Nokea
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.
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The nurse is interviewing a client with internal hemorrhoids. What would the nurse expect the client to report?
- A. Rectal bleeding
- B. Pain
- C. Itching
- D. Soreness
Correct Answer: A
Rationale: Internal hemorrhoids cause bleeding but are less likely to cause pain, unless they protrude through the anus. External hemorrhoids may cause few symptoms, or they can produce pain, itching, and soreness of the anal area.
A client with a hernia decides to manage the herniation with a truss. The nurse would emphasize which of the following?
- A. Using laxatives to ensure regular bowel movement
- B. Wearing warm, woolen clothes to avoid dryness
- C. Applying a sunscreen to prevent exposure to direct sunlight
- D. Using cornstarch to absorb moisture in the area
Correct Answer: D
Rationale: When a client is managing herniation with a truss, the nurse informs the client to keep the skin clean and dry or to use cornstarch to absorb moisture. This minimizes the risk for infection. Use of warm, woolen clothes will not help reduce moisture, it may increase the moisture and increase the risk of infections. If the client's bowel movements are regular, laxatives would not be necessary. However, the client would need teaching to prevent constipation. Applying sunscreen is a general recommendation for any client to reduce the risk of exposure to ultraviolet radiation from the sun.
The nurse is teaching a client with constipation to increase dietary fiber intake to 25 g/day. Which recommendation would the nurse include?
- A. Avoiding bran cereals and beans in the diet
- B. Adding fiber-rich foods to the diet gradually
- C. Limiting fluid intake to 5 to 6 glasses per day
- D. Minimizing activity levels for at least 2 months
Correct Answer: B
Rationale: The nurse instructs the client to add fiber-rich foods to the diet gradually to avoid bloating, gas, and diarrhea. It is essential for a client to include bran cereals and beans in the diet because they ease defecation. The nurse also instructs the client to increase fluids to 6 to 8 glasses per day to prevent hard, dry stools. The client should also develop a regular exercise program to increase peristalsis and promote bowel elimination.
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.