IBD - ulcerative colitis and Crohns
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy
abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to
A. administer IV metoclopramide (Reglan).
B. discontinue the patient's oral food intake.
C. administer cobalamin (vitamin B12) injections.
D. teach the patient about total colectomy surgery. - answerANS: B
An initial therapy for an acute exacerbation of inflammatory bowel disease (IBD) is to
rest the bowel by making the patient NPO. Metoclopramide increases peristalsis and
will worsen symptoms. Cobalamin (vitamin B12) is absorbed in the ileum, which is not
affected by ulcerative colitis. Although total colectomy is needed for some patients,
there is no indication that this patient is a candidate.
Which nursing action will the nurse include in the plan of care for a 35-yr-old male
patient admitted with an exacerbation of inflammatory bowel disease (IBD)?
a. Restrict oral fluid intake.
b. Monitor stools for blood.
c. Ambulate six times daily.
d. Increase dietary fiber intake - answerANS: B
Because anemia or hemorrhage may occur with IBD, stools should be assessed for the
presence of blood. The other actions would not be appropriate for the patient with IBD.
Dietary fiber may increase gastrointestinal motility and exacerbate the diarrhea, severe
fatigue is common with IBD exacerbations, and dehydration may occur.
Which patient statement indicates that the nurse's teaching about sulfasalazine
(Azulfidine) for ulcerative colitis has been effective?
A. "The medication will be tapered if I need surgery."
B. "I will need to use a sunscreen when I am outdoors."
C."I will need to avoid contact with people who are sick."
D. "The medication prevents the infections that cause diarrhea." - answerANS: B
Sulfasalazine may cause photosensitivity in some patients. It is not used to treat
infections. Sulfasalazine does not reduce immune function. Unlike corticosteroids,
tapering of sulfasalazine is not needed.
A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20
stools daily and has excoriated perianal skin. Which patient behavior indicates that
teaching regarding maintenance of skin integrity has been effective?
A. The patient uses incontinence briefs to contain loose stools.
B. The patient uses witch hazel compresses to soothe irritation.
C. The patient asks for antidiarrheal medication after each stool.
D. The patient cleans the perianal area with soap after each stool. - answerANS: B
, Witch hazel compresses are suggested to reduce anal irritation and discomfort.
Incontinence briefs may trap diarrhea and increase the incidence of skin breakdown.
Antidiarrheal medications are not given 15 to 20 times a day. The perianal area should
be washed with plain water or pH balanced cleanser after each stool.
Which diet choice by the patient with an acute exacerbation of inflammatory bowel
disease (IBD) indicates a need for more teaching?
a. Scrambled eggs
b. White toast and jam
c. Oatmeal with cream
d. Pancakes with syrup - answerANS: C
During acute exacerbations of IBD, the patient should avoid high-fiber foods such as
whole grains. High-fat foods also may cause diarrhea in some patients. The other
choices are low residue and would be appropriate for this patient.
After a total proctocolectomy and permanent ileostomy, the patient tells the nurse, "I
cannot manage all these changes. I don't want to look at the stoma." What is the best
action by the nurse?
A. Reassure the patient that ileostomy care will become easier.
B. Ask the patient about the concerns with stoma management.
C. Postpone any teaching until the patient adjusts to the ileostomy.
D. Develop a detailed written list of ostomy care tasks for the patient. - answerANS: B
Encouraging the patient to share concerns assists in helping the patient adjust to the
body changes. Acknowledgment of the patient's feelings and concerns is important
rather than offering false reassurance. Because the patient indicates that the feelings
about the ostomy are the reason for the difficulty with the many changes, development
of a detailed ostomy care plan will not improve the patient's ability to manage the
ostomy. Although detailed ostomy teaching may be postponed, the nurse should offer
teaching about some aspects of living with an ostomy.
A patient has a new diagnosis of Crohn's disease after having frequent diarrhea and a
weight loss of 10 lb (4.5 kg) over 2 months. The nurse will plan to teach about
a. medication use.
b. fluid restriction.
c. enteral nutrition.
d. activity restrictions. - answerANS: A
Medications are used to induce and maintain remission in patients with inflammatory
bowel disease (IBD). Decreased activity level is indicated only if the patient has severe
fatigue and weakness. Fluids are needed to prevent dehydration. There is no advantage
to enteral feedings.
A young woman who has Crohn's disease develops a fever and symptoms of a urinary
tract infection (UTI) with tan, fecal-smelling urine. What information will the nurse add to
a general teaching plan about UTIs in order to individualize the teaching for this patient?
A. Bacteria in the perianal area can enter the urethra.
B. Fistulas can form between the bowel and bladder.
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy
abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to
A. administer IV metoclopramide (Reglan).
B. discontinue the patient's oral food intake.
C. administer cobalamin (vitamin B12) injections.
D. teach the patient about total colectomy surgery. - answerANS: B
An initial therapy for an acute exacerbation of inflammatory bowel disease (IBD) is to
rest the bowel by making the patient NPO. Metoclopramide increases peristalsis and
will worsen symptoms. Cobalamin (vitamin B12) is absorbed in the ileum, which is not
affected by ulcerative colitis. Although total colectomy is needed for some patients,
there is no indication that this patient is a candidate.
Which nursing action will the nurse include in the plan of care for a 35-yr-old male
patient admitted with an exacerbation of inflammatory bowel disease (IBD)?
a. Restrict oral fluid intake.
b. Monitor stools for blood.
c. Ambulate six times daily.
d. Increase dietary fiber intake - answerANS: B
Because anemia or hemorrhage may occur with IBD, stools should be assessed for the
presence of blood. The other actions would not be appropriate for the patient with IBD.
Dietary fiber may increase gastrointestinal motility and exacerbate the diarrhea, severe
fatigue is common with IBD exacerbations, and dehydration may occur.
Which patient statement indicates that the nurse's teaching about sulfasalazine
(Azulfidine) for ulcerative colitis has been effective?
A. "The medication will be tapered if I need surgery."
B. "I will need to use a sunscreen when I am outdoors."
C."I will need to avoid contact with people who are sick."
D. "The medication prevents the infections that cause diarrhea." - answerANS: B
Sulfasalazine may cause photosensitivity in some patients. It is not used to treat
infections. Sulfasalazine does not reduce immune function. Unlike corticosteroids,
tapering of sulfasalazine is not needed.
A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20
stools daily and has excoriated perianal skin. Which patient behavior indicates that
teaching regarding maintenance of skin integrity has been effective?
A. The patient uses incontinence briefs to contain loose stools.
B. The patient uses witch hazel compresses to soothe irritation.
C. The patient asks for antidiarrheal medication after each stool.
D. The patient cleans the perianal area with soap after each stool. - answerANS: B
, Witch hazel compresses are suggested to reduce anal irritation and discomfort.
Incontinence briefs may trap diarrhea and increase the incidence of skin breakdown.
Antidiarrheal medications are not given 15 to 20 times a day. The perianal area should
be washed with plain water or pH balanced cleanser after each stool.
Which diet choice by the patient with an acute exacerbation of inflammatory bowel
disease (IBD) indicates a need for more teaching?
a. Scrambled eggs
b. White toast and jam
c. Oatmeal with cream
d. Pancakes with syrup - answerANS: C
During acute exacerbations of IBD, the patient should avoid high-fiber foods such as
whole grains. High-fat foods also may cause diarrhea in some patients. The other
choices are low residue and would be appropriate for this patient.
After a total proctocolectomy and permanent ileostomy, the patient tells the nurse, "I
cannot manage all these changes. I don't want to look at the stoma." What is the best
action by the nurse?
A. Reassure the patient that ileostomy care will become easier.
B. Ask the patient about the concerns with stoma management.
C. Postpone any teaching until the patient adjusts to the ileostomy.
D. Develop a detailed written list of ostomy care tasks for the patient. - answerANS: B
Encouraging the patient to share concerns assists in helping the patient adjust to the
body changes. Acknowledgment of the patient's feelings and concerns is important
rather than offering false reassurance. Because the patient indicates that the feelings
about the ostomy are the reason for the difficulty with the many changes, development
of a detailed ostomy care plan will not improve the patient's ability to manage the
ostomy. Although detailed ostomy teaching may be postponed, the nurse should offer
teaching about some aspects of living with an ostomy.
A patient has a new diagnosis of Crohn's disease after having frequent diarrhea and a
weight loss of 10 lb (4.5 kg) over 2 months. The nurse will plan to teach about
a. medication use.
b. fluid restriction.
c. enteral nutrition.
d. activity restrictions. - answerANS: A
Medications are used to induce and maintain remission in patients with inflammatory
bowel disease (IBD). Decreased activity level is indicated only if the patient has severe
fatigue and weakness. Fluids are needed to prevent dehydration. There is no advantage
to enteral feedings.
A young woman who has Crohn's disease develops a fever and symptoms of a urinary
tract infection (UTI) with tan, fecal-smelling urine. What information will the nurse add to
a general teaching plan about UTIs in order to individualize the teaching for this patient?
A. Bacteria in the perianal area can enter the urethra.
B. Fistulas can form between the bowel and bladder.
