The medications prescribed for the patient with inflammatory bowel disease include cobalamin and iron injections. What is the rationale for using these drugs?

Correct Answer: C

Rationale: In the context of inflammatory bowel disease (IBD), the rationale for prescribing cobalamin (Vitamin B12) and iron injections is primarily to correct malnutrition (Option C). IBD, which includes conditions like Crohn's disease and ulcerative colitis, often leads to malabsorption of essential nutrients due to chronic inflammation and damage to the gastrointestinal tract. This can result in deficiencies in vitamins and minerals, including cobalamin and iron. Cobalamin is essential for the production of red blood cells and proper neurological function, while iron is crucial for oxygen transport in the blood. Supplementing these nutrients via injections helps address deficiencies that can arise in IBD patients, thereby improving their overall nutritional status and health outcomes. Option A, alleviating stress, is not directly related to the nutritional deficiencies commonly seen in IBD. While stress management is important for overall well-being, it is not the primary reason for prescribing cobalamin and iron injections in this context. Option B, combating infection, is also not the main purpose of these specific medications in IBD treatment. While IBD does involve chronic inflammation, the focus of cobalamin and iron injections is on addressing malnutrition rather than directly targeting infections. Option D, improving quality of life, is a broad goal of managing IBD, but the specific use of cobalamin and iron injections is more targeted at addressing nutrient deficiencies and related complications rather than solely aiming to improve quality of life. Educationally, understanding the rationale behind prescribing specific medications in IBD is crucial for healthcare providers to provide effective care to patients. By addressing nutritional deficiencies with appropriate interventions like cobalamin and iron injections, healthcare professionals can help manage IBD symptoms and improve the overall health outcomes of patients.

Correct Answer: A

Rationale: In the context of caring for a patient with viral hepatitis, providing adequate nutritional intake (Option A) is one of the most challenging nursing interventions to promote healing. This is because hepatitis can lead to poor appetite, nausea, and malabsorption, making it difficult for patients to meet their nutritional needs. Adequate nutrition is crucial for liver function and overall healing, so ensuring the patient receives the necessary nutrients is essential. Promoting strict bed rest during the icteric phase (Option B) is not recommended as prolonged bed rest can lead to muscle deconditioning and increase the risk of complications like deep vein thrombosis. Patients with hepatitis should be encouraged to engage in light physical activity as tolerated. Providing pain relief without using liver-metabolized drugs (Option C) is important due to the impaired liver function in hepatitis patients. However, while pain management is essential, it is not the most challenging nursing intervention in this context. Providing quiet diversional activities during periods of fatigue (Option D) can be helpful in managing symptoms, but it is not as critical to promoting healing in viral hepatitis as ensuring adequate nutritional intake. Educationally, understanding the rationale behind each option helps nurses prioritize interventions based on their impact on the patient's healing process. By focusing on nutritional support, nurses can significantly contribute to the patient's recovery from viral hepatitis.

Correct Answer: C

Rationale: In this scenario, option C is the correct answer. Positioning the patient on the side with the head of the bed elevated 45 degrees is beneficial for pain relief in acute pancreatitis. This position helps to reduce pressure on the pancreas and decreases pain associated with peritoneal irritation by promoting drainage of pancreatic enzymes and fluids. Option A, providing diversional activities, may be helpful for pain management in some cases, but it does not directly address the physiological process of pancreatitis as option C does. Option B, providing small, frequent meals, is not appropriate in acute pancreatitis as the pancreas needs time to rest and heal, so fasting or NPO status is often indicated. Option D, ambulating the patient, may be beneficial in some cases to prevent complications, but it is not specifically targeted at pain relief in acute pancreatitis. Educationally, it is important to understand the rationale behind each intervention to provide optimal care for patients with acute pancreatitis. Proper positioning not only helps with pain relief but also supports the overall management of the condition. Understanding the pathophysiology of acute pancreatitis and its impact on the patient's comfort and recovery is crucial for nurses to deliver effective care.

Correct Answer: B

Rationale: The correct answer is B) Pruritus (itching). When there is a buildup of bile salts, it can lead to a condition known as cholestasis, where the flow of bile from the liver is impaired. This can cause bile salts to accumulate in the body, leading to itching or pruritus. This symptom is often seen in conditions like primary biliary cholangitis or obstructive jaundice. Option A) Hypotension is incorrect because the buildup of bile salts does not directly cause low blood pressure. Bile salts are not known to have a direct effect on blood pressure regulation. Option C) Ecchymosis (bruising) is incorrect as bile salt buildup does not lead to bruising. Ecchymosis is typically caused by broken blood vessels under the skin, often due to trauma or blood clotting disorders. Option D) Urticaria (hives) is incorrect because hives are commonly caused by allergic reactions, autoimmune conditions, or infections, and not by the buildup of bile salts. In an educational context, understanding the systemic symptoms of gastrointestinal disorders like cholestasis is crucial for healthcare professionals as it helps in early identification, diagnosis, and management of these conditions. Recognizing pruritus as a potential symptom of bile salt accumulation can prompt further investigation and appropriate treatment to address the underlying issue.