A nurse is monitoring the urinary output of an adult client who had a colon resection.
Which of the following 24-hr output totals indicates oliguria?

Choice A rationale

While laboratory testing may eventually be necessary to identify the cause of diarrhea, the immediate priority is to gather more information about the patient's condition. Jumping directly to testing without understanding the symptoms could delay appropriate initial interventions and fail to address immediate needs.

Choice B rationale

Assessing the characteristics of the stools, such as frequency, consistency, color, and any associated symptoms like abdominal pain, nausea, vomiting, or fever, is crucial for determining the potential cause and severity of the diarrhea. This information guides subsequent interventions and helps differentiate between self-limiting conditions and those requiring further investigation.

Choice C rationale

Advising the use of loperamide without a proper assessment could mask underlying issues, potentially delaying appropriate treatment if the diarrhea is due to an infection or other serious condition. Antidiarrheal medications are not always indicated and should be used cautiously.

Choice D rationale

While maintaining hydration and electrolyte balance is important, especially with diarrhea, it is not the first action a nurse should take before understanding the nature of the patient's symptoms. The initial step should be to gather more information to guide appropriate advice and interventions.

Choice A rationale

Intestinal parasites can cause anemia through various mechanisms, such as blood loss, nutrient malabsorption, and inflammation. However, this is not a direct manifestation of ulcerative colitis itself but rather a separate potential cause of anemia in any individual. Ulcerative colitis primarily affects the colon and rectum.

Choice B rationale

Chronic blood loss is a significant contributing factor to anemia in patients with ulcerative colitis. The inflammation and ulceration of the colonic mucosa lead to bleeding into the intestinal lumen. Over time, this persistent blood loss can result in iron deficiency anemia, characterized by low hemoglobin and hematocrit levels. Normal hemoglobin ranges are typically 13.5 to 17.5 g/dL for men and 12.0 to 15.5 g/dL for women.

Choice C rationale

Intestinal malabsorption syndrome can lead to anemia by impairing the absorption of essential nutrients like iron, vitamin B12, and folate, which are crucial for red blood cell production. While malabsorption can occur in inflammatory bowel diseases, it is more commonly associated with Crohn's disease, which affects the entire gastrointestinal tract, rather than primarily ulcerative colitis.

Choice D rationale

Dietary iron restrictions would limit the intake of a necessary component for hemoglobin synthesis, potentially leading to or exacerbating anemia. However, this is an external factor and not a manifestation of ulcerative colitis itself. In fact, patients with ulcerative colitis are often encouraged to maintain a diet rich in iron-containing foods to compensate for blood loss.