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The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder?
- A. The bowel twists and turns itself and obstructs the intestinal lumen.
- B. One part of the intestine telescopes into another portion of the intestine.
- C. The bowel protrudes through a weakened area in the abdominal wall.
- D. A loop of intestine adheres to an area that is healing slowly after surgery.
Correct Answer: B
Rationale: In intussusception of the bowel, one part of the intestine telescopes into another portion of the intestine. When the bowel twists and turns itself and obstructs the intestinal lumen, this is known as a volvulus. A hernia is when the bowel protrudes through a weakened area in the abdominal wall. An adhesion is a loop of intestine that adheres to an area that is healing slowly after surgery.
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A client realizes that regular use of laxatives has led to bowel pattern improvement. However, the nurse cautions this client against the prolonged use of laxatives for which reason?
- A. The client may develop inflammatory bowel disease.
- B. The client may develop arthritis or arthralgia.
- C. The client's natural bowel function may become sluggish.
- D. The client's appetite may be depleted.
Correct Answer: C
Rationale: It is essential for the nurse to caution the client against the prolonged use of laxatives because it decreases muscle tone in the large intestine. Prolonged use of laxatives may cause the client's natural bowel function to become sluggish. Laxatives do not increase the risk of developing inflammatory bowel disease, arthritis, or arthralgia, nor do they cause a loss in appetite.
A client has developed an anorectal abscess. Which client is likely at risk for the development of this type of abscess?
- A. A client with Crohn disease
- B. A client with hemorrhoids
- C. A client with colon cancer
- D. A client with diverticulosis
Correct Answer: A
Rationale: An anorectal abscess is common in clients with Crohn disease. The other disorders do not predispose the client to risk for anorectal abscess.
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.
Which test will best determine whether a client has an abnormality of the muscles surrounding the anal sphincter?
- A. Kidneys, ureters, bladder (KUB)
- B. Colonic transit studies
- C. Defecography
- D. Abdominal radiography
Correct Answer: C
Rationale: In defecography, a thick barium paste is inserted into the rectum. Radiographs are taken as the client expels the barium to determine whether there are any anatomic abnormalities or problems with the muscles surrounding the anal sphincter. A KUB will not determine this. Colonic transit studies are used to determine how long it takes for food to travel through the intestines. Abdominal radiography will show the structure but does not determine the muscle ability surrounding the anal sphincter.
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.