Which of the following symptoms may be exhibited by a client with Crohn's disease?

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: 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.

Correct Answer: C

Rationale: In a client with Crohn's disease, the correct answer for the symptom that should not be a direct result of antibiotic therapy is option C) Decrease in body weight. Crohn's disease is a chronic inflammatory condition that affects the gastrointestinal tract, leading to symptoms such as abdominal pain, diarrhea, weight loss, and malnutrition. Antibiotic therapy is often used to manage infections or complications in Crohn's disease, but it is not primarily aimed at causing weight loss. Option A) Decrease in bleeding is incorrect because antibiotics can help resolve infections that may be contributing to gastrointestinal bleeding in Crohn's disease. Option B) Decrease in temperature is incorrect as antibiotics can help reduce fever associated with infections. Option D) Decrease in the number of stools is incorrect because antibiotics can help improve diarrhea by treating underlying infections or inflammation in Crohn's disease. From an educational perspective, understanding the expected outcomes of antibiotic therapy in Crohn's disease is essential for nurses caring for these patients. By knowing the appropriate responses to treatment, nurses can monitor and evaluate the effectiveness of interventions and provide comprehensive care to promote positive patient outcomes. Additionally, differentiating between expected and unexpected responses to therapy helps nurses identify potential complications and adjust the plan of care accordingly.

Correct Answer: D

Rationale: In the context of medical surgical nursing, understanding the rationale behind the surgical management of ulcerative colitis is crucial for providing effective patient care. In this scenario, the correct answer is D) Bowel perforation. Ulcerative colitis is a chronic inflammatory condition that primarily affects the colon and rectum. In severe cases, ulcerative colitis can lead to complications such as toxic megacolon, which can result in bowel perforation. Surgical management in ulcerative colitis is often indicated for patients who do not respond to medical therapy or who develop serious complications like bowel perforation. Now, let's analyze why the other options are incorrect: A) Gastritis: Gastritis refers to inflammation of the stomach lining, which is not a direct complication of ulcerative colitis. B) Bowel herniation: While bowel herniation can occur in various conditions, it is not a common complication specifically associated with ulcerative colitis. C) Bowel outpouching: This is more commonly seen in conditions like diverticulosis/diverticulitis and is not a typical complication of ulcerative colitis. Educationally, this question highlights the importance of recognizing the potential complications of ulcerative colitis and the need for timely surgical intervention in cases of bowel perforation to prevent further complications like sepsis or peritonitis. Understanding these concepts is essential for nurses caring for patients with ulcerative colitis to ensure prompt identification and appropriate management of complications.