A nurse is caring for a client who is admitted to the medical-surgical unit.

Exhibits

Complete the following sentence by using the lists of options.

The nurse anticipates the client will likely require

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as evidenced by the client's 

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A. Discussing stress management strategies such as relaxation exercises is more appropriate in later stages of the relationship, once trust is established.
B. Establishing roles in the initial session is key to a successful therapeutic relationship. The client and
nurse should understand each other’s roles and expectations to foster clear communication and trust.
C. Teaching relaxation exercises may be helpful, but it should come after setting the groundwork for a trusting relationship in the orientation phase.
D. Discussing resources can be beneficial, but it is premature in the orientation phase before the therapeutic relationship is solidified.

Steatorrhea (Fatty stool) Consistent with Crohn's Disease

Steatorrhea refers to the presence of fat in the stool, which often results in fatty, foul-smelling stools. This is seen in Crohn's disease due to malabsorption in the small intestine (especially in the ileum), where fat is not absorbed properly. Ulcerative colitis typically affects the colon, not the small intestine, and does not usually result in steatorrhea. Diverticulitis is an infection or inflammation of diverticula in the colon and is not associated with steatorrhea.

Weight Loss

Consistent with Ulcerative Colitis and Crohn's Disease

Weight loss is a common finding in both ulcerative colitis and Crohn’s disease. In Crohn's disease, weight loss occurs due to malabsorption and inflammatory damage in the gastrointestinal tract. In ulcerative colitis, weight loss can occur during flare-ups due to poor nutrient absorption and inflammation of the colon. Diverticulitis may cause weight loss if it leads to complications like chronic inflammation, but it is not a primary or typical symptom.

Diarrhea

Consistent with Ulcerative Colitis, Diverticulitis and Crohn's Disease

Diarrhea is a hallmark symptom of both ulcerative colitis and Crohn's disease. In ulcerative colitis, diarrhea is usually accompanied by blood and mucus, as the disease primarily affects the colon. In Crohn’s disease, diarrhea is also common, but it may be more chronic and associated with areas of the GI tract other than the colon, such as the small intestine. Diverticulitis typically presents with abdominal pain, fever, and changes in bowel habits- diarrhea in 25% of patients.

Fever

Consistent with Ulcerative Colitis, Diverticulitis, and Crohn's Disease

Fever can be seen in all three conditions, though it is more commonly associated with diverticulitis during an acute infection of the diverticula. Fever in ulcerative colitis and Crohn’s disease can occur during active inflammation or flare-ups, especially if there is significant bowel involvement or complications like perforation or abscess. In Crohn's disease, fever is often seen in more severe or complicated disease phases, but it is not always present. Diverticulitis often presents with fever, especially in the case of an infection or abscess formation.

Anemia

Consistent with Ulcerative Colitis and Crohn's Disease

Anemia can be seen in both ulcerative colitis and Crohn's disease. In ulcerative colitis, chronic blood loss due to inflammation and ulceration in the colon can lead to iron-deficiency anemia. In Crohn's disease, anemia can result from chronic inflammation, bleeding, or malabsorption of nutrients (like iron, vitamin B12, or folic acid). Diverticulitis may also cause anemia, particularly if there is significant bleeding, but it is not a hallmark feature like it is in ulcerative colitis and Crohn’s disease.