The nurse is providing education to a client with a history of Crohn's Disease and a new diagnosis of anemia. Which of the following statements by the client would require farther teaching?

"This condition is correlated to chronic blood loss.”

"Villi within my intestine are damaged.”

“Poor nutrition is a causative factor.”

"The ferrous sulfate is prescribed will replace the lost iron.”

Answer and Explanation

The Correct Answer is B

A. "This condition is correlated to chronic blood loss.” : Chronic inflammation and ulceration in Crohn’s disease can cause occult GI bleeding, leading to iron-deficiency anemia.

B. "Villi within my intestine are damaged.”: Crohn’s disease affects the entire intestinal wall, but it does not damage villi specifically. Villi damage occurs in celiac disease, not Crohn’s disease.

C. "Poor nutrition is a causative factor.": Malabsorption of iron, vitamin B12, and folate due to inflammation contributes to anemia in Crohn’s disease.

D. "The ferrous sulfate prescribed will replace the lost iron.": Iron supplements (ferrous sulfate) are commonly prescribed for anemia in Crohn’s disease due to chronic blood loss.

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Correct Answer is B

Explanation

A. Dorsiflex the client’s foot: Foot dorsiflexion does not assess asterixis; it is used in neurologic tests (e.g., clonus assessment).

B. Ask the client to extend the arms: Asterixis ("liver flap") is a flapping tremor seen in hepatic encephalopathy due to high ammonia levels. The nurse assesses for asterixis by asking the client to extend their arms and dorsiflex their wrists—a positive sign is a flapping movement of the hands.

C. Measure the abdominal girth: Abdominal girth measurement is used to assess ascites, not asterixis.

D. Instruct the client to lean forward: Leaning forward does not help in assessing asterixis; it is more relevant in pericarditis (relieves chest pain).

A. Hang IV fluids of CSNS with 20 mEq of potassium chloride at 125 ml/hr B. Insert a nasogastric tube C. Draw a basic metabolic panel D. Ambulate in the hallway

Correct Answer is B

Explanation

A. Hang IV fluids of CSNS with 20 mEq of potassium chloride at 125 ml/hr: Fluid resuscitation is important, but potassium should not be administered until electrolyte levels are assessed. Also, potassium administration in a client with a bowel obstruction requires caution due to the risk of hyperkalemia if renal function is impaired.

B. Insert a nasogastric tube: A nasogastric (NG) tube is essential in managing bowel obstruction as it helps decompress the stomach, relieve pressure, and prevent aspiration. This should be done first to stabilize the client.

C. Draw a basic metabolic panel: Checking electrolyte imbalances is important but should be done after stabilizing the client with NG tube insertion.

D. Ambulate in the hallway: Ambulation is contraindicated in acute bowel obstruction due to the risk of worsening symptoms such as nausea, vomiting, and severe pain.

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The nurse is providing education to a client with a history of Crohn's Disease and a new diagnosis of anemia. Which of the following statements by the client would require farther teaching?

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