The nurse is caring for a patient with acute ulcerative colitis flare-up. The provider wants to start the patient on medication. Which medications are appropriate for use in ulcerative colitis? (Select All that Apply.)

Ciprofloxacin

Golimumab

Sumatriptan

Ibuprofen

Aspirin

Methylprednisolone

Answer and Explanation

Correct Answer : B,F

A. Ciprofloxacin: Ciprofloxacin is an antibiotic used to treat bacterial infections, but it is not typically used for the treatment of ulcerative colitis unless there is a secondary infection. It does not directly address the inflammation associated with ulcerative colitis.

B. Golimumab: Golimumab is a biologic medication (TNF-alpha inhibitor) used for the treatment of moderate to severe ulcerative colitis. It helps to reduce inflammation in the colon and is appropriate for use during a flare-up of ulcerative colitis.

C. Sumatriptan: Sumatriptan is a medication used to treat migraines and does not have a role in the treatment of ulcerative colitis. It does not affect the inflammatory processes involved in ulcerative colitis.

D. Ibuprofen: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen should be avoided in patients with ulcerative colitis because they can exacerbate symptoms, cause irritation, and potentially worsen the disease by increasing the risk of gastrointestinal bleeding.

E. Aspirin: Aspirin is also an NSAID (acetylsalicylic acid). Similar to ibuprofen, NSAIDs like aspirin can worsen ulcerative colitis symptoms, increase inflammation, and irritate the gastrointestinal lining. Therefore, aspirin is generally avoided in clients with ulcerative colitis

F. Methylprednisolone: Methylprednisolone is a corticosteroid used for managing acute flare-ups of ulcerative colitis. It works by reducing inflammation in the colon and is commonly prescribed during active flare-ups to control symptoms.

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Correct Answer is D

Explanation

A. Instruct the client to take slow deep breaths: While slow deep breathing can help with minor respiratory issues, the ABG results indicate serious hypoxemia and metabolic acidosis. Oxygen support is the priority, not just deep breathing exercises.

B. Ask the unit secretary to call a Code Blue: The ABG results show concerning findings but not an immediate life-threatening crisis that requires a Code Blue. Oxygen therapy should be the initial intervention to stabilize the patient.

C. Reposition the client in low Fowler's position: Although positioning can sometimes help, the primary issue here is hypoxemia. Providing supplemental oxygen should be the first step before considering repositioning for comfort.

D. Page the respiratory therapist to set up O2: The ABG shows hypoxemia (pO2 74) and metabolic acidosis (pH 7.35, HCO3 20). The immediate concern is to improve oxygenation, which can be managed by administering supplemental oxygen. Oxygen therapy will address both the low pO2 and help with compensatory acidosis.

A. Potassium 10 meq IV mini bag B. Warfarin 5mg by mouth C. Regular insulin 5 units subcutaneously D. Discontinue indwelling catheter

Correct Answer is B

Explanation

A. Potassium 10 meq IV mini bag: The potassium level is at the lower end of the normal range (3.5 mEq/L), but it is not critically low. Potassium supplementation may be needed, but it is not as urgent as managing the elevated INR and low platelet count.

B. Warfarin 5mg by mouth: The patient's INR is elevated at 5.0 (normal range: 2.0-3.0), which significantly increases the risk of bleeding, especially with low platelet levels (50,000/mm3, normal range: 150,000-450,000/mm3). Given the critical low platelets and elevated INR, this order should be brought to the provider's attention to reduce the bleeding risk.

C. Regular insulin 5 units subcutaneously: The patient’s blood glucose is elevated at 240 mg/dL, but insulin administration at 5 units is appropriate for the patient's condition and not an immediate concern compared to the bleeding risk from Warfarin.

D. Discontinue indwelling catheter: The catheter is scheduled for discontinuation, but this is not as urgent as addressing the bleeding risk associated with the elevated INR and low platelet count.

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The nurse is caring for a patient with acute ulcerative colitis flare-up. The provider wants to start the patient on medication. Which medications are appropriate for use in ulcerative colitis? (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

Exhibits On day 3, the RN consults with the provider, who places an order for an arterial blood gas and serum lactate level. The ABG results are as follows: pH 7.35, pCO2 30, pO2 74, and HCO3 20. Based upon the results, what would the RN's most appropriate action be?

Correct Answer is D

Explanation

Exhibits Based upon the day 3 lab results, which order should the nurse bring to the provider's attention?

Correct Answer is B

Explanation

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