A nurse is caring for a patient in the primary care office who has a recent diagnosis of a hiatal hernia. Which of the following new information will be beneficial for the nurse to relay to the patient?

Choice A rationale
While dietary iron restrictions can contribute to iron-deficiency anemia, they are not typically a symptom of ulcerative colitis. Ulcerative colitis is an inflammatory bowel disease that primarily affects the colon and rectum, and its symptoms are generally related to inflammation and damage in these areas.
Choice B rationale
Chronic blood loss is a common symptom of ulcerative colitis and a major contributing factor to the development of anemia in these patients. This is because the inflammation and ulceration in the colon and rectum can lead to bleeding, which over time can result in a significant loss of red blood cells.
Choice C rationale
Frequent diarrhea is a common symptom of ulcerative colitis, but it does not directly contribute to the development of anemia. However, severe or prolonged diarrhea can lead to malnutrition and malabsorption of nutrients, including iron, which could indirectly contribute to anemia.
Choice D rationale

Abdominal pain is a common symptom of ulcerative colitis, but it does not directly contribute to the development of anemia. The pain is typically caused by inflammation and ulceration in the colon and rectum, not by a loss of red blood cells.

Choice A rationale
Documenting the bowel sounds as hypoactive is not the most appropriate action. Hypoactive bowel sounds are fewer than three bowel sound events in a minute or none at all. However, the absence of bowel sounds does not necessarily mean they are hypoactive. It could be due to other reasons such as ileus.
Choice B rationale
Administering prescribed drugs for constipation is not the immediate course of action when the nurse doesn’t hear any gurgling while listening to bowel sounds. Constipation is a condition that can cause hypoactive bowel sounds, but it’s not the only reason for the absence of bowel sounds. The nurse should first confirm the absence of bowel sounds before considering this action.
Choice C rationale

Reviewing dietary intake for the past 24 hours is not the immediate course of action. While diet can affect bowel sounds, it’s not the first step when bowel sounds are not heard. The nurse should first confirm the absence of bowel sounds before considering this action.
Choice D rationale
The correct action when the nurse doesn’t hear any gurgling while listening to bowel sounds is to continue to listen for at least another 60 seconds. Bowel sounds are produced by the movement of fluid, gas, and contents through the intestines. An absence of bowel sounds for greater than two minutes may indicate that there is no peristalsis—which implies an ileus.
Therefore, the nurse should continue to listen for at least another 60 seconds to confirm the absence of bowel sounds.