The nurse assesses a client admitted 4 hours ago with a diagnosis of diverticulitis. Which assessment finding must be reported immediately to the healthcare provider?

Choice A rationale

Tenesmus is a frequent urge to defecate, common in ulcerative colitis but not indicative of toxic megacolon. It results from inflammation and irritation of the rectal and colonic mucosa, causing discomfort and straining during bowel movements.

Choice B rationale

Hyperactive bowel sounds are associated with increased gastrointestinal activity, often seen in diarrheal states and early mechanical bowel obstruction but not typically linked to toxic megacolon. Toxic megacolon often presents with reduced or absent bowel sounds due to colonic paralysis.

Choice C rationale

An enlarging abdominal girth indicates distension, a significant sign of toxic megacolon. This condition involves extreme dilation of the colon, which can lead to severe abdominal distension due to trapped gas and stool. This can be life-threatening if not treated promptly.

Choice D rationale

Anal fissures are tears in the anal canal, common in chronic constipation or Crohn’s disease, not typically a sign of toxic megacolon. They cause pain and bleeding during bowel movements but do not indicate toxic megacolon.

Choice A rationale

Eating quickly and leaving the table can lead to overeating because it takes about 20 minutes for the brain to recognize satiety signals from the stomach. Eating slowly and mindfully is a better strategy for weight management as it allows time for these signals to take effect, reducing the likelihood of consuming excess calories.

Choice B rationale

Checking weight twice per day is not recommended. Frequent weight checks can lead to obsession and anxiety. Weight can fluctuate naturally due to various factors such as fluid retention, and monitoring it too often does not provide a clear picture of weight loss progress. A more balanced approach is to weigh oneself once a week.

Choice C rationale

Increasing alcohol intake with meals is not a recommended strategy for weight loss. Alcohol adds empty calories and can stimulate appetite, leading to overeating. It also affects metabolism and can contribute to weight gain rather than weight loss.

Choice D rationale

Learning to recognize satiety is a crucial strategy for weight loss. It involves being aware of the body's hunger and fullness cues, which can prevent overeating. Mindful eating practices help individuals eat in response to true hunger rather than emotional or situational cues.

Choice E rationale

Keeping a food diary helps track food intake, identify eating patterns, and make conscious dietary choices. It is an effective tool for weight loss as it increases awareness of what, how much, and when one eats, helping to manage and reduce caloric intake.