A nurse is educating a patient about the risk factors for GERD (gastroesophageal reflux disease). Which of the following statements should the nurse include?

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.

Choice A rationale
This statement is not entirely accurate. Crohn’s disease does not resemble a second-degree burn. It is an inflammatory bowel disease that can affect any part of the gastrointestinal tract.
Choice B rationale
While this statement is technically correct, it uses medical jargon that may be difficult for a patient to understand. Crohn’s disease is indeed characterized by transmural granulomatous inflammation, meaning it affects the entire wall of the gastrointestinal tract. However, this description may not be easily understood by a patient without a medical background.
Choice C rationale
This statement is partially correct but not entirely accurate. Crohn’s disease can cause inflammation in the mucosa and sub-mucosa of the colon and rectal linings, but it is not limited to these areas. It can affect any part of the gastrointestinal tract from the mouth to the anus.
Choice D rationale
This is the most simplistic and non-medical description of the disorder. Crohn’s disease can indeed give the appearance of a “patchwork quilt” in the gastrointestinal tract, with some areas

clear and others inflamed or ulcerated. This description provides a visual analogy that may be easier for a patient to understand.