A client who follows Mormon beliefs is on a clear liquid diet following abdominal surgery. Which menu items should the nurse request for this client? Select all that apply.

Choice A rationale
While a case management evaluation of the client’s home environment could potentially identify areas for improvement, it may not directly address the caregiver’s immediate need for relief from their caregiving responsibilities. The caregiver is experiencing sleepless nights and frequent bouts of crying, which could be signs of caregiver burnout or depression. Therefore, immediate respite care may be more beneficial.

Choice B rationale
Employing a private duty nurse for respite could provide temporary relief for the caregiver. However, this option might not be feasible due to potential financial constraints. Additionally, it may not provide the caregiver with the emotional support they may need.

Choice C rationale
Proposing that extended family could relocate to the area to provide support is a potential long-term solution. However, it may not be feasible or practical for extended family members to relocate. This option also does not address the caregiver’s immediate need for relief and support.

Choice D rationale

Advising the caregiver to contact social services to locate a respite care facility for the client could provide the caregiver with the immediate relief they need. Respite care facilities offer temporary relief for caregivers by providing short-term care for the individual they are caring for. This would allow the caregiver to rest and take care of their own needs, which could help alleviate their symptoms of sleepless nights and frequent bouts of crying.

The correct answer is Choice A

Choice A rationale: Crohn’s disease involves transmural inflammation of the gastrointestinal tract, often leading to hypermotility and increased peristalsis. Activity restriction reduces sympathetic stimulation, thereby minimizing intestinal motility and mechanical stress on inflamed mucosa. This helps prevent exacerbation of symptoms and promotes mucosal rest. By limiting physical exertion, the body can redirect energy toward immune modulation and tissue repair. Normal bowel motility varies, but excessive activity worsens inflammation and nutrient malabsorption in Crohn’s pathology.

Choice B rationale: While diarrhea is a common symptom in Crohn’s disease, activity restriction does not directly modulate stool frequency or water reabsorption. Diarrhea results from mucosal damage, cytokine-mediated secretion, and impaired absorption, not physical activity. Management typically involves anti-inflammatory agents, antidiarrheals, and dietary modifications. Restricting movement may indirectly reduce diarrhea by decreasing intestinal stimulation, but it is not the primary mechanism. Stool water content normally ranges from 60–85%, and inflammation disrupts this balance.

Choice C rationale: Healing in Crohn’s disease is multifactorial, involving immunosuppression, mucosal regeneration, and nutritional support. While rest contributes to systemic recovery, it is not the primary driver of mucosal healing. Healing requires suppression of TNF-alpha, IL-6, and other pro-inflammatory mediators. Activity restriction may support healing indirectly by reducing metabolic demand and stress hormone release, but pharmacologic and nutritional interventions are more central. Normal mucosal turnover occurs every 3–5 days, but inflammation delays this process.

Choice D rationale: Abdominal pain in Crohn’s disease arises from transmural inflammation, bowel distension, and neural sensitization. Although rest may reduce visceral stimulation, pain control is better achieved through anti-inflammatory therapy, bowel rest, and analgesics. Activity restriction does not directly modulate nociceptive pathways or cytokine levels. Pain perception involves complex neuroimmune interactions, and physical rest alone cannot address the underlying pathology. Normal visceral pain thresholds are altered in Crohn’s due to chronic inflammation and fibrosis.