The nurse is providing education to a client with a history of Crohn's Disease and a new diagnosis of anemia. Which of the following statements by the client would require farther teaching?

"This condition is correlated to chronic blood loss.”

"Villi within my intestine are damaged.”

“Poor nutrition is a causative factor.”

"The ferrous sulfate is prescribed will replace the lost iron.”

Answer and Explanation

The Correct Answer is B

A. "This condition is correlated to chronic blood loss.” : Chronic inflammation and ulceration in Crohn’s disease can cause occult GI bleeding, leading to iron-deficiency anemia.

B. "Villi within my intestine are damaged.”: Crohn’s disease affects the entire intestinal wall, but it does not damage villi specifically. Villi damage occurs in celiac disease, not Crohn’s disease.

C. "Poor nutrition is a causative factor.": Malabsorption of iron, vitamin B12, and folate due to inflammation contributes to anemia in Crohn’s disease.

D. "The ferrous sulfate prescribed will replace the lost iron.": Iron supplements (ferrous sulfate) are commonly prescribed for anemia in Crohn’s disease due to chronic blood loss.

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Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}

Explanation

The client's ammonia level is critically elevated (250 mcg/dL), which can lead to altered mental status, confusion, and lethargy, consistent with hepatic encephalopathy. In cirrhosis, the liver loses its ability to detoxify ammonia, leading to its accumulation in the bloodstream. This excess ammonia crosses the blood-brain barrier, impairing neuronal function and causing hepatic encephalopathy.

Incorrect answers:

DKA is characterized by high blood glucose (>250 mg/dL), metabolic acidosis, and ketonemia. This client has a moderate glucose elevation (148 mg/dL) but no signs of acidosis, Kussmaul respirations, or ketonuria.

Dehydration: While dehydration can contribute to mental status changes, severe hyperammonemia is a direct cause of hepatic encephalopathy. The client's crackles in the lungs and peripheral edema suggest fluid retention, not dehydration.

Acute kidney disease presents with rising creatinine levels, oliguria, and electrolyte imbalances. This client’s creatinine level is normal, ruling out acute kidney disease.

Malnutrition is characterized by low albumin, muscle wasting, and weight loss, but this client's elevated glucose is more likely due to diabetes mellitus rather than malnutrition.

A. Explain the possible surgical procedures available to treat this disorder B. Discuss coping skills to assist with adaptation to required lifestyle modifications C. Educate on possible medication side effects and when to notify the health care provider. D. Provide information on decreasing protein intake to reduce ammonia levels E. Discuss the risks of fluid volume overload and methods to restrict fluid intake

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

Explanation

A. Explain the possible surgical procedures available to treat this disorder: Clients with IBD, particularly ulcerative colitis, may require surgical interventions such as colectomy or ileostomy if medical management fails. Providing information about surgical options helps clients make informed decisions.

B. Discuss coping skills to assist with adaptation to required lifestyle modifications: IBD significantly affects daily life, including dietary changes, medication adherence, and emotional well-being. Teaching coping strategies helps clients manage stress and improve quality of life.

C. Educate on possible medication side effects and when to notify the healthcare provider: Medications for IBD (e.g., corticosteroids, immunosuppressants, biologics) have side effects such as increased infection risk, osteoporosis, and GI disturbances. Patients should be informed about when to seek medical attention.

D. Provide information on decreasing protein intake to reduce ammonia levels: This advice is more relevant to liver disease, such as cirrhosis, where protein restriction can help manage hepatic encephalopathy. In IBD, adequate protein intake is needed to prevent malnutrition.

E. Discuss the risks of fluid volume overload and methods to restrict fluid intake: Clients with IBD are at risk for dehydration due to diarrhea and malabsorption. Increasing fluid intake, rather than restricting it, is often necessary.

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The nurse is providing education to a client with a history of Crohn's Disease and a new diagnosis of anemia. Which of the following statements by the client would require farther teaching?

Nursing Test Bank

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Explanation

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