A nurse is reviewing the medical record of a patient who has a peptic ulcer.
Which of the following findings should the nurse recognize as a risk factor for this condition?

Choice A rationale

Obtaining a dietary history is important in managing ulcerative colitis, as certain foods can exacerbate symptoms. However, in an acute exacerbation, the immediate priority is to address physiological instability, which electrolyte imbalances can significantly contribute to.

Choice B rationale

During an acute exacerbation of ulcerative colitis, patients can experience significant fluid and electrolyte losses due to frequent and bloody diarrhea. Reviewing electrolyte values, such as potassium, sodium, and magnesium, is the priority to identify and promptly correct any imbalances that could lead to cardiac arrhythmias or other complications. Normal ranges for serum electrolytes are: Sodium: 135-145 mEq/L, Potassium: 3.5-5.0 mEq/L, Chloride: 98-106 mEq/L, Bicarbonate: 22-26 mEq/L, Calcium: 8.5-10.5 mg/dL, Magnesium: 1.5-2.5 mEq/L.

Choice C rationale

Checking perianal skin integrity is important because frequent diarrhea can lead to skin breakdown. However, this assessment is secondary to addressing potential life-threatening electrolyte imbalances that can occur during an acute flare-up.

Choice D rationale

Addressing the patient's emotional concerns is a crucial aspect of holistic care for patients with chronic conditions like ulcerative colitis. However, in the context of an acute exacerbation, the immediate physiological needs, such as identifying and correcting electrolyte imbalances, take precedence.

Choice A rationale

Localized erythema, or redness, around a puncture wound is a classic sign of inflammation, which is an early manifestation of acute osteomyelitis, an infection of the bone. The inflammatory response causes vasodilation and increased blood flow to the infected area.

Choice B rationale

Hypothermia, or low body temperature, is not a typical manifestation of acute osteomyelitis. Fever is more common as the body mounts a systemic response to the infection. Normal body temperature is around 98.6°F (37°C).

Choice C rationale

Numbness of the toes on the affected foot suggests nerve damage or vascular compromise, which are not typical early manifestations of acute osteomyelitis resulting from a puncture wound. Pain and tenderness are more likely localized symptoms.

Choice D rationale

Bradycardia, or a slow heart rate, is not a typical finding in acute osteomyelitis. Tachycardia (rapid heart rate) might occur due to fever and the body's stress response to infection. Normal adult heart rate ranges from 60 to 100 beats per minute. .

NGN NGN NGN