Question 1

A patient with irritable bowel syndrome is being started on the FODMAP diet.What foods should the nurse instruct the patient to avoid when following this diet? (Select all that apply.)

Accepted Answer

FODMAP stands for Fermentable Oligosaccharides,Disaccharides,Monosaccharides,and Polyols.Foods that should be avoided on this diet include milk,pears,apples,and Brussels sprouts.D.Broccoli does not need to be avoided on this diet.

Question 2

The nurse is teaching a patient newly diagnosed with ulcerative colitis about triggers for exacerbation of the disease.What should the nurse urge the patient to do to prevent a future exacerbation? (Select all that apply.)

Accepted Answer

Environmental agents such as pesticides,tobacco,radiation,and food additives may precipitate an exacerbation.Diet or psychological stress may trigger or worsen an attack of symptoms.C,There is no need for the patient to restrict fluids.

Question 3

A patient with fecal incontinence has an excoriated perianal region.Which interventions should be discussed with the RN? (Select all that apply.)

Accepted Answer

Research supports the use of the Flexi-Seal Management System-a soft silicone tube with a low-pressure balloon at the end inserted into the rectum.Stool cultures are appropriate to identify the presence of an infectious agent.Protective barrier cream is recommended to protect the skin from digestive enzymes.F.NG tube to suction is not necessary,although bowel rest with NPO status may be ordered.D.Baby powder will not promote healing or protect the skin.B.Antibiotics will not be ordered until stool specimen results indicate an infectious agent.

Question 4

The nurse is assisting to prepare dietary teaching for a patient with diverticulosis.Which food items should the nurse suggest be added to this patient's teaching plan? (Select all that apply.)

Accepted Answer

Dietary considerations for a patient with diverticulosis (without evidence of inflammation)include foods that are soft but high in fiber,such as prunes,raisins,and peas.Unprocessed bran can be added to soups,cereals,and salads to give added bulk to the diet.Fiber should be in-creased in the diet slowly to prevent excess gas and cramping.C.Cheese can cause constipation and should be avoided.

Question 5

A patient with Crohn's disease is scheduled for an ileoanal pouch.What should the nurse include when teaching the patient about this surgery? (Select all that apply.)

Accepted Answer

Because the anus and sphincter are saved,stool still passes through the anus.A temporary ileostomy is created to allow the pouch to heal..Several bowel movements per day occur.C.The stool is of soft consistency.D.An ileoanal pouch does not require an ostomy pouch to be worn.

Question 6

A patient comes into the client after experiencing diarrhea with five liquid stools in the past 24 hours.Which additional patient symptoms should cause the nurse concern? (Select all that apply.)

Accepted Answer

Indications for medical intervention related to diarrhea include large volumes of stool; severe abdominal cramping; bloody stool; protracted duration of diarrhea; systemic symptoms such as fever; or history of a medical condition in which fasting,dehydration,or infection are hazardous.E.Oral intake of 3 L in 24 hours is sufficient to prevent dehydration.D.The listed blood pressure is stable.F.While weight loss is concerning,1 pound in a week is not overly concerning.

Question 7

The nurse is contributing to a patient's plan of care.Which foods should the nurse recommend to be avoided or used with caution to reduce the possibility of ileostomy blockage? (Select all that apply.)

Accepted Answer

Foods that can cause ileostomy blockage include celery,apples,dried fruits,and mushrooms.C.F.Potatoes and chicken are not identified as causing ostomy blockages.

Question 8

During a health history,the nurse learns that a patient uses laxatives every day to ensure a bowel movement.What should the nurse expect to be prescribed for this patient? (Select all that apply.)

Accepted Answer

Chronic laxative use should be discontinued.Bulk-forming agents such as psyllium (Metamucil)or stool softeners such as docusate sodium (Colace)should be used instead of laxatives.Enemas and rectal suppositories are used only in extreme cases and are discontinued when an acute episode is resolved.Methylnaltrexone (Relistor)given subcutaneously treats opioid-induced constipation for patients receiving palliative care when other laxatives have not been effective.It does not treat other forms of constipation.

Quiz 34: Nursing Care of Patients With Lower Gastrointestinal Disorders