A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions. How should the nurse respond?

Instruct the client to avoid foods with gluten, such as wheat bread.

Describe the use of an elimination diet to find trigger foods.

Advise the client to limit foods that are high in calcium and iron.

Explain that the need to restrict fluids is the primary limitation.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

While some individuals with Crohn's disease may find that avoiding gluten improves their symptoms, this is not a universal recommendation.

Gluten restriction is more often indicated for those with celiac disease or gluten sensitivity.

It's important to individualize dietary recommendations based on personal triggers and sensitivities.

Choice B rationale:

An elimination diet is a systematic approach to identifying foods that may trigger or worsen Crohn's disease symptoms.

It involves removing certain foods from the diet for a period of time, typically 2-4 weeks, and then gradually reintroducing them one at a time to observe any reactions.

This process can help individuals pinpoint specific foods that contribute to their symptoms and make informed dietary choices to manage their condition.

Choice C rationale:

There is no evidence to support a general restriction of calcium and iron in individuals with Crohn's disease.

In fact, these nutrients are essential for overall health and should be consumed in adequate amounts unless a specific deficiency or intolerance is identified.

Restriction of these nutrients could lead to nutritional deficiencies.

Choice D rationale:

Fluid restriction is not a primary dietary limitation for individuals with Crohn's disease.

Maintaining adequate hydration is crucial for overall health, especially during flares when fluid loss through diarrhea may be increased.

Restricting fluids could potentially lead to dehydration and electrolyte imbalances.

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Correct Answer is D

Explanation

Choice A rationale:

Amber urine can be a sign of dehydration, but it is not specific to cholelithiasis with a gallstone lodged in the common bile duct.

While it's important to monitor hydration status in patients with nausea and vomiting, amber urine alone would not be the most urgent finding to report to the healthcare provider in this context.

Choice B rationale:

Belching is a common symptom of gastrointestinal disorders, but it is not specific to cholelithiasis with a gallstone obstruction. It can be caused by various factors, such as swallowing air, eating too quickly, or drinking carbonated beverages.

While belching might be a symptom the nurse documents, it would not be the most concerning finding to report immediately.

Choice C rationale:

Flatulence is another common gastrointestinal symptom that can have various causes, including dietary choices, bacterial fermentation in the intestines, and certain medications.

It is not specific to cholelithiasis with a gallstone obstruction and would not be the most relevant finding to prioritize reporting.

Choice D rationale:

Yellow sclera, also known as jaundice, is a significant finding that strongly suggests cholestasis, which is the obstruction of bile flow.

Bile, a fluid produced by the liver, aids in digestion and gives stool its brownish color.

When bile flow is obstructed, as in the case of a gallstone lodged in the common bile duct, bilirubin (a component of bile) builds up in the bloodstream and tissues, leading to yellowing of the skin and sclera (the whites of the eyes).

This is a crucial finding to report to the healthcare provider because it indicates a worsening of the patient's condition and the need for prompt intervention to address the obstruction.

A. Chronic pain related to tissue destruction by tumor. B. Anxiety and grieving related to progression of disease. C. Risk for aspiration related to difficulty swallowing. D. Imbalanced nutrition: less than body requirements.

Correct Answer is C

Explanation

Choice A rationale:

Chronic pain is a significant concern for this client, but it is not the immediate priority. Pain can be managed with medications and comfort measures, while aspiration can be life-threatening.

Tissue destruction by the tumor is likely contributing to the pain, but addressing the risk of aspiration takes precedence.

Uncontrolled pain can exacerbate anxiety and make it difficult to focus on other interventions, but ensuring airway safety is paramount.

Choice B rationale:

Anxiety and grieving are expected reactions to a diagnosis of esophageal cancer, and they should be addressed as part of the client's care plan. However, they are not the immediate priority in this case.

The progression of the disease is a significant stressor, but attending to the risk of aspiration is essential for the client's safety. Psychological distress can negatively impact coping and quality of life, but addressing physical needs takes precedence.

Choice D rationale:

Imbalanced nutrition is a concern for this client due to dysphagia and anorexia. However, it is not the immediate priority. Nutritional interventions can be implemented once the risk of aspiration is addressed.

Difficulty swallowing can lead to inadequate intake and malnutrition, but ensuring airway safety is the primary concern.

Anorexia can further contribute to nutritional deficits, but preventing aspiration is the most pressing issue.

Choice C is the priority nursing problem because:

The client's dysphagia puts them at immediate risk for aspiration, which can lead to pneumonia, respiratory failure, and even death.

Addressing the risk of aspiration is essential to ensure the client's safety and prevent life-threatening complications. It's crucial to implement interventions to minimize the risk of aspiration, such as:

Elevating the head of the bed during meals and for 30-60 minutes after eating Thickening liquids and pureeing foods

Encouraging small, frequent meals

Monitoring for signs of aspiration, such as coughing, choking, or difficulty breathing

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A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink without becoming nauseated and vomiting.Which finding should the nurse report to the healthcare provider?

Correct Answer is D

Explanation

The nurse is caring for a client who has been admitted with a diagnosis of esophageal cancer.The client reports a pain level of 8 on a 0 to 10 pain scale, dysphagia, anorexia, anxiety, and a hoarse voice. Which nursing problem is the priority for this client?

Correct Answer is C

Explanation

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