A nurse collects the health history of a 65-year-old client. Which of the following risk factors in the client's history puts the client at the highest risk for embolic stroke?

Choice A Reason: Sweating and pallor are early signs and symptoms of dumping syndrome, which is a condition where food moves too quickly from the stomach to the small intestine, causing rapid fluid shifts and hormonal changes. Sweating and pallor are caused by hypoglycemia, which occurs when the high concentration of food in the small intestine stimulates insulin secretion.

Choice B Reason: Abdominal cramping and pain are late signs and symptoms of dumping syndrome, which occur about one to three hours after eating. Abdominal cramping and pain are caused by intestinal distension, spasms, and gas formation.

Choice C Reason: Double vision and chest pain are not signs and symptoms of dumping syndrome, but may indicate other serious conditions, such as stroke or heart attack. Double vision and chest pain should be reported to the provider immediately.

Choice D Reason: Bradycardia and indigestion are not signs and symptoms of dumping syndrome, but may be related to other gastrointestinal disorders, such as gastritis or peptic ulcer disease. Bradycardia and indigestion should be evaluated by the provider for further diagnosis and treatment.

Choice A reason: This is the correct answer because both ulcerative colitis and Crohn's disease are inflammatory bowel diseases (IBD) that cause chronic inflammation of the digestive tract. The inflammation can cause symptoms such as abdominal pain, diarrhea, bleeding, weight loss, or fever. The nurse should educate the client on how to manage inflammation and prevent complications.

Choice B reason: This is incorrect because both ulcerative colitis and Crohn's disease do not affect the entire alimentary canal, but different parts of it. Ulcerative colitis affects only the colon (large intestine) and rectum, while Crohn's disease can affect any part of the digestive tract from mouth to anus, most commonly the ileum (the last part of the small intestine). The nurse should explain the differences in location and extent of
the diseases.

Choice C reason: This is incorrect because both ulcerative colitis and Crohn's disease do not always require a bowel diversion, but only in some cases. A bowel diversion is a surgical procedure that creates an opening (stoma) in the abdomen to divert fecal matter into an external bag or pouch. It may be done to treat severe complications such as perforation, obstruction, fistula, or cancer. The nurse should inform the client about the indications, types, and care of bowel diversions.

Choice D reason: This is incorrect because both ulcerative colitis and Crohn's disease are not caused by low-fat, high-fiber diets, but by unknown factors. The exact causes of IBD are not clear, but they may involve genetic, immune, environmental, or microbial factors. Low-fat, high-fiber diets may help prevent or reduce symptoms of IBD, but they do not cause them. The nurse should advise the client on how to follow a balanced and nutritious diet that suits their individual needs and preferences.