A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions. How should the nurse respond?
Instruct the client to avoid foods with gluten, such as wheat bread.
Describe the use of an elimination diet to find trigger foods.
Advise the client to limit foods that are high in calcium and iron.
Explain that the need to restrict fluids is the primary limitation.
The Correct Answer is B
Choice A rationale:
While some individuals with Crohn's disease may find that avoiding gluten improves their symptoms, this is not a universal recommendation.
Gluten restriction is more often indicated for those with celiac disease or gluten sensitivity.
It's important to individualize dietary recommendations based on personal triggers and sensitivities.
Choice B rationale:
An elimination diet is a systematic approach to identifying foods that may trigger or worsen Crohn's disease symptoms.
It involves removing certain foods from the diet for a period of time, typically 2-4 weeks, and then gradually reintroducing them one at a time to observe any reactions.
This process can help individuals pinpoint specific foods that contribute to their symptoms and make informed dietary choices to manage their condition.
Choice C rationale:
There is no evidence to support a general restriction of calcium and iron in individuals with Crohn's disease.
In fact, these nutrients are essential for overall health and should be consumed in adequate amounts unless a specific deficiency or intolerance is identified.
Restriction of these nutrients could lead to nutritional deficiencies.
Choice D rationale:
Fluid restriction is not a primary dietary limitation for individuals with Crohn's disease.
Maintaining adequate hydration is crucial for overall health, especially during flares when fluid loss through diarrhea may be increased.
Restricting fluids could potentially lead to dehydration and electrolyte imbalances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice B rationale:
Isoniazid's Mechanism of Action:
It targets and inhibits the synthesis of mycolic acids, which are essential components of the cell wall of Mycobacterium tuberculosis, the bacteria that cause tuberculosis.
By disrupting cell wall formation, isoniazid prevents bacterial growth and multiplication, leading to the suppression and eventual eradication of the infection.
Clinical Manifestations of Active TB:
Persistent cough, often productive of sputum (phlegm), is a hallmark symptom of TB. The sputum may contain blood or have a rusty-colored appearance.
Other common symptoms include fever, night sweats, fatigue, weight loss, and chest pain. How Isoniazid Reduces Cough and Sputum:
As isoniazid effectively kills the TB bacteria, the inflammatory process within the lungs subsides.
This leads to a gradual decrease in the production of sputum, which is a direct result of the inflammatory response. Consequently, the frequency and severity of coughing episodes also diminish.
Monitoring Treatment Response:
Regular sputum smears and cultures are essential to assess the response to treatment.
A positive sputum smear indicates the presence of live TB bacteria, while a positive culture confirms their growth in the laboratory.
A gradual decrease in the number of bacteria seen on sputum smears, followed by negative cultures, signals a favorable response to treatment.
Timeframe for Improvement:
It's important to note that clinical improvement, including a reduction in cough and sputum, may not be immediately evident. It typically takes several weeks of consistent isoniazid therapy to achieve noticeable results.
Therefore, adherence to the prescribed treatment regimen is crucial for successful TB eradication. Addressing Other Choices:
Choice A: Decreased appetite and weight loss are often associated with active TB due to systemic inflammation and nutritional deficiencies. While isoniazid treatment may indirectly improve appetite and weight gain over time, these are not primary indicators of its effectiveness in suppressing the TB infection itself.
Choice C: Vertigo and tinnitus are potential side effects of isoniazid, but they do not reflect its efficacy in treating TB.
Choice D: A positive sputum smear and culture would indicate ongoing TB infection and a lack of response to treatment.
Correct Answer is D
Explanation
The correct answer is Choice D.
Choice A rationale: Auscultating bowel sounds and measuring abdominal girth are not directly related to the management of erosive esophagitis and GERD symptoms. These actions are more pertinent to assessing gastrointestinal motility and distension, not the effectiveness of lansoprazole.
Choice B rationale: Lansoprazole is a proton pump inhibitor that should be taken before meals to reduce stomach acid production effectively. Confirming that the patient is taking the medication before meals could help optimize its efficacy but is not the most immediate step.
Choice C rationale: Notifying the healthcare provider about a potential need for a dosage change may be considered if symptoms persist. However, since healing with proton pump inhibitors can take several weeks, this action may be premature after only one week of use.
Choice D rationale: It is appropriate to inform the patient that healing of erosive esophagitis and symptom relief from GERD can take several weeks with lansoprazole. This education helps set realistic expectations and encourages adherence to the prescribed treatment.
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