The patient provides three positive responses to items on the CAGE (Cut down, Annoyed, Guilty, Eye-opener) query.
What interpretation should the nurse provide to the patient?

The correct answer is Choice A

Choice A rationale: Crohn’s disease involves transmural inflammation of the gastrointestinal tract, often leading to hypermotility and increased peristalsis. Activity restriction reduces sympathetic stimulation, thereby minimizing intestinal motility and mechanical stress on inflamed mucosa. This helps prevent exacerbation of symptoms and promotes mucosal rest. By limiting physical exertion, the body can redirect energy toward immune modulation and tissue repair. Normal bowel motility varies, but excessive activity worsens inflammation and nutrient malabsorption in Crohn’s pathology.

Choice B rationale: While diarrhea is a common symptom in Crohn’s disease, activity restriction does not directly modulate stool frequency or water reabsorption. Diarrhea results from mucosal damage, cytokine-mediated secretion, and impaired absorption, not physical activity. Management typically involves anti-inflammatory agents, antidiarrheals, and dietary modifications. Restricting movement may indirectly reduce diarrhea by decreasing intestinal stimulation, but it is not the primary mechanism. Stool water content normally ranges from 60–85%, and inflammation disrupts this balance.

Choice C rationale: Healing in Crohn’s disease is multifactorial, involving immunosuppression, mucosal regeneration, and nutritional support. While rest contributes to systemic recovery, it is not the primary driver of mucosal healing. Healing requires suppression of TNF-alpha, IL-6, and other pro-inflammatory mediators. Activity restriction may support healing indirectly by reducing metabolic demand and stress hormone release, but pharmacologic and nutritional interventions are more central. Normal mucosal turnover occurs every 3–5 days, but inflammation delays this process.

Choice D rationale: Abdominal pain in Crohn’s disease arises from transmural inflammation, bowel distension, and neural sensitization. Although rest may reduce visceral stimulation, pain control is better achieved through anti-inflammatory therapy, bowel rest, and analgesics. Activity restriction does not directly modulate nociceptive pathways or cytokine levels. Pain perception involves complex neuroimmune interactions, and physical rest alone cannot address the underlying pathology. Normal visceral pain thresholds are altered in Crohn’s due to chronic inflammation and fibrosis.

Choice A rationale
While obtaining a serum drug screen might be helpful in confirming the presence of benzodiazepines or other substances, it is not the most immediate concern in a client experiencing severe agitation and tremors due to withdrawal.
Choice B rationale
Naloxone is an opioid antagonist and would not be effective in managing withdrawal symptoms from benzodiazepines.
Choice C rationale
Seizure precautions should be initiated as withdrawal from benzodiazepines can lead to severe withdrawal symptoms, including seizures. Therefore, ensuring the safety of the client by initiating seizure precautions is the best initial nursing action.
Choice D rationale

While education is an important part of nursing care, in this situation, the client’s immediate physical needs take precedence.