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LWW Chapter 47: Management of Patients With Intestinal and Rectal Disorders, Prep U--Ch. 47: Mgmt of Patients With Intestinal and Rectal Disorders (Answered) 2022$12.28
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LWW Chapter 47: Management of Patients With Intestinal and Rectal Disorders, Prep U--Ch. 47: Mgmt of Patients With Intestinal and Rectal Disorders (Answered) 2022
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Management of Patients
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Management Of Patients
LWW Chapter 47: Management of Patients With Intestinal and Rectal Disorders, Prep U--Ch. 47: Mgmt of Patients With Intestinal and Rectal Disorders (Answered) 2022
severe abdominal pain with direct palpation or rebound tenderness.
Peritonitis decreases intestinal motility and causes intestin...
lww chapter 47 management of patients with intestinal and rectal disorders
prep u ch 47 mgmt of patients with intestinal and rectal disorders answered 2022 severe abdominal pain with direct
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LWW Chapter 47: Management of Patients
With Intestinal and Rectal Disorders, Prep
U--Ch. 47: Mgmt of Patients With Intestinal
and Rectal Disorders (Answered) 2022
severe abdominal pain with direct palpation or rebound tenderness.
Peritonitis decreases intestinal motility and causes intestinal distention. A classic sign of
peritonitis is a sudden, diffuse, severe abdominal pain that intensifies in the area of the
underlying causative disorder (such as appendicitis, diverticulitis, ulcerative colitis, or a
strangulated obstruction). The client may also have rebound tenderness. Tenderness
and pain in the right upper abdominal quadrant suggest cholecystitis. Jaundice and
vomiting are signs of cirrhosis of the liver. Rectal bleeding or a change in bowel habits
may indicate colorectal cancer.
Nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and
signs and symptoms of dehydration. The nurse also expects to find:
White blood cell (WBC) count 22.8/mm3
The nurse should report the elevated WBC count. This finding, which is a sign of
infection, indicates that the client's appendix might have ruptured. Hematocrit of 42%,
serum potassium of 4.2 mEq/L, and serum sodium of 135 mEq/L are within normal
limits. Alterations in these levels don't indicate appendicitis.
A client with complaints of right lower quadrant pain is admitted to the emergency
department. Blood specimens are drawn and sent to the laboratory. Which laboratory
finding should be reported to the physician immediately?
Drink at least 8 to 10 large glasses of fluid every day
The nurse should instruct a client with diverticulosis to drink at least 8 to 10 large
glasses of fluid every day. The client should include unprocessed bran in the diet
because it adds bulk, and should avoid the use of laxatives or enemas except when
recommended by the physician. In addition, regular exercise should be encouraged if
the client's current lifestyle is somewhat inactive.
What information should the nurse include in the teaching plan for a client being treated
for diverticulosis?
Ask the client to remain inactive for 5 minutes.
Explanation:
After applying the ostomy appliance, the nurse should ask the client to remain inactive
for 5 minutes to allow body heat to strengthen the adhesive bond. The adhesive
faceplate should be pressed from the stomal edge outward to prevent the formation of
,wrinkles. A small amount of air should also be allowed to be trapped in the pouch; liquid
feces will then drain to the bottom of the pouch, placing less tension on it.
A nurse applies an ostomy appliance to a client who is recovering from ileostomy
surgery. Which intervention should the nurse utilize to prevent leakage from the
appliance?
The client's natural bowel function may become sluggish.
Explanation:
It is essential for the nurse to caution the client against the prolonged use of laxatives
because it decreases muscle tone in the large intestine. Prolonged use of laxatives may
cause the client's natural bowel function to become sluggish. Laxatives do not increase
the risk of developing inflammatory bowel disease, arthritis, or arthralgia, nor do they
cause a loss in appetite.
A client realizes that regular use of laxatives has greatly improved his bowel pattern.
However, the nurse cautions this client against the prolonged use of laxatives for which
reason?
Sudden, sustained abdominal pain
Sudden, sustained pain, abdominal distention, and fever are symptoms of perforation in
a client with intestinal obstruction. A decrease in blood pressure and decrease in urine
output are symptoms of shock. Purulent drainage from the gluteal fold is not a symptom
of perforation; it only indicates that the client has developed a condition of anorectal
abscess.
Which of the following will the nurse observe as symptoms of perforation in a patient
with intestinal obstruction?
Computed tomography scan
A computed tomography scan is the diagnostic of choice if the suspected diagnosis is
diverticulitis; it can also reveal one or more abscesses. A barium enema or colonoscopy
may be used to diagnosis diverticulosis. Magnetic resonance imaging would not be
used to diagnose diverticulitis.
Which of the following is the diagnostic of choice if the suspected diagnosis is
diverticulitis?
Insufficient fiber
Emotional stress
Inactivity
A client reports having increased incidence of constipation. What can cause
constipation?
It is the third most common cancer in the United States.
Colorectal cancer is the third most common type of cancer in the United States. The
lifetime risk of developing colorectal cancer is 1 in 20. The incidence increases with age
(the incidence is highest in people older than 85). Colorectal cancer occurrence is
higher in people with a family history of colon cancer.
The nurse is conducting a community education program on colorectal cancer. Which
statement should the nurse include in the program?
, Notify the physician.
Abdominal pain, a rigid board-like abdomen, loss of bowel sounds, and signs and
symptoms of shock occur with peritonitis. Peritonitis is typically a life-threatening
emergency that requires prompt surgical intervention, and typically involves
postoperative critical care monitoring due to the risk of sepsis, organ failure, and
subsequent infections; thus, the nurse should notify the physician.
The nurse is admitting a patient with a diagnosis of diverticulitis and assesses that the
patient has a boardlike abdomen, no bowel sounds, and complains of severe abdominal
pain. What is the nurse's first action?
Peritonitis
Peritonitis is inflammation of the peritoneum, the serous membrane lining the abdominal
cavity and covering the viscera. Peritonitis is typically a life-threatening emergency that
requires prompt surgical intervention, and typically involves postoperative critical care
monitoring due to the risk of sepsis, organ failure, and subsequent infections.
Post appendectomy, a nurse should assess the patient for abdominal rigidity and
tenderness, fever, loss of bowel sounds, and tachycardia, all clinical signs of:
Hypotension
Clinical manifestations include hypotension, increased temperature, tachycardia, and
elevated ESR.
The nurse is caring for a patient diagnosed with abdominal perforation. Which of the
following is a clinical manifestation of this disease process?
Borborygmus
Borborygmus is the intestinal rumbling caused by the movement of gas through the
intestines that accompanies diarrhea. Tenesmus refers to ineffectual straining at stool.
Azotorrhea refers to excess of nitrogenous matter in the feces or urine. Diverticulitis
refers to inflammation of a diverticulum from obstruction (by fecal matter) resulting in
abscess formation.
The nurse is performing and documenting the findings of an abdominal assessment.
When the nurse hears intestinal rumbling and the client then experiences diarrhea, the
nurse documents the presence of which condition?
Nausea
Nausea, with or without vomiting, is typically associated with appendicitis. Pain is
generally felt in the right lower quadrant. Rebound tenderness, or pain felt upon the
release of pressure applied to the abdomen, may be present with appendicitis. Low-
grade fever is associated with appendicitis.
The nurse working in the ED is evaluating a client for signs and symptoms of
appendicitis. Which of the client's signs/symptoms should the nurse report to the
physician?
Borborygmus
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