A nurse is caring for a client.

For each assessment finding, click to specify if the finding is consistent with ulcerative colitis, diverticulitis, or Crohn's disease. Each finding may support more than 1 disease process.

A. Obtain a brain natriuretic peptide (BNP) test: BNP is a marker of heart failure and is indicated given the client’s new-onset dyspnea, crackles, and S3/S4 heart sounds. Measuring BNP helps assess for possible acute decompensated heart failure following surgery.

B. Obtain a complete blood count: A CBC helps identify infection, anemia, or other hematologic changes that could contribute to dyspnea, tachypnea, or hypoxia in the postoperative client. The client’s fever and tachycardia warrant this assessment.

C. Request respiratory therapy for intubation: Intubation is not immediately indicated as the client is still alert, maintaining oxygen saturation of 92% on supplemental oxygen. Less invasive diagnostics and interventions are prioritized first.

D. Obtain a STAT MRI: MRI is not the first-line diagnostic tool for acute dyspnea and postoperative cardiopulmonary assessment. It is not indicated in emergent evaluation of pulmonary or cardiac complications.

E. Obtain ABGs: Arterial blood gases are important to assess oxygenation, ventilation, and acid-base status given the client’s tachypnea, hypoxemia, and sudden respiratory distress.

F. Prepare the client for cardiac catheterization: Cardiac catheterization is invasive and not the immediate priority. Initial noninvasive assessment should guide the need for further intervention.

G. Obtain a chest x-ray: A chest x-ray is indicated to assess for pulmonary edema, pleural effusion, or other cardiopulmonary complications in a postoperative client presenting with dyspnea, crackles, and hypoxia.

Rationale

• Diarrhea: Diarrhea is common in both ulcerative colitis and Crohn's disease because chronic inflammation disrupts absorption and increases motility. UC typically presents with bloody diarrhea, while Crohn’s can present with non-bloody, intermittent diarrhea. Diverticulitis more often presents with left-lower-quadrant pain and constipation rather than chronic diarrhea.

• Steatorrhea: Steatorrhea is strongly associated with Crohn’s disease due to small-bowel involvement leading to fat-malabsorption. UC affects only the colon and does not impair fat absorption, so steatorrhea is not expected. Diverticulitis is a localized colonic infection and does not interfere with digestion or absorption.

• Weight loss: Weight loss occurs in both UC and Crohn’s because chronic inflammation increases metabolic demand and reduces nutritional intake. Malabsorption in Crohn’s disease further contributes to weight loss severity. Weight loss is not typical in diverticulitis unless the condition is prolonged or severe, so it is not strongly associated.

• Anemia: Anemia appears in both UC and Crohn’s disease due to chronic blood loss, reduced intake, and inflammation-driven suppression of erythropoiesis. UC often causes iron-deficiency anemia from recurrent rectal bleeding. Crohn’s may also cause anemia due to B12 or iron malabsorption. Diverticulitis does not typically cause chronic anemia.

• Fever: Fever is a sign of active inflammation and can occur in UC, Crohn’s flares, and acute diverticulitis. UC and Crohn’s involve systemic inflammatory activity during exacerbations. Diverticulitis produces fever due to infection of the diverticulum, making fever consistent across all three in varying degrees.