The nurse is writing a care plan for a client who was diagnosed with Crohn's disease a year ago and is now hospitalized with a fourth acute exacerbation. Which client problem should receive the highest priority?

Fluid overload

Altered body image

Imbalanced nutrition - less than body requirements

Social isolation

Answer and Explanation

The Correct Answer is C

C.   Crohn's disease exacerbation often leads to malnutrition due to decreased oral intake, malabsorption, and increased nutrient losses through diarrhea. Addressing imbalanced nutrition is crucial to replenish depleted nutrient stores, support healing, and prevent further complications.
A.   While fluid overload can be a concern in certain situations, such as when administering intravenous fluids or in clients with renal impairment, it is not typically a primary concern in clients hospitalized with Crohn's disease exacerbation. Crohn's disease is more commonly associated with dehydration due to diarrhea and malabsorption rather than fluid overload.
B.   In the acute phase of Crohn's disease exacerbation, addressing immediate physiological needs and stabilizing the client's condition typically take precedence over psychosocial concerns.
D. Social isolation can be a concern for clients with chronic illnesses, including Crohn's disease, as it may impact their quality of life and emotional well-being. However, in the acute phase of exacerbation, addressing physiological needs and stabilizing the client's condition typically takes precedence over psychosocial concerns such as social isolation.

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Correct Answer is D

Explanation

D. "You will probably begin to notice changes in how you feel with just a few weeks of diet and exercise.": This statement focuses on short-term benefits of weight loss, such as improvements in energy levels, mood, and overall well-being. Teenagers may be more motivated by immediate or short-term results rather than long-term outcomes. Feeling better quickly can provide positive reinforcement and encouragement to continue with healthy habits.
A. Water weight loss may not lead to significant changes in appearance or health outcomes, which are often key motivators for weight loss.
B. This statement emphasizes the importance of making lasting lifestyle changes for successful weight loss, which is a key concept for long-term success. However, it may sound daunting or overwhelming to a teenager.
C. Connecting weight loss to long-term health outcomes is unlikely to motivate some teenagers. This is because most teenagers feel immune to most chronic illnesses.

A. cleans and dries the perianal area after each diarrheal stool. B. uses alcohol compresses to provide relief from anal irritation. C. asks for antidiarrheal medication after each stool. D. takes an hour-long Sitz bath following each stool.

Correct Answer is A

Explanation

A. Cleans and dries the perianal area after each diarrheal stool: This is the correct option. Effective perianal care for a client with diarrhea, such as ulcerative colitis, involves gentle cleansing and thorough drying of the perianal area after each stool. Proper hygiene helps prevent skin breakdown and irritation caused by prolonged contact with stool.
B. Alcohol can be irritating to the skin and may exacerbate perianal irritation and discomfort. Therefore, using alcohol compresses is not considered an appropriate perianal care practice.
C. While antidiarrheal medications may be prescribed for clients with ulcerative colitis to help manage symptoms, asking for medication after each stool is not a typical or recommended approach. The frequency and timing of antidiarrheal medication administration should be based on healthcare provider recommendations and individual symptom management plans.
D. While Sitz baths can provide relief from perianal discomfort and promote healing, taking an hour-long Sitz bath after each stool may be impractical and excessive. Sitz baths are typically recommended for shorter durations (e.g., 10-20 minutes) and may be used periodically rather than after every stool.

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The nurse is writing a care plan for a client who was diagnosed with Crohn's disease a year ago and is now hospitalized with a fourth acute exacerbation. Which client problem should receive the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement made by the nurse to a 14-year-old extremely obese teenager is most likely to motivate him to lose weight?

Correct Answer is D

Explanation

The nurse identifies a client problem of impaired skin integrity related to diarrhea for a client who has ulcerative colitis. The nurse recognizes that teaching about perianal care has been effective when the client:

Correct Answer is A

Explanation

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