A nurse is attending to a client who has just been admitted due to an acute exacerbation of ulcerative colitis. What should be the nurse’s initial course of action?
Investigate the client’s emotional concerns.
Check the client’s perianal skin integrity.
Obtain a dietary history from the client.
Review the client’s electrolyte values.
The Correct Answer is B
Choice A rationale
While emotional concerns are important to address in a holistic care approach, they are not the initial course of action when a client is admitted due to an acute exacerbation of ulcerative colitis. Emotional concerns are usually addressed once the client’s physical condition is stabilized.
Choice B rationale
Checking the client’s perianal skin integrity is a crucial initial step when a client is admitted due to an acute exacerbation of ulcerative colitis. Ulcerative colitis can cause rectal bleeding and diarrhea, which can lead to skin breakdown in the perianal area. Therefore, assessing for skin integrity helps in early detection and management of potential skin complications.
Choice C rationale
Obtaining a dietary history from the client is important but not the initial course of action in this scenario. Dietary history is usually obtained once the client’s condition is stabilized and when planning for discharge or dietary modifications.
Choice D rationale
Reviewing the client’s electrolyte values is important in managing ulcerative colitis, but it’s not the initial course of action. Electrolyte imbalances can occur due to diarrhea and
malabsorption, which are common in ulcerative colitis. However, this is usually done after initial physical assessments and stabilization of the client.
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Related Questions
Correct Answer is A
Explanation
Choice A rationale
A stool guaiac test is a simple check to find blood in your stool. It involves smearing a tiny amount of your stool on a special card, which is then tested for hidden blood. This test helps detect problems like bleeding ulcers or colon cancer in an early stage when they might not show other symptoms. The stool guaiac test looks for hidden (occult) blood in a stool sample. It can find blood even if you cannot see it yourself. It is a common type of fecal occult blood test (FOBT). Guaiac is a substance from a plant that is used to coat the FOBT test cards to make them able to detect blood.
Choice B rationale
Steatorrhea refers to the presence of excess fat in the stool. While this can be a symptom of various digestive disorders, it is not what a stool guaiac test is designed to detect. The primary purpose of a stool guaiac test is to identify hidden blood in the stool, which can be an indicator of conditions such as gastrointestinal bleeding or colon cancer.
Choice C rationale
While bacteria can be present in the stool and certain tests are designed to detect them, a stool guaiac test is not one of these. The stool guaiac test is specifically designed to detect the presence of hidden blood in the stool. The presence of blood can indicate a variety of conditions, including gastrointestinal bleeding or colon cancer.
Choice D rationale
Yeast can be present in the stool, and certain tests can detect it. However, a stool guaiac test is not designed to detect yeast. The primary purpose of a stool guaiac test is to identify hidden
blood in the stool, which can be an indicator of conditions such as gastrointestinal bleeding or colon cancer.
Correct Answer is B
Explanation
Choice A rationale
While chronic exposure to UV rays can cause skin dryness, it does not decrease the water content of the skin20. Skin dryness is more of a symptom rather than a risk factor for skin cancer20.
Choice B rationale
Chronic exposure to UV rays can cause an error in the skin’s genetic code20. This can lead to the development of skin cancer, as the damaged DNA can lead to uncontrolled cell growth20.
Choice C rationale
Increased blood flow to the skin is not a direct result of chronic exposure to UV rays20. While UV rays can cause skin redness and inflammation, these are not directly linked to an increased risk of skin cancer20.
Choice D rationale
Chronic exposure to UV rays does not cause degeneration of elastic fibers in skin tissue20. While UV rays can cause skin aging and wrinkles, these are not direct risk factors for skin cancer20. Diabetic retinopathyDiabetic retinopathy Explore
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