Nokea
The 25-year-old client, hospitalized with an exacerbation of distal ulcerative colitis, is prescribed mesalamine rectally via enema. The client states that an enema is disgusting and wants to know why the medication cannot be given orally. Which is the best response by the nurse?
- A. “It can be given orally; I’ll contact the doctor and see if the change can be made.”
- B. “Rectal administration delivers the mesalamine directly to the affected area.”
- C. “Oral administration is not possible for treating your ulcerative colitis exacerbation.”
- D. “It can be given orally; I’ll make the change, and we’ll tell the doctor in the morning.”
Correct Answer: B
Rationale: A. If the client still desires a change in medication route after the rationale for rectal administration is explained, the HCP should be consulted. B. This is the nurse’s best response because it explains the purpose for administration via enema. This route delivers mesalamine (Asacol) directly to the affected area, thus maximizing effectiveness and minimizing side effects. C. Oral administration is possible, but rectal administration is preferred in distal colitis. D. Nurses cannot order medications or change medication routes without specific approval by the HCP, who is licensed to prescribe medications.
You may also like to solve these questions
The nurse is preparing a client diagnosed with GERD for discharge following an esophagogastroduodenoscopy (EGD). Which statement indicates the client understands the discharge instructions?
- A. I should not eat for at least one (1) day following this procedure.
- B. I can lie down whenever I want after a meal. It won't make a difference.
- C. The stomach contents won't bother my esophagus but will make me nauseous.
- D. I should avoid orange juice and eating tomatoes until my esophagus heals.
Correct Answer: D
Rationale: Avoiding acidic foods like orange juice and tomatoes reduces irritation to the esophagus, indicating understanding of dietary modifications for GERD. Not eating for a day is unnecessary, lying down after meals worsens reflux, and nausea is not the primary concern with GERD.
Which data should the nurse expect to assess in the client diagnosed with acute gastroenteritis?
- A. Decreased gurgling sounds on auscultation of the abdominal wall.
- B. A hard, firm, edematous abdomen on palpation.
- C. Frequent, small melena-type liquid bowel movements.
- D. Bowel assessment reveals loud, rushing bowel sounds.
Correct Answer: D
Rationale: Loud, rushing bowel sounds are expected in gastroenteritis due to increased peristalsis from irritation. Decreased sounds, hard abdomen, or melena suggest other conditions.
Which problems should the nurse include in the plan of care for the client diagnosed with peptic ulcer disease to observe for physiological complications?
- A. Alteration in bowel elimination patterns.
- B. Knowledge deficit in the causes of ulcers.
- C. Inability to cope with changing family roles.
- D. Potential for alteration in gastric emptying.
Correct Answer: A
Rationale: Peptic ulcer disease can lead to complications like bleeding or perforation, which alter bowel elimination patterns (e.g., melena or hematochezia). Knowledge deficits and coping issues are psychosocial, and gastric emptying is less commonly affected.
The client diagnosed with AIDS is experiencing voluminous diarrhea. Which interventions should the nurse implement? Select all that apply.
- A. Monitor diarrhea, charting amount, character, and consistency.
- B. Assess the client's tissue turgor every day.
- C. Encourage the client to drink carbonated soft drinks.
- D. Weigh the client daily in the same clothes and at the same time.
- E. Assist the client with a warm sitz bath PRN.
Correct Answer: A,B,D,E
Rationale: Monitoring diarrhea, assessing turgor, daily weighing, and sitz baths address dehydration, skin integrity, and comfort. Carbonated drinks may worsen diarrhea.
The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?
- A. The client's Bernstein esophageal test was positive.
- B. The client's abdominal x-ray shows a hiatal hernia.
- C. The client's WBC count is 14,000/mm3.
- D. The client's hemoglobin is 13.8 g/dL.
Correct Answer: C
Rationale: An elevated WBC count (14,000/mm3) suggests infection or inflammation, which could complicate surgery and requires immediate attention. A positive Bernstein test and hiatal hernia are expected in GERD, and a hemoglobin of 13.8 g/dL is within normal limits.