The nurse is writing a care plan for a client who was diagnosed with Crohn's disease a year ago and is now hospitalized with a fourth acute exacerbation. Which client problem should receive the highest priority?

Fluid overload

Altered body image

Imbalanced nutrition - less than body requirements

Social isolation

Answer and Explanation

The Correct Answer is C

C.   Crohn's disease exacerbation often leads to malnutrition due to decreased oral intake, malabsorption, and increased nutrient losses through diarrhea. Addressing imbalanced nutrition is crucial to replenish depleted nutrient stores, support healing, and prevent further complications.
A.   While fluid overload can be a concern in certain situations, such as when administering intravenous fluids or in clients with renal impairment, it is not typically a primary concern in clients hospitalized with Crohn's disease exacerbation. Crohn's disease is more commonly associated with dehydration due to diarrhea and malabsorption rather than fluid overload.
B.   In the acute phase of Crohn's disease exacerbation, addressing immediate physiological needs and stabilizing the client's condition typically take precedence over psychosocial concerns.
D. Social isolation can be a concern for clients with chronic illnesses, including Crohn's disease, as it may impact their quality of life and emotional well-being. However, in the acute phase of exacerbation, addressing physiological needs and stabilizing the client's condition typically takes precedence over psychosocial concerns such as social isolation.

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Correct Answer is C

Explanation

C. Costovertebral tenderness, which is tenderness over the costovertebral angle (where the ribs meet the vertebral column) on palpation, is more indicative of acute pyelonephritis rather than cystitis. In acute pyelonephritis, inflammation of the kidney parenchyma and surrounding tissues can lead to tenderness in this area.

A. Both acute pyelonephritis and cystitis can present with urinary urgency, as it is a common symptom of urinary tract infections (UTIs) in general.
B. Increased WBCs in urinalysis: While an increased number of white blood cells (WBCs) in the urinalysis can indicate a urinary tract infection, it is not specific to either acute pyelonephritis or cystitis.
D. Hematuria can occur in both acute pyelonephritis and cystitis.

A. explore whether the client has made any changes to diet or exercise pattern. B. discuss bariatric surgery with the client. C. review diet and exercise guidelines with the client. D. instruct the client to record weight weekly.

Correct Answer is A

Explanation

A. Before taking further action, the nurse should investigate whether there have been any changes in the client's diet, exercise routine, or lifestyle that may have contributed to the plateau in weight loss. Understanding any modifications made by the client can provide valuable insights into potential factors affecting their weight loss progress.
B. Bariatric surgery is a significant decision that requires careful consideration and evaluation of various factors. It is not appropriate to jump to this option without first exploring other potential reasons for the lack of weight loss.
C. While it's essential to review diet and exercise guidelines periodically to ensure the client is following appropriate recommendations, this option may not address the underlying cause of the recent lack of weight loss.
D. Regular weight monitoring is an important component of weight management and can provide valuable information about the client's progress. However, instructing the client to record weight weekly alone may not address the underlying reason for the lack of weight loss.

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The nurse is writing a care plan for a client who was diagnosed with Crohn's disease a year ago and is now hospitalized with a fourth acute exacerbation. Which client problem should receive the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client comes to the Urgent Care center complaining of urinary frequency accompanied by pain when voiding. Which clinical manifestation would make the nurse suspect acute pyelonephritis rather than cystitis?

Correct Answer is C

Explanation

After successfully losing 0.5 to 1 pound weekly for several months, a client at the clinic has not lost any weight for the last month. The nurse should first:

Correct Answer is A

Explanation

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