An acute care nurse receives a shift report for a client who has increased intracranial pressure. The nurse is told that the client demonstrates decorticate posturing. Which of the following findings should the nurse expect to observe when assessing the client?

Choice A Reason:

Weight gain is not typically associated with tuberculosis (TB). In fact, weight loss is a common symptom of TB due to the chronic nature of the infection and the body’s increased metabolic demands to fight the disease. Patients with TB often experience a loss of appetite and significant weight loss as the disease progresses.

Choice B Reason:

Low-grade fever is a common symptom of TB. The body’s immune response to the infection often results in a persistent low-grade fever, which can be one of the early signs of the disease. This fever is usually accompanied by other systemic symptoms such as night sweats and fatigue.

Choice C Reason:

Dyspnea, or difficulty breathing, can occur in patients with TB, especially if the infection has caused significant lung damage or if there is a large amount of fluid in the pleural space (pleural effusion). Dyspnea is a concerning symptom that indicates the need for further evaluation and treatment.

Choice D Reason:

Contusion, or bruising, is not a symptom associated with TB. TB primarily affects the lungs and can cause systemic symptoms, but it does not typically cause bruising. Contusions are more commonly associated with trauma or conditions that affect blood clotting.

Choice E Reason:

Lethargy, or a general sense of fatigue and weakness, is a common symptom of TB. The chronic nature of the infection and the body’s ongoing immune response can lead to significant fatigue. Patients with TB often feel tired and may have difficulty performing daily activities.

Choice F Reason:

Night sweats are a hallmark symptom of TB. Patients often experience drenching night sweats that can be quite severe. This symptom, along with fever and weight loss, is part of the classic triad of TB symptoms and is an important indicator for healthcare providers to consider TB in the differential diagnosis.

Order a high-fiber diet

Choice A Reason:

Encourage dietary intake

Encouraging dietary intake is generally important for maintaining nutritional status, but it is not specific to the preparation for a barium enema. The preparation for a barium enema typically involves dietary restrictions to ensure the colon is clear for the procedure. Therefore, this choice is not correct.

Choice B Reason:

Encourage plenty of fat

Encouraging plenty of fat is not appropriate for the preparation of a barium enema. High-fat foods can slow down the digestive process and may interfere with the clarity of the images obtained during the procedure. Therefore, this choice is not correct.

Choice C Reason:

Serve dairy products

Serving dairy products is not recommended before a barium enema. Dairy products can cause gas and bloating, which can interfere with the procedure. Additionally, some patients may be lactose intolerant, which can further complicate the preparation. Therefore, this choice is not correct.

Choice D Reason:

Order a high-fiber diet

Ordering a high-fiber diet is the correct choice. A high-fiber diet helps to clear the intestines by promoting bowel movements. This is important for ensuring that the colon is empty and clear for the barium enema, which allows for better imaging and more accurate results.