects ulcerative colitis. Which findings support the nurse's conclusion? Select all that apply.

Presence of blood in stools Intolerance to milk and milk products Use of non-steroidal anti-inflammatory drugs for pain

A patient is experiencing an exacerbation of ulcerative colitis (UC). What is an important nursing action to help minimize the patient's discomfort?

Restricting lactose-containing foods

A patient returns to the unit after having an exploratory abdominal laparotomy. How does the nurse position this patient after the patient is situated in bed?

Semi-Fowler's

The nurse is caring for a patient with chronic inflammatory bowel disease. What parameters should be monitored? Select all that apply.

Skin in perianal area Physical and emotional rest Color, volume, consistency of stools

An 80-year-old patient with a 2-day history of myalgia, nausea, vomiting, and diarrhea is admitted to the medical-surgical unit with a diagnosis of gastroenteritis. Which health care provider request does the nurse implement first?

Start an IV solution of 5% dextrose in 0.45 normal saline at 125 mL/hr.