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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.
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A nurse is working with a patient who has chronic constipation. What should be included in patient teaching to promote normal bowel function?
- A. Use glycerin suppositories on a regular basis.
- B. Limit physical activity to promote bowel peristalsis.
- C. Consume high-residue, high-fiber foods.
- D. Resist the urge to defecate until the urge becomes intense.
Correct Answer: C
Rationale: Goals for the patient include restoring or maintaining a regular pattern of elimination by responding to the urge to defecate, ensuring adequate intake of fluids and high-fiber foods, learning about methods to avoid constipation, relieving anxiety about bowel elimination patterns, and avoiding complications. Ongoing use of soaps or pharmacologic aids should not be promoted, due to the risk of dependence. Increased mobility helps to maintain a regular pattern of elimination. The urge to defecate should be heeded.
A nursing instructor is discussing hemorrhoids with the nursing class. Which patients would the nursing instructor identify as most likely to develop hemorrhoids?
- A. A 45-year-old teacher who stands for 6 hours per day
- B. A pregnant woman at 28 weeks gestation
- C. A 37-year-old construction worker who does heavy lifting
- D. A 60-year-old professional who is under stress
Correct Answer: B
Rationale: Hemorrhoids commonly affect 50% of patients after the age of 50. Pregnancy may initiate hemorrhoids or aggravate existing ones. This is due to increased constipation during pregnancy. The significance of pregnancy is greater than that of standing, lifting, or stress in the development of hemorrhoids.
A patient with a diagnosis of colon cancer is 2 days postoperative following bowel resection and anastomosis. The nurse has planned the patients care in the knowledge of potential complications. What assessment should the nurse prioritize?
- A. Close monitoring of temperature
- B. Frequent abdominal auscultation
- C. Assessment of hemoglobin, hematocrit, and red blood cell levels
- D. Palpation of peripheral pulses and leg girth
Correct Answer: B
Rationale: After bowel surgery, it is important to frequently assess the abdomen, including bowel sounds and abdominal girth, to detect bowel obstruction. The resumption of bowel motility is a priority over each of the other listed assessments, even though each should be performed by the nurse.
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.
The nurse is providing care for a patient whose inflammatory bowel disease has necessitated hospital treatment. Which of the following would most likely be included in the patients medication regimen?
- A. Anticholinergic medications 30 minutes before a meal
- B. Antiemetics on a PRN basis
- C. Vitamin B12 injections to prevent pernicious anemia
- D. Beta adrenergic blockers to reduce bowel motility
Correct Answer: A
Rationale: The nurse administers anticholinergic medications 30 minutes before a meal as prescribed to decrease intestinal motility and administers analgesics as prescribed for pain. Antiemetics, vitamin B12 injections, and beta blockers do not address the signs, symptoms, or etiology of inflammatory bowel disease.