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.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Total protein is a measure of the overall protein content in the blood. It includes albumin and globulin.
While it can be helpful in assessing nutritional status and liver function, it is not directly relevant to the client's current symptoms of pallor and fatigue.
Decreased total protein can indicate malnutrition or liver disease, but these conditions would not typically cause the specific symptoms of pallor and fatigue.
Therefore, total protein is not the most important laboratory value to review in this case.
Choice B rationale:
Hemoglobin is the protein in red blood cells that carries oxygen throughout the body.
Paleness (pallor) is a common sign of anemia, which is a condition characterized by a low hemoglobin level. Fatigue is also a common symptom of anemia, as the body's tissues are not receiving enough oxygen.
Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), can cause gastrointestinal bleeding, which can lead to anemia. Therefore, it is essential for the nurse to review the client's hemoglobin level to assess for potential anemia.
Choice C rationale:
Glucose is a type of sugar that the body uses for energy.
Abnormal glucose levels can cause various symptoms, including fatigue. However, glucose levels would not typically cause pallor.
Additionally, there is no indication in the question stem that the client has any risk factors for diabetes or other disorders that affect glucose metabolism.
Therefore, glucose is not the most likely cause of the client's symptoms.
Choice D rationale:
Sodium is an electrolyte that helps regulate fluid balance in the body.
Abnormal sodium levels can cause various symptoms, including fatigue and weakness. However, sodium levels would not typically cause pallor.
Additionally, there is no indication in the question stem that the client has any risk factors for electrolyte imbalances. Therefore, sodium is not the most likely cause of the client's symptoms.
Correct Answer is C
Explanation
Choice A rationale:
Sterile gloves are not necessary for routine oral care, even in the presence of oral Candida albicans.
Standard precautions, which include the use of gloves, are sufficient to protect the UAP from exposure to blood and body fluids.
Sterile gloves would only be indicated for invasive procedures, such as oral surgery or deep tissue sampling.
Choice B rationale:
Delegating oral care to the UAP is appropriate, as it is a routine task that does not require the specialized skills of a nurse.
The nurse should provide clear instructions to the UAP on how to perform oral care, but it is not necessary for the nurse to complete the task themselves.
Choice C rationale:
Using a soft-bristled toothbrush is important for patients with oral Candida albicans, as it can help to remove plaque and debris without further irritating the delicate tissues of the mouth.
A soft-bristled toothbrush is less likely to cause bleeding or pain than a harder-bristled toothbrush.
Choice D rationale:
Mouthwash is not typically recommended for patients with oral Candida albicans, as it can actually dry out the mouth and worsen symptoms.
In some cases, a healthcare provider may prescribe a special antifungal mouthwash, but this should only be used under their supervision.
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