The nurse suspects that the client, hospitalized with severe ulcerative colitis, is experiencing the complication of toxic megacolon. Which assessment finding would support this suspicion?

Increased passage of gas and stool

Enlarging abdominal girth

Hyperactive bowel sounds

Afebrile

Answer and Explanation

The Correct Answer is B

B. Toxic megacolon is characterized by severe colonic dilation, leading to a significant increase in abdominal girth. As the colon becomes distended, it can cause visible abdominal swelling and bloating, which may be accompanied by tenderness upon palpation.
A. In the context of toxic megacolon, there may be a reduction or cessation of bowel movements due to colonic dilation and paralysis.
C. In toxic megacolon, bowel sounds may initially be hyperactive due to increased peristalsis as the colon attempts to overcome the obstruction. However, as the condition progresses, bowel sounds may diminish or become absent due to colonic dilation and paralysis.
D. While fever can be present in toxic megacolon due to the underlying inflammatory process, it is not universally seen in all cases.

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Correct Answer is C

Explanation

C. Decrease the rate to 27.1 mL/hr until the new bag is brought to the unit: This option is a suitable approach to conserve the remaining TPN solution until the new bag arrives. By halving the infusion rate, the remaining volume of TPN will last longer, ensuring the client continues to receive some nutrition and fluid support while awaiting the delivery of the new bag.
A. While it's important to inform the healthcare team about the low volume of TPN remaining, it may not require immediate physician intervention unless the situation worsens or alternative actions need to be taken.
B. Notifying the pharmacy when the bag is empty is a reasonable action, as they can prepare and deliver the next infusion bag promptly. However, it does not address the immediate need for fluid and nutrition replacement.
D. D10W (dextrose 10% in water) can help prevent hypoglycemia and provide some energy, but it does not provide the full nutritional support that TPN does. However, it can be a reasonable short- term measure while waiting for the replacement TPN bag.

A. "Removal of the colon can provide a cure for Crohn's disease." B. "Most people who have Crohn's disease require an ostomy to control the disease, but you will adjust to that." C. "You can expect to lead a totally normal life and may have long periods without symptoms." D. "Your physician will prescribe medications to help you manage Crohn's, but there currently is no cure."

Correct Answer is D

Explanation

D. Crohn's disease is a chronic condition for which there is currently no cure. Treatment focuses on managing symptoms, reducing inflammation, and preventing complications through medications, lifestyle changes
A. Crohn's disease is a chronic condition that can affect any part of the gastrointestinal tract, and surgical removal of affected portions does not eliminate the underlying disease process.
B. While some individuals with Crohn's disease may require surgery resulting in an ostomy, it is not true that most people with Crohn's will need this intervention. Many individuals with Crohn's can manage their symptoms with medications and lifestyle modifications without the need for surgery.
C. Crohn's disease is a chronic illness with unpredictable flare-ups and periods of remission. Managing symptoms and maintaining a good quality of life often require ongoing medical management and lifestyle adjustments.

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The nurse suspects that the client, hospitalized with severe ulcerative colitis, is experiencing the complication of toxic megacolon. Which assessment finding would support this suspicion?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client receiving a TPN Infusion running at 54.2 mL/hr and there is only 25 mL remaining in the bag. The next Infusion bag has not been brought to the unit. Which action would be appropriate?

Correct Answer is C

Explanation

A client newly diagnosed with Crohn's disease asks the nurse what to expect in the future. The best response by the nurse would be:

Correct Answer is D

Explanation

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