A client with irritable bowel syndrome is being prepared for discharge. Which of the following meal plans should the nurse give the client?

Correct Answer: B

Rationale: In the case of irritable bowel syndrome (IBS), the correct meal plan for a client being discharged would be option B) High fiber, low-fat. This choice is based on the understanding of IBS management principles. High fiber helps regulate bowel movements and prevent constipation, a common issue in IBS patients. Additionally, a low-fat diet is recommended to reduce the risk of triggering IBS symptoms such as abdominal pain and diarrhea. Option A) Low fiber, low-fat would not be ideal as low fiber intake can exacerbate constipation, a common symptom in some IBS patients. Option C) Low fiber, high-fat is also not recommended as high-fat foods can worsen IBS symptoms like diarrhea and discomfort. Option D) High-fiber, high-fat is not suitable as high-fat intake can trigger symptoms, while high-fiber foods may be beneficial in moderation but not when combined with high-fat content. In an educational context, understanding the rationale behind dietary recommendations for specific conditions like IBS is crucial for nursing students. It helps in providing holistic care to patients and tailoring interventions based on individual needs. By grasping the impact of different dietary components on gastrointestinal health, nurses can effectively support patients in managing their conditions and promoting overall well-being.

Correct Answer: C

Rationale: The priority nursing diagnosis in this scenario is "Deficient fluid volume" (Option C). This is because a small-bowel obstruction can lead to significant fluid loss and dehydration due to the inability of fluid and contents to pass through the intestines. The insertion of a Miller-Abbott tube is aimed at decompressing the bowel and relieving the obstruction, which can result in further fluid loss. Therefore, addressing the deficient fluid volume is crucial to prevent complications such as hypovolemic shock and electrolyte imbalances. Option A, "Imbalanced nutrition: Less than body requirements," is not the priority in this situation as fluid volume deficit poses a more immediate threat to the client's physiological stability. While nutrition is important for recovery, addressing fluid volume deficit takes precedence. Option B, "Acute pain," is also important to address, but in the context of a small-bowel obstruction and the need for bowel decompression, fluid volume deficit poses a greater risk to the client's immediate well-being. Option D, "Excess fluid volume," is incorrect as there is no indication of fluid overload in this scenario. In fact, the client is more likely experiencing fluid volume deficit due to the obstruction. Educationally, understanding the priority nursing diagnosis in a specific clinical situation is crucial for providing safe and effective care to patients. This rationale highlights the importance of prioritizing interventions based on the client's immediate needs and the potential risks associated with the condition.

Correct Answer: D

Rationale: In teaching an elderly client how to prevent constipation, including regular exercise (option D) is crucial for several reasons. Exercise helps stimulate intestinal motility, promoting more regular bowel movements. It also enhances overall health and well-being in older adults by improving circulation, muscle tone, and metabolism. Additionally, physical activity can help alleviate stress, which may contribute to constipation. Option A, drinking 6 glasses of fluid daily, is important for overall hydration but alone may not be sufficient to prevent constipation. Adequate fluid intake should be encouraged, but exercise plays a more direct role in preventing constipation in this scenario. Avoiding grain products and nuts (option B) is not necessary for preventing constipation unless the individual has specific dietary sensitivities or intolerances to these foods. In fact, whole grains and nuts can provide essential dietary fiber, which is beneficial for bowel regularity. Adding 4 grams of bran to cereal (option C) may seem like a good way to increase fiber intake, but it is not as effective or sustainable as incorporating a variety of fiber-rich foods into the diet. Furthermore, some individuals may find bran difficult to digest, leading to potential gastrointestinal discomfort. In an educational context, it is important to emphasize a holistic approach to preventing constipation in the elderly, which includes a balanced diet rich in fiber, adequate hydration, regular physical activity, and addressing any underlying health conditions or medications that may contribute to constipation. Encouraging lifestyle modifications like exercise can empower older adults to take an active role in their digestive health and overall well-being.

Correct Answer: C

Rationale: In a client with diarrhea, the outcome that indicates fluid resuscitation is successful is when the client exhibits firm skin turgor. Firm skin turgor is a reliable indicator of adequate hydration status. When a person is dehydrated, their skin loses elasticity and becomes less turgid, whereas improved skin turgor suggests proper fluid balance has been restored. Option A, the client passing formed stools at regular intervals, is incorrect as it primarily reflects bowel motility and consistency, not necessarily hydration status. Option B, the client reporting a decrease in stool frequency and liquidity, is also incorrect as it may indicate symptom improvement but does not directly reflect hydration status. Option D, the client no longer experiencing perianal burning, is related to symptom relief but does not provide a direct measure of hydration. In an educational context, understanding the signs of dehydration and effective fluid resuscitation is crucial in managing patients with diarrhea. By recognizing the importance of skin turgor assessment, nurses can accurately gauge hydration status and tailor interventions accordingly to promote optimal patient outcomes.

Correct Answer: A

Rationale: The correct answer to the question about preventing colon cancer in a community group is option A: Limit fat intake to 20% to 25% of your total daily calories. This instruction is crucial because high-fat diets have been linked to an increased risk of colon cancer. By reducing fat intake to the recommended percentage, individuals can lower their risk of developing this type of cancer. Option B, which suggests including 15 to 20 grams of fiber into the daily diet, is a good dietary recommendation for overall gastrointestinal health but is not specifically targeted at preventing colon cancer. Fiber can help with bowel regularity and overall digestive health but does not have a direct preventive effect on colon cancer. Option C, advising to get an annual rectal examination after age 35, is not a primary prevention measure for colon cancer. While regular screenings such as colonoscopies are essential for early detection, they are not preventive measures. Option D, recommending annual sigmoidoscopy after age 50, is also not the best preventive measure for colon cancer. While colonoscopies and sigmoidoscopies are important screening tools, they are typically not required annually and have specific guidelines for timing based on individual risk factors and findings. It is vital to educate the community on evidence-based preventive measures for colon cancer, such as maintaining a healthy diet low in fat, high in fiber, engaging in regular physical activity, avoiding tobacco and excessive alcohol use, and participating in recommended screening tests based on individual risk factors and guidelines. These interventions can significantly reduce the risk of developing colon cancer and promote overall gastrointestinal health.