The nurse is creating a home care checklist for a patient diagnosed with inflammatory bowel disease (IBD) who is being discharged. The patient had an ostomy from a previous surgery. What interventions will the nurse include in this plan?

Perform weekly occult blood testing with gastric analysis test.

Discuss nutritional management with inclusion of a high-protein, high-vitamin diet.

Leave ostomy site open to air for an hour each day when changing the appliance.

Instruct the patient and family how to give medications through their G-tube.

Answer and Explanation

The Correct Answer is B

Choice A reason: Performing weekly occult blood testing with gastric analysis is not typically required for managing IBD at home. While monitoring for blood in the stool can be important, weekly testing and gastric analysis are more invasive and usually performed under specific medical instructions rather than as a routine home care intervention.

Choice B reason: Discussing nutritional management with the inclusion of a high-protein, high-vitamin diet is crucial for patients with IBD. These patients often experience malnutrition due to poor absorption and increased nutritional needs during flare-ups. A high-protein, high-vitamin diet can help promote healing, maintain muscle mass, and prevent deficiencies. This intervention supports overall health and recovery.

Choice C reason: Leaving the ostomy site open to air for an hour each day when changing the appliance is not recommended. Ostomy sites need to be kept clean and protected to prevent infection and skin irritation. Instead, the focus should be on proper cleaning and secure application of the ostomy appliance.

Choice D reason: Instructing the patient and family on how to give medications through their G-tube is not relevant if the patient has an ostomy. A G-tube is used for feeding and medication administration in patients with impaired oral intake, which is not indicated in this scenario. The focus should be on ostomy care and management.

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Correct Answer is B

Explanation

Choice A reason: An arterial pH less than 7.3 indicates acidosis, which is common in diabetic ketoacidosis but not typical in hyperglycemic hyperosmolar syndrome. Patients with hyperglycemic hyperosmolar syndrome typically have a near-normal pH.

Choice B reason: Altered mental status is a significant clinical manifestation in hyperglycemic hyperosmolar syndrome due to severe hyperglycemia and the hyperosmolar state, which can lead to dehydration and impaired brain function.

Choice C reason: The presence of ketones in urine is more commonly associated with diabetic ketoacidosis rather than hyperglycemic hyperosmolar syndrome. The absence of significant ketonemia differentiates hyperglycemic hyperosmolar syndrome from diabetic ketoacidosis.

Choice D reason: Serum bicarbonate less than 15 mEq/L is indicative of metabolic acidosis, typically seen in diabetic ketoacidosis rather than hyperglycemic hyperosmolar syndrome, where bicarbonate levels are usually normal or slightly decreased.

A. Take your immunosuppressive medications only when you notice symptoms of rejection. B. It's important to avoid exercise for the first year after the transplant. C. You should follow the prescribed medication regimen exactly as directed, even if you feel well. D. You should take herbal supplements to boost your immune system.

Correct Answer is C

Explanation

Choice A reason: Taking immunosuppressive medications only when symptoms of rejection are noticed is incorrect. Immunosuppressive medications must be taken consistently as prescribed to prevent rejection, even when the patient feels well.

Choice B reason: Avoiding exercise for the first year after the transplant is not necessary. Patients are usually encouraged to engage in light to moderate exercise to promote overall health and recovery. The type and level of exercise should be discussed with the healthcare provider.

Choice C reason: Following the prescribed medication regimen exactly as directed is crucial for preventing organ rejection. Consistent use of immunosuppressive medications helps maintain the balance needed to prevent the immune system from attacking the transplanted organ.

Choice D reason: Taking herbal supplements to boost the immune system is incorrect. Patients with organ transplants need to suppress their immune system to prevent rejection. Herbal supplements can interact with immunosuppressive medications and are generally not recommended without consulting a healthcare provider.

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The nurse is creating a home care checklist for a patient diagnosed with inflammatory bowel disease (IBD) who is being discharged. The patient had an ostomy from a previous surgery. What interventions will the nurse include in this plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with type 2 diabetes who has been diagnosed with hyperglycemic hyperosmolar syndrome. What clinical manifestation will the nurse expect to find in this patient?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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