A patient with Crohn’s disease has recently undergone surgery to create an ileostomy.
For which common complication of this type of surgery should the nurse monitor the patient in the postoperative period?

Intestinal obstruction.

Fluid and electrolyte imbalance.

Malabsorption of fat.

Folate deficiency.

Answer and Explanation

The Correct Answer is B

Choice A rationale
While intestinal obstruction can occur after any abdominal surgery, it is not the most common complication following ileostomy creation.
Choice B rationale
Fluid and electrolyte imbalance is a common complication following ileostomy surgery. This is due to the fact that the ileum, which is now rerouted to an external opening in the abdominal wall, is responsible for absorbing a significant amount of fluid and electrolytes. When it is diverted, these substances can be lost, leading to imbalances.
Choice C rationale
Malabsorption of fat is not typically a primary concern following ileostomy surgery. While malabsorption can occur in diseases affecting the ileum, it is not a direct result of the surgery itself.
Choice D rationale
Folate deficiency is not a common complication following ileostomy surgery. The terminal ileum, which is typically used to create the ileostomy, is primarily responsible for the absorption of vitamin B12, not folate.

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Correct Answer is D

Explanation

Choice A rationale

While a bulge at the hernia site is a common symptom of an umbilical hernia, it is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice B rationale
Mild discomfort may be associated with an umbilical hernia, but it is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice C rationale
A bulge that disappears when lying down is a common characteristic of an umbilical hernia and is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice D rationale
Nausea and vomiting could indicate that the hernia has become strangulated, which is a medical emergency. Strangulation occurs when the blood supply to the herniated tissue is cut off. This is a serious complication that requires immediate medical attention.
Question 50.

A. Increase fiber intake B. CT of the abdomen with contrast C. Flexible sigmoidoscopy D. Change IV fluids to 0.9% sodium chloride with KCl E. Type and crossmatch blood F. Administer IV piperacillin-tazobactam

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"C"}}

Explanation

• Increase fiber intake: This is nonessential at this time. While a high-fiber diet can help prevent future episodes of diverticulitis, it won’t help in the acute phase, especially when the client is unable to eat or drink without vomiting.
• CT of the abdomen with contrast: This is an anticipated action. A CT scan can help confirm the diagnosis of diverticulitis and assess the severity of the condition.
• Flexible sigmoidoscopy: This is an anticipated action. A flexible sigmoidoscopy can help visualize the diverticula and assess the extent of the inflammation.

• Change IV fluids to 0.9% sodium chloride with KCl: This is an anticipated action. The client is likely dehydrated due to vomiting and unable to take oral fluids, so IV hydration is necessary. The client’s potassium level is at the lower end of the normal range, so adding KCl to the IV fluids can help prevent hypokalemia.
• Type and crossmatch blood: This is an anticipated action. The client has a positive stool occult blood test and a lower than normal hemoglobin and hematocrit, suggesting that he may be experiencing bleeding. It’s important to have blood ready for a transfusion if necessary.
• Administer IV piperacillin-tazobactam: This is contraindicated. Piperacillin-tazobactam is a penicillin-based antibiotic, and the client has a known allergy to penicillin. Another class of antibiotics should be used. Please note that these are potential actions and the healthcare provider should be informed immediately for further evaluation and management. It’s important to continue following the provider’s prescriptions and closely monitor the client’s condition.

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A patient with Crohn’s disease has recently undergone surgery to create an ileostomy. For which common complication of this type of surgery should the nurse monitor the patient in the postoperative period?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with an umbilical hernia. Which symptom should prompt the nurse to alert the healthcare provider?

Correct Answer is D

Explanation

A nurse is caring for a 45-year-old male client in the emergency department who reports severe abdominal pain. Exhibits Based on the information provided, which of the following provider’s prescriptions are anticipated, nonessential, or contraindicated for the client? Select one response per row.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"C"}}

Explanation

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A patient with Crohn’s disease has recently undergone surgery to create an ileostomy.
For which common complication of this type of surgery should the nurse monitor the patient in the postoperative period?