Nokea
A nurse is caring for a patient with constipation whose primary care provider has recommended senna (Senokot) for the management of this condition. The nurse should provide which of the following education points?
- A. Limit your fluid intake temporarily so you dont get diarrhea.
- B. Avoid taking the drug on a long-term basis.
- C. Make sure to take a multivitamin with each dose.
- D. Take this on an empty stomach to ensure maximum effect.
Correct Answer: B
Rationale: Laxatives should not be taken on an ongoing basis in order to reduce the risk of dependence. Fluid should be increased, not limited, and there is no need to take each dose with a multivitamin. Senna does not need to be taken on an empty stomach.
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The nurse is caring for a patient who is undergoing diagnostic testing for suspected malabsorption. When taking this patients health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis?
- A. Recurrent constipation coupled with weight loss
- B. Foul-smelling diarrhea that contains fat
- C. Fever accompanied by a rigid, tender abdomen
- D. Bloody bowel movements accompanied by fecal incontinence
Correct Answer: B
Rationale: The hallmarks of malabsorption syndrome from any cause are diarrhea or frequent, loose, bulky, foul-smelling stools that have increased fat content and are often grayish (steatorrhea). Constipation and bloody bowel movements are not suggestive of malabsorption syndromes. Fever and a tender, rigid abdomen are associated with peritonitis.
A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, what characteristics would the nurse anticipate for the patient's stools?
- A. Watery with blood and mucus
- B. Hard and black or tarry
- C. Dry and streaked with blood
- D. Loose with visible fatty streaks
Correct Answer: A
Rationale: The predominant symptoms of ulcerative colitis are diarrhea and abdominal pain. Stools may be bloody and contain mucus. Stools are not hard, dry, tarry, black, or fatty in patients who have ulcerative colitis.
A nurse is assessing a patients stoma on postoperative day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding?
- A. Irrigate the ostomy to clear a possible obstruction.
- B. Contact the primary care provider to report this finding.
- C. Document that the stoma appears healthy and well perfused.
- D. Document a nursing diagnosis of Impaired Skin Integrity.
Correct Answer: C
Rationale: A healthy, viable stoma should be shiny and pink to bright red. This finding does not indicate that the stoma is blocked or that skin integrity is compromised.
A patients screening colonoscopy revealed the presence of numerous polyps in the large bowel. What principle should guide the subsequent treatment of this patients health problem?
- A. Adherence to a high-fiber diet will help the polyps resolve.
- B. The patient should be assured that these are a normal, age-related physiologic change.
- C. The patients polyps constitute a risk factor for cancer.
- D. The presence of polyps is associated with an increased risk of bowel obstruction.
Correct Answer: C
Rationale: Although most polyps do not develop into invasive neoplasms, they must be identified and followed closely. They are very common, but are not classified as a normal, age-related physiologic change. Diet will not help them resolve and they do not typically lead to obstructions.
A nurse is caring for a patient who has been admitted to the hospital with diverticulitis. Which of the following would be appropriate nursing diagnoses for this patient?
- A. Acute Pain Related to Increased Peristalsis and GI Inflammation
- B. Activity Intolerance Related to Generalized Weakness
- C. Bowel Incontinence Related to Increased Intestinal Peristalsis
- D. Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea
- E. Impaired Urinary Elimination Related to GI Pressure on the Bladder
Correct Answer: A,B,D
Rationale: Patients with diverticulitis are likely to experience pain and decreased activity levels, and are at risk of fluid volume deficit. The patient is unlikely to experience fecal incontinence and urinary function is not directly influenced.