Nokea
A client informs the nurse of having abdominal pain that is relieved when having a bowel movement. The health care provider diagnosed the client with irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder?
- A. Weight loss due to malabsorption
- B. Blood and mucus in the stool
- C. Chronic constipation with sporadic bouts of diarrhea.
- D. Client is awakened from sleep due to abdominal pain.
Correct Answer: C
Rationale: Most clients with irritable bowel syndrome (IBS) describe having chronic constipation with sporadic bouts of diarrhea. Some report the opposite pattern, although less commonly. Most clients experience various degrees of abdominal pain that defecation may relieve. Weight usually remains stable, indicating that when diarrhea occurs, malabsorption of nutrients does not accompany it. Stools may have mucus, but blood is not usually found because the bowel is not locally inflamed. The sleep is not disturbed from abdominal pain.
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A client is diagnosed with colon cancer, located in the lower third of the rectum. What does the nurse understand will be the surgical treatment option for this client?
- A. Colectomy
- B. Segmental resection
- C. Abdominoperineal resection
- D. A low colectomy
Correct Answer: C
Rationale: A cancerous mass in the lower third of the rectum will result in an abdominoperineal resection with a wide excision of the rectum and the creation of a sigmoid colostomy. An encapsulated colorectal tumor may be removed without taking away surrounding healthy tissue. This type of tumor, however, may call for partial or complete surgical removal of the colon (colectomy). Occasionally, the tumor causes a partial or complete bowel obstruction. If the tumor is in the colon and upper third of the rectum, a segmental resection is performed. In this procedure, the surgeon removes the cancerous portion of the colon and rejoins the remaining portions of the GI tract to restore normal intestinal continuity.
The nurse is caring for a client who has had diarrhea for 3 days. What major problem(s) associated with severe or prolonged diarrhea should the nurse monitor for when caring for this client? Select all that apply.
- A. Oral candidiasis
- B. Dehydration
- C. Electrolyte imbalances
- D. Vitamin deficiencies
- E. Rectal fissures
Correct Answer: B,C,D
Rationale: Three major problems associated with severe or prolonged diarrhea include dehydration, electrolyte imbalances, and vitamin deficiencies.
The nurse is reviewing the laboratory test results of a client with Crohn disease. Which of the following would the nurse most likely find?
- A. Decreased white blood cell count
- B. Increased albumin levels
- C. Stool cultures negative for microorganisms or parasite
- D. Decreased erythrocyte sedimentation rate
Correct Answer: C
Rationale: Stool cultures fail to reveal an etiologic microorganism or parasite, but occult blood and white blood cells (WBCs) often are found in the stool. Results of blood studies indicate anemia from chronic blood loss and nutritional deficiencies. The WBC count and erythrocyte sedimentation rate may be elevated, confirming an inflammatory disorder. Serum protein and albumin levels may be low because of malnutrition.
A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder?
- A. Abdominal distention
- B. Frank blood in the stool
- C. A change in bowel habits
- D. Abdominal pain
Correct Answer: C
Rationale: Although abdominal distention and blood in the stool (frank or occult) may be present, the chief characteristic of cancer of the colon is a change in bowel habits, such as alternating constipation and diarrhea. Abdominal pain is a late sign.
The instructor is teaching a group of students about Crohn disease and antidiarrheal agents. The instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-based antidiarrheal agent?
- A. Diphenoxylate with atropine
- B. Bismuth subsalicylate
- C. Kaolin and pectin
- D. Bisacodyl
Correct Answer: A
Rationale: Diphenoxylate with atropine is an example of an opiate-based antidiarrheal agent. Bismuth subsalicylate and kaolin and pectin are examples of absorbent antidiarrheal agents. Bisacodyl is a chemical stimulant laxative.