The nurse identifies a need for additional teaching when a patient with acute infectious diarrhea makes which statement?

Correct Answer: C

Rationale: In this scenario, option C, "I may use over-the-counter Imodium or Parepectolin when I need to control the diarrhea," is the statement that indicates a need for additional teaching. This is because using anti-diarrheal medications like Imodium can be harmful in cases of infectious diarrhea as they can prolong the infection by trapping the infectious organism in the intestines. Option A, "I can use A&D ointment or Vaseline jelly around the anal area to protect my skin," is correct as it helps prevent skin irritation from frequent bowel movements. Option B, "Gatorade is a good liquid to drink because it replaces the fluid and salts I have lost," is a correct statement as it helps in rehydration by replacing lost fluids and electrolytes. Option D, "I must wash my hands after every bowel movement to prevent spreading the diarrhea to my family," is also correct as proper hand hygiene is crucial in preventing the spread of infectious diarrhea. In an educational context, it's important to emphasize the appropriate management of infectious diarrhea, including the avoidance of anti-diarrheal medications unless prescribed by a healthcare provider. Teaching patients about proper fluid intake, hygiene practices, and skin protection is essential for effective self-care management of gastrointestinal disorders.

Correct Answer: D

Rationale: After a hemorrhoidectomy, the nurse should advise the patient to take warm sitz baths several times a day to promote comfort and cleaning. This is the correct answer because warm sitz baths help reduce pain, inflammation, and promote healing by increasing blood flow to the area, keeping it clean, and soothing discomfort. Option A is incorrect as using daily laxatives can cause straining during bowel movements, which should be avoided after a hemorrhoidectomy to prevent complications and discomfort. Option B is incorrect because while ice packs can help reduce swelling, they are not the primary recommendation post-hemorrhoidectomy. Option C is incorrect as avoiding bowel movements can lead to constipation, which can worsen the condition and delay healing. In an educational context, it is crucial for nursing students to understand the appropriate postoperative care for patients undergoing a hemorrhoidectomy to ensure optimal recovery outcomes. Teaching patients the correct postoperative care, like taking sitz baths, is essential for managing their symptoms and preventing complications.

Correct Answer: B

Rationale: In a patient with cirrhosis, the correct laboratory test result to expect is option B) Total bilirubin: 3.2 mg/dL (54.7 mmol/L). Elevated levels of total bilirubin are indicative of impaired liver function, as the liver is unable to properly metabolize and excrete bilirubin. This occurs in cirrhosis due to the liver's reduced ability to process bilirubin effectively. Option A) Serum albumin: 7.0 g/dL (70 g/L) is not typically elevated in cirrhosis; instead, it is often decreased due to impaired liver synthesis. Option C) Serum cholesterol: 260 mg/dL (6.7 mmol/L) may be elevated in conditions like hyperlipidemia but is not a specific marker for cirrhosis. Option D) Aspartate aminotransferase (AST): 6.0 U/L (0.1 mkat/L) may be elevated in liver damage, but it is less specific for cirrhosis compared to elevated bilirubin levels. Educationally, understanding the significance of specific laboratory values in cirrhosis is crucial for nurses to assess and monitor patients effectively. Knowing the expected lab findings aids in early detection, appropriate intervention, and patient education regarding their condition. This knowledge enhances nurses' ability to provide optimal care and support for patients with gastrointestinal disorders like cirrhosis.

Correct Answer: B

Rationale: The correct answer is B) Absence of bile salts in the intestine and duodenum, preventing fat emulsion and digestion. In a patient with an obstruction of the common bile duct, bile salts are unable to reach the intestine and duodenum due to the blockage. Bile salts are essential for emulsifying fats, aiding in their digestion and absorption. Without bile salts, fat digestion is impaired, leading to the passage of undigested fat in the stool, which presents as clay-colored and fatty stools. Option A is incorrect because soluble bilirubin in the blood being excreted into the urine is not directly related to the manifestation of clay-colored fatty stools in this scenario. Option C is incorrect as contraction of the gallbladder and obstructed ducts due to cholecystokinin stimulation do not explain the specific manifestation of clay-colored fatty stools. Option D is incorrect as it describes the consequences of the obstruction but does not directly address the pathophysiologic change leading to clay-colored fatty stools. Educationally, understanding the pathophysiology of gastrointestinal disorders is crucial for healthcare professionals to provide appropriate care and interventions for patients with these conditions. Recognizing the manifestations of common bile duct obstruction, such as clay-colored fatty stools, helps in diagnosing and managing patients effectively.

Correct Answer: D

Rationale: In this question, the correct answer is D) Red- or maroon-colored stool rectally. Hematochezia refers to the passage of fresh blood through the rectum, which presents as red- or maroon-colored stool. This is indicative of lower gastrointestinal bleeding. Option A) Vomiting of bright red or maroon blood is incorrect as it describes hematemesis, which is the vomiting of blood from the upper gastrointestinal tract. Option B) Black, tarry stool describes melena, which is dark, tarry stool resulting from the upper gastrointestinal bleeding and the digestion of blood. Option C) Coffee ground emesis refers to the appearance of vomited material that resembles coffee grounds, indicating upper gastrointestinal bleeding that has been partially digested. Understanding these distinctions is crucial in diagnosing gastrointestinal bleeding accurately. Educating healthcare professionals on these symptoms helps in prompt identification and appropriate management of patients with GI bleeding, ultimately improving patient outcomes.