A nurse is completing discharge teaching with a patient who has irritable bowel syndrome (IBS). Which of the following instructions should the nurse include?
Limit fluid intake to 1L each day.
Keep a food diary to identify triggers.
Plan three moderate to large meals per day.
Consume 12 to 20g of fiber daily.
The Correct Answer is B
Choice A rationale
Limiting fluid intake to 1L each day is generally not recommended for individuals with irritable bowel syndrome (IBS) unless specifically indicated due to other co-existing conditions. Adequate hydration is important for overall health and can help prevent constipation, a common symptom of IBS. General recommendations for fluid intake are around 2-3 liters per day, depending on individual needs and activity levels.
Choice B rationale
Keeping a food diary is a valuable strategy for individuals with irritable bowel syndrome (IBS) to identify specific food triggers that exacerbate their symptoms such as abdominal pain, bloating, diarrhea, or constipation. By meticulously recording food intake and associated symptoms, patients can often discern patterns and work with healthcare providers to develop an individualized dietary management plan.
Choice C rationale
Planning three moderate to large meals per day might not be suitable for all individuals with irritable bowel syndrome (IBS). Some people with IBS find that smaller, more frequent meals are better tolerated as large meals can distend the bowel and trigger symptoms. Individual responses to meal size and frequency can vary significantly.
Choice D rationale
While fiber is generally beneficial for bowel regularity, a blanket recommendation of 12 to 20g of fiber daily might not be appropriate for all individuals with irritable bowel syndrome (IBS). For some individuals, particularly those with diarrhea-predominant IBS, increasing fiber intake too quickly or consuming certain types of high-fiber foods can worsen their symptoms. Fiber intake should be individualized and often increased gradually.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Discussing the client's anxiety only after obtaining consent dismisses their current emotional state and fails to address their immediate concerns about pain. Addressing anxiety proactively fosters trust and ensures the client feels heard and supported before proceeding with the procedure. Delaying the conversation can increase the client's anxiety levels.
Choice B rationale
While the provider may administer a sedative, this statement doesn't fully address the client's anxiety about potential pain. It provides information about medication but doesn't offer reassurance or acknowledge the client's feelings. A more comprehensive approach would involve both medication and supportive communication.
Choice C rationale
Minimizing the client's anxiety by comparing it to the bowel preparation can be dismissive and doesn't validate their feelings about the procedure itself. Each individual experiences procedures differently, and focusing on the discomfort of the preparation might not alleviate their fear of pain during the colonoscopy.
Choice D rationale
Acknowledging the client's anxiety validates their feelings and establishes a supportive nurse-client relationship. Reassuring the client that measures will be taken to ensure their comfort directly addresses their concern about pain. This approach promotes trust and can help reduce the client's anxiety about the procedure.
Correct Answer is A
Explanation
Choice A rationale
Both ulcerative colitis and Crohn's disease are classified as inflammatory bowel diseases (IBD). This means that both conditions involve chronic inflammation of the gastrointestinal tract, although the specific areas affected and the patterns of inflammation differ between the two diseases.
Choice B rationale
Ulcerative colitis typically begins in the rectum and extends proximally in a continuous manner through the colon. Crohn's disease, however, can affect any part of the gastrointestinal tract, from the mouth to the anus, and often presents with patchy, discontinuous areas of inflammation.
Choice C rationale
Fistula formation, an abnormal connection between two body parts, is a common complication of Crohn's disease due to its transmural (full-thickness) inflammation of the bowel wall. While less common, fistulas can occur in ulcerative colitis in severe cases, but it is not a typical manifestation.
Choice D rationale
While surgery may be necessary for managing both ulcerative colitis and Crohn's disease in cases of severe symptoms or complications, it is generally considered a more definitive treatment for ulcerative colitis, often involving a colectomy (removal of the colon). Crohn's disease often recurs after surgery, making it a less frequent primary treatment.
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