The nurse is caring for a client with an exacerbation of inflammatory bowel disease: Which of the following orders would be anticipated for this patient?

NG tube placement

Low calorie and low protein diet

Stool softeners and laxatives

Barium contrast imaging studies

Answer and Explanation

The Correct Answer is A

A. NG tube placement:
In patients with an exacerbation of inflammatory bowel disease (IBD), particularly in cases of severe flare-ups, the gastrointestinal tract may need rest, and the patient may have difficulty maintaining adequate nutrition. An NG (nasogastric) tube may be used for enteral feeding if the patient is unable to tolerate oral intake, or to provide bowel rest if indicated. Nutritional support via an NG tube can help provide essential nutrients and manage symptoms during an exacerbation, especially if the patient is experiencing severe nausea, vomiting, or malabsorption.

B. Low calorie and low protein diet:
During an IBD flare, the patient typically needs a higher-calorie, higher-protein diet to support healing and immune function. A low-calorie, low-protein diet would not be appropriate, as it would not provide the necessary nutrients for recovery and tissue repair. In fact, nutritional support is often one of the key components in managing IBD exacerbations. A diet rich in calories and protein is often recommended to prevent malnutrition.

C. Stool softeners and laxatives:
Stool softeners and laxatives are generally contraindicated during an IBD flare, as they can exacerbate diarrhea and increase bowel motility, which may worsen symptoms such as abdominal pain, cramping, and diarrhea. The focus during an exacerbation of IBD is typically on controlling inflammation, rest, and reducing bowel irritation, rather than promoting bowel movements.

D. Barium contrast imaging studies:
Barium contrast imaging studies are generally not performed during an acute exacerbation of IBD because they can cause further irritation to the inflamed bowel. Imaging studies are typically used for diagnosis and assessment of disease extent in a stable or chronic phase, rather than during an acute flare. The priority during a flare is managing symptoms and controlling inflammation, not conducting procedures that could aggravate the condition.

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Correct Answer is B

Explanation

A. Sedate the client with PRN medications so they stay in bed:
Sedating a client to prevent movement is not an appropriate intervention for fall prevention. This approach could have adverse effects, such as increased confusion, sedation, and even a greater risk for falls once the medication wears off. It may also contribute to a decreased level of independence and quality of life for the client. Non-pharmacological interventions such as environmental modifications and supportive devices should be prioritized.

B. Implement the bed alarm and call light system:
Implementing a bed alarm and call light system is an effective and appropriate strategy to prevent falls in an older adult client. The bed alarm alerts the healthcare team when the client attempts to get out of bed, reducing the risk of falls. The call light allows the client to request assistance before attempting to move independently, ensuring timely support and reducing fall risk. This intervention promotes safety while maintaining the client’s autonomy.

C. Ensure all four side rails on the bed are up:
While side rails may prevent a client from falling out of bed, raising all four side rails can increase the risk of injury. Clients may try to climb over the rails, which can lead to entrapment or falls. In addition, side rails can create a false sense of security and reduce the client's ability to mobilize independently. A more appropriate measure would be using one or two side rails or providing assistance with repositioning or transferring when necessary.

D. Avoid night lights in the client's room to promote sleep:
Avoiding night lights is not advisable for older adults, particularly those at risk for falls. A dark environment can increase confusion and disorientation, leading to unsafe movements. Providing soft night lights in the room can enhance visibility during nighttime hours, reducing the likelihood of accidents and falls when the client needs to get up to use the bathroom or reposition. Adequate lighting is a key aspect of fall prevention.

A. Aim to keep your HDL cholesterol as low as possible B. Controlling your diabetes is an important factor C. Exercising and achieving your goal weight are recommended D. Increase saturated fat intake and limit unsaturated fats E. It is important to keep your blood pressure within normal limits

Correct Answer is ["B","C","E"]

Explanation

A) Aim to keep your HDL cholesterol as low as possible:
High-density lipoprotein (HDL) cholesterol is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream, thereby reducing the risk of atherosclerosis and coronary artery disease. The goal should be to raise HDL cholesterol levels, not lower them. Higher levels of HDL are associated with a lower risk of heart disease.

B) Controlling your diabetes is an important factor:
Diabetes is a major risk factor for coronary artery disease (CAD). Uncontrolled blood sugar levels can lead to damage of the blood vessels, increase the risk of atherosclerosis, and raise the likelihood of heart disease. Proper management of diabetes through diet, medication, and lifestyle changes is essential to reduce the risk of CAD.

C) Exercising and achieving your goal weight are recommended:
Regular exercise and maintaining a healthy weight are crucial for reducing the risk of coronary artery disease. Exercise helps improve cardiovascular health, lowers blood pressure, increases HDL cholesterol, and helps control body weight and blood sugar. Achieving and maintaining a healthy weight reduces the strain on the heart and lowers the risk of developing CAD.

D) Increase saturated fat intake and limit unsaturated fats:
Saturated fats can raise low-density lipoprotein (LDL) cholesterol, also known as "bad" cholesterol, which contributes to plaque buildup in the arteries and increases the risk of heart disease. Unsaturated fats, found in foods like olive oil, avocados, and fatty fish, are healthier and can help reduce cholesterol levels and improve heart health. The goal should be to limit saturated fats and increase the intake of unsaturated fats.

E) It is important to keep your blood pressure within normal limits:
High blood pressure is a significant risk factor for coronary artery disease. It can lead to the hardening and narrowing of the arteries, increasing the risk of heart attacks, strokes, and other cardiovascular events. Keeping blood pressure within normal limits through lifestyle changes, such as reducing salt intake, managing stress, exercising, and taking medications if needed, is essential for heart health.

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The nurse is caring for a client with an exacerbation of inflammatory bowel disease: Which of the following orders would be anticipated for this patient?

Nursing Test Bank

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Correct Answer is B

Explanation

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Correct Answer is ["B","C","E"]

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