Nokea
A teenage patient with a pilonidal cyst has been brought for care by her mother. The nurse who is contributing to the patients care knows that treatment will be chosen based on what risk?
- A. Risk for infection
- B. Risk for bowel incontinence
- C. Risk for constipation
- D. Risk for impaired tissue perfusion
Correct Answer: A
Rationale: Pilonidal cysts frequently develop into an abscess, necessitating surgical repair. These cysts do not contribute to bowel incontinence, constipation, or impaired tissue perfusion.
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A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize?
- A. Insertion of a nasogastric tube
- B. Insertion of a central venous catheter
- C. Administration of a mineral oil enema
- D. Administration of a glycerin suppository and an oral laxative
Correct Answer: A
Rationale: Decompression of the bowel through a nasogastric tube is necessary for all patients with small bowel obstruction. Peripheral IV access is normally sufficient. Enemas, suppositories, and laxatives are not indicated if an obstruction is present.
A nurse is providing care for a patient who has a diagnosis of irritable bowel syndrome (IBS). When planning this patients care, the nurse should collaborate with the patient and prioritize what goal?
- A. Patient will accurately identify foods that trigger symptoms.
- B. Patient will demonstrate appropriate care of his ileostomy.
- C. Patient will demonstrate appropriate use of standard infection control precautions.
- D. Patient will adhere to recommended guidelines for mobility and activity.
Correct Answer: A
Rationale: A major focus of nursing care for the patient with IBS is to identify factors that exacerbate symptoms. Surgery is not used to treat this health problem and infection control is not a concern that is specific to this diagnosis. Establishing causation likely is more important to the patient than managing physical activity.
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.
A nurse at an outpatient surgery center is caring for a patient who had a hemorrhoidectomy. What discharge education topics should the nurse address with this patient?
- A. The appropriate use of antibiotics to prevent postoperative infection
- B. The correct procedure for taking a sitz bath
- C. The need to eat a low-residue, low-fat diet for the next 2 weeks
- D. The correct technique for keeping the perianal region clean without the use of water
Correct Answer: B
Rationale: Sitz baths are usually indicated after perianal surgery. A low-residue, low-fat diet is not necessary and water is used to keep the region clean. Postoperative antibiotics are not normally prescribed.
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.