A nurse is completing dietary teaching with a client who has the inflammatory bowel disorder ulcerative colitis. Which of the following statements by the client indicates an understanding of the teaching?

"I should choose cold foods over warm foods."

"I should follow a low-protein diet."

"I should increase my fiber intake to 35 grams a day."

"I should eat small, frequent meals throughout the day."

Answer and Explanation

The Correct Answer is D

A) "I should choose cold foods over warm foods.": Cold foods are not necessarily better than warm foods for someone with ulcerative colitis. The choice of temperature depends on individual tolerance, but there is no specific recommendation that cold foods are preferable. Warm, easily digestible foods can also be soothing and well-tolerated.

B) "I should follow a low-protein diet.": This is not an accurate recommendation for ulcerative colitis. Protein is essential for healing and maintaining muscle mass, especially if the client is experiencing malnutrition or weight loss due to the disease. A balanced diet with adequate protein is important for overall health.

C) "I should increase my fiber intake to 35 grams a day.": High fiber intake can be problematic for those with active ulcerative colitis as it may increase symptoms such as bloating, gas, and diarrhea. It is often recommended to limit fiber intake during flare-ups and focus on low-residue diets to reduce bowel activity.

D) "I should eat small, frequent meals throughout the day.": This is a recommended approach for managing ulcerative colitis. Small, frequent meals can help ensure adequate nutrient intake without overwhelming the digestive system, which can help manage symptoms and improve overall comfort.

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Correct Answer is A

Explanation

A) High-pitched bowel sounds: High-pitched bowel sounds, also known as "tinkling" sounds, are characteristic of mechanical bowel obstructions. These sounds are created by the intestines as they try to move contents past the obstruction, resulting in increased peristaltic activity. In the case of intussusception, where one segment of the intestine telescopes into another, the obstruction can cause these distinctive high-pitched sounds due to the narrowing of the bowel lumen.

B) Abdominal bruit: An abdominal bruit is a swishing sound heard over the abdomen, usually indicating turbulent blood flow through narrowed arteries. It is commonly associated with vascular conditions such as atherosclerosis or renal artery stenosis. It is not related to bowel obstruction, as bowel sounds in obstruction cases are generally due to changes in peristaltic activity rather than blood flow.

C) Bruising on the flank area: Bruising on the flank area, known as Grey Turner's sign, is typically seen in conditions involving retroperitoneal hemorrhage, such as severe pancreatitis or trauma. It is not a symptom of bowel obstruction. Bowel obstruction symptoms generally relate to the gastrointestinal tract and include abdominal pain, distension, and altered bowel sounds.

D) Coffee-ground emesis: Coffee-ground emesis is vomit that appears like coffee grounds, indicating the presence of partially digested blood. This is a sign of upper gastrointestinal bleeding, often due to peptic ulcers or gastritis. In mechanical bowel obstruction, vomiting is more likely to contain bile (bilious vomiting) and may occur if the obstruction is high in the small intestine. The appearance of coffee-ground emesis is not typical for bowel obstructions and indicates a different type of gastrointestinal issue.

A. Administer a dose of subcutaneous epinephrine. B. Advise the client not to consume grapefruit products. C. Place warm compresses on both sides of the client's face. D. Swab the client's oral mucosa with nystatin suspension.

Correct Answer is A

Explanation

A. Administer a dose of subcutaneous epinephrine.: The swelling of the lips and tongue is indicative of angioedema, a serious adverse reaction to captopril. Epinephrine is the first-line treatment for severe allergic reactions or angioedema to quickly counteract the swelling and prevent airway obstruction.

B. Advise the client not to consume grapefruit products.: Grapefruit can interact with some medications, but it is not related to the management of angioedema. This action would be more relevant for drugs metabolized by CYP3A4, not specifically for angioedema.

C. Place warm compresses on both sides of the client's face.: Warm compresses are not appropriate for angioedema and may not address the underlying issue. This action does not manage the immediate, potentially life-threatening reaction caused by captopril.

D. Swab the client's oral mucosa with nystatin suspension.: Nystatin is used for fungal infections of the oral mucosa, not for angioedema. This action does not address the adverse reaction related to captopril.

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A nurse is completing dietary teaching with a client who has the inflammatory bowel disorder ulcerative colitis. Which of the following statements by the client indicates an understanding of the teaching?

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Explanation

A nurse is monitoring a client who is taking captopril and has developed swelling of the lips and tongue. Which of the following actions should the nurse plan to take to manage this adverse medication reaction?

Correct Answer is A

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