A client has had an exacerbation of Ulcerative Colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which complication?
heart failure
hypokalemia
deep vein thrombosis
hypocalcemia
The Correct Answer is B
A. heart failure: While severe fluid loss and electrolyte imbalances can increase cardiac workload, heart failure is not a common direct complication of ulcerative colitis exacerbations. The primary concerns are related to volume depletion, electrolyte disturbances, and systemic inflammation rather than chronic cardiac dysfunction in the acute phase.
B. hypokalemia: Persistent diarrhea associated with ulcerative colitis results in significant loss of potassium through the stool. Hypokalemia can lead to muscle weakness, cardiac dysrhythmias, and decreased gastrointestinal motility. Monitoring serum potassium and initiating replacement therapy as needed are critical during prolonged diarrheal episodes.
C. deep vein thrombosis: Inflammatory bowel disease increases the risk of hypercoagulability, which can contribute to deep vein thrombosis. However, this is less immediate than electrolyte disturbances during an acute flare. DVT assessment is important but is not the first priority when evaluating a client with ongoing diarrhea.
D. hypocalcemia: Although malabsorption can eventually lead to calcium deficits, acute ulcerative colitis exacerbations rarely cause immediate hypocalcemia. Calcium loss is not directly linked to short-term diarrhea, making hypocalcemia a less likely acute complication.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
A. Genetics: A family history of multiple sclerosis (MS) increases susceptibility, indicating a genetic predisposition. Specific human leukocyte antigen (HLA) genes are associated with higher risk, suggesting that inheritance plays a role in disease development, though MS is not strictly hereditary.
B. Environmental factors: Geographic location, low vitamin D levels, and reduced sun exposure have been implicated as environmental contributors to MS. Epidemiologic studies show higher prevalence in temperate regions, supporting the influence of environmental conditions on disease risk.
C. Upper respiratory infections: While infections (specifically viral infections like Epstein-Barr) are being studied as potential triggers that might kickstart the autoimmune response in susceptible people, ordinary bacterial URIs or UTIs are not identified as causes of the development of the disease.
D. Autoimmune factors: MS is widely considered an autoimmune disorder in which the body’s immune system erroneously targets central nervous system myelin. T-cell and B-cell mediated immune responses lead to demyelination and axonal injury, driving the characteristic neurologic deficits.
E. Urinary tract infections: While urinary tract infections are common complications in clients with MS due to neurogenic bladder dysfunction, they are not causative factors in the development of the disease. They exacerbate symptoms but do not contribute to disease onset.
Correct Answer is C
Explanation
A. Diverticulitis: Diverticulitis typically presents in older adults with left lower quadrant abdominal pain, fever, and sometimes changes in bowel habits. While diarrhea can occur, chronic bloody stools and systemic symptoms like weight loss are not characteristic. Extraintestinal manifestations such as joint pain are uncommon in diverticulitis.
B. Colon cancer: Colon cancer may cause changes in bowel habits, occult bleeding, and weight loss, but it is less common in young adults and usually does not present with recurrent diarrhea, fecal urgency, or widespread joint pain. The combination of bloody stools and systemic inflammatory symptoms points to an inflammatory bowel disease rather than malignancy.
C. Ulcerative Colitis: Ulcerative colitis typically presents with bloody diarrhea, fecal urgency, cramping abdominal pain (commonly in the left lower quadrant), and weight loss. Extraintestinal manifestations, including arthritis affecting large joints such as elbows and knees, are common. The client’s age, symptom pattern, and joint involvement strongly support ulcerative colitis.
D. Crohn Disease: Crohn’s disease can cause diarrhea, abdominal pain, weight loss, and extraintestinal symptoms. However, Crohn’s often involves the terminal ileum and presents with patchy, transmural inflammation. Bloody diarrhea is less prominent than in ulcerative colitis, and pain is more often right-sided or diffuse rather than strictly left lower quadrant.
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