Which of the following associated disorders may a client with ulcerative colitis exhibit?

Correct Answer: D

Rationale: In the context of ulcerative colitis, the correct answer is D) Toxic megacolon. Ulcerative colitis is a chronic inflammatory bowel disease that primarily affects the colon and rectum. Toxic megacolon is a severe complication seen in some patients with ulcerative colitis where there is a rapid dilation of the colon, leading to systemic toxicity and the potential for perforation. It is a life-threatening condition that requires immediate medical intervention. Option A) Gallstones, option B) Hydronephrosis, and option C) Nephrolithiasis are not typically associated with ulcerative colitis. Gallstones are more commonly related to conditions such as obesity and rapid weight loss. Hydronephrosis is the swelling of the kidneys due to a build-up of urine, usually caused by conditions like kidney stones or tumors. Nephrolithiasis refers to the formation of kidney stones, which is not directly linked to ulcerative colitis. Understanding the associated disorders of ulcerative colitis is crucial for nurses caring for patients with this condition. Recognizing the signs and symptoms of complications like toxic megacolon can help facilitate early intervention and prevent life-threatening outcomes. Educating patients with ulcerative colitis about potential complications and the importance of regular monitoring can improve their overall quality of care and outcomes.

Correct Answer: D

Rationale: In the context of medical surgical nursing, understanding the distinctive symptoms of various gastrointestinal disorders is crucial for accurate assessment and management of patients. In the case of Crohn's disease, the correct symptom exhibited is "D) Steatorrhea." This is because Crohn's disease, an inflammatory bowel disease, can affect the absorption of fats in the small intestine, leading to steatorrhea, which is characterized by foul-smelling, greasy, bulky stools due to the presence of excess fat. Option A) Bloody diarrhea is more commonly associated with conditions like ulcerative colitis, another type of inflammatory bowel disease, rather than Crohn's disease. Option B) Narrow stools are seen in conditions like colorectal cancer or strictures, not typically in Crohn's disease. Option C) Nausea and vomiting (N/V) are nonspecific symptoms that can occur in various gastrointestinal disorders but are not specific to Crohn's disease. Educationally, knowing these distinctions is vital for nurses to provide appropriate care, educate patients on their condition, and collaborate effectively with the healthcare team to optimize patient outcomes. By understanding the unique manifestations of Crohn's disease, nurses can intervene promptly, monitor for complications, and support patients in managing their symptoms effectively.

Correct Answer: B

Rationale: In the context of medical-surgical nursing, understanding the manifestations of gastrointestinal disorders like ulcerative colitis is crucial. The correct answer, B) Rectal bleeding, is associated with ulcerative colitis due to the inflammation and ulceration of the colon and rectum characteristic of this condition. Rectal bleeding is a hallmark symptom, indicating the presence of active disease and mucosal damage in ulcerative colitis. Option A) Dumping syndrome is incorrect as it is associated with rapid gastric emptying post-gastrectomy or gastric surgery, not ulcerative colitis. Option C) Soft stools are not specific to ulcerative colitis and can be seen in various gastrointestinal disorders. Option D) Fistulas are more commonly associated with conditions like Crohn's disease rather than ulcerative colitis. Educationally, recognizing the unique symptoms of ulcerative colitis, such as rectal bleeding, aids in prompt diagnosis and appropriate management of patients with this chronic inflammatory bowel disease. Understanding these distinctions is essential for nurses to provide quality care, educate patients on their condition, and collaborate effectively with healthcare teams in managing ulcerative colitis.

Correct Answer: D

Rationale: In the context of a client with irritable bowel syndrome, the diagnostic test that would help differentiate between Crohn's disease and ulcerative colitis is a colonoscopy with biopsy, which is option D. This test allows direct visualization of the colon and rectum, providing essential information about the mucosal lining, presence of inflammation, and specific features indicative of either Crohn's disease or ulcerative colitis. A colonoscopy with biopsy is considered the gold standard for diagnosing inflammatory bowel diseases like Crohn's and ulcerative colitis due to its ability to provide detailed information for accurate differentiation. Option A, an abdominal CT scan, may show some features suggestive of inflammatory bowel disease but lacks the ability to provide the detailed mucosal information that a colonoscopy with biopsy offers. Option B, an abdominal x-ray, is not specific or sensitive enough to differentiate between Crohn's disease and ulcerative colitis. Option C, a barium swallow, is used to evaluate the esophagus and stomach, making it irrelevant for assessing the colon and differentiating between these two specific conditions. Understanding the diagnostic tests specific to gastrointestinal disorders is crucial in nursing practice, as it guides appropriate treatment plans and interventions. By choosing the correct test based on the clinical presentation, healthcare providers can ensure timely and accurate diagnosis, leading to better outcomes for patients with gastrointestinal conditions.

Correct Answer: C

Rationale: In the medical management of Crohn's disease, using long-term steroid therapy (Option C) is the correct intervention. Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract that requires anti-inflammatory medications like steroids to reduce inflammation and manage symptoms over the long term. Steroids help control the immune response, decrease inflammation, and provide relief from symptoms such as abdominal pain, diarrhea, and fatigue. Options A, B, and D are incorrect interventions for Crohn's disease. - Increasing oral intake of fiber (Option A) can exacerbate symptoms in Crohn's disease as high-fiber foods may worsen diarrhea and abdominal pain in individuals with inflamed intestines. - Administering laxatives (Option B) is not recommended in Crohn's disease as they can further irritate the intestines and worsen diarrhea. - Increasing physical activity (Option D) can be beneficial for overall health but is not a primary intervention for managing the symptoms and inflammation associated with Crohn's disease. Educationally, understanding the rationale behind the medical management of Crohn's disease is crucial for nursing students to provide safe and effective care to patients with this condition. It highlights the importance of appropriate medication management and individualized treatment plans based on the pathophysiology of the disease. This rationale reinforces the need for evidence-based practice in nursing and the importance of considering the specific needs of patients with chronic conditions like Crohn's disease.