A client with ulcerative colitis is experiencing persistent diarrhea. What should the nurse anticipate during the assessment of the client?

Hypotension due to vasodilation

Dehydration due to fluid loss

Hyperkalemia due to potassium retention

Weight gain due to improved absorption

Answer and Explanation

The Correct Answer is B

A. Hypotension due to vasodilation: Hypotension from diarrhea is due to volume depletion (hypovolemia), not primary vasodilation; vasodilation is not the main mechanism.

B. Dehydration due to fluid loss: Persistent diarrhea causes significant fluid and electrolyte losses leading to dehydration - this is the expected and priority assessment finding.

C. Hyperkalemia due to potassium retention: Diarrhea typically causes potassium loss and hypokalemia, not hyperkalemia.

D. Weight gain due to improved absorption: Ongoing diarrhea causes weight loss from fluid and nutrient loss; weight gain would not be expected.

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Correct Answer is A

Explanation

A. Cirrhosis:Alcohol-related liver damage impairs synthesis of clotting factors, leading to easy bruising, bleeding, and nosebleeds. Portal hypertension may also contribute to coagulopathy.

B. Diabetes mellitus:Diabetes can cause microvascular complications over time but does not directly cause easy bruising or spontaneous bleeding.

C. Cholecystitis:Inflammation of the gallbladder causes right upper quadrant pain and digestive symptoms, but does not affect clotting or platelet function.

D. Hepatitis A:Hepatitis A causes acute liver inflammation and jaundice but is usually self-limiting and does not typically result in frequent spontaneous bleeding in adults.

A. Decreased liver enzymes B. Decreased platelets C. Elevated sodium levels D. Elevated albumin level

Correct Answer is B

Explanation

A. Decreased liver enzymes: Liver enzymes may initially be elevated due to liver inflammation, but in end-stage cirrhosis they may appear normal or even low due to massive hepatocyte loss. A decreased enzyme level does not reliably indicate improved liver function.

B. Decreased platelets:Thrombocytopenia occurs because portal hypertension causes splenic enlargement, leading to platelet sequestration. In addition, reduced hepatic production of thrombopoietin further lowers platelet count, making this a common finding.

C. Elevated sodium levels:Cirrhosis commonly leads to low sodium (hyponatremia) due to fluid retention, activation of antidiuretic hormone, and impaired renal function. Elevated sodium would not typically be expected in advanced liver disease.

D. Elevated albumin level:Because the liver synthesizes albumin, cirrhosis results in decreased production. This leads to low albumin levels, contributing to edema and ascites due to reduced oncotic pressure. Elevated albumin is not consistent with cirrhosis.

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A client with ulcerative colitis is experiencing persistent diarrhea. What should the nurse anticipate during the assessment of the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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