The nurse provides care for a client with a 10-year history of Crohn's disease. Which finding best describes a common complication of Crohn's disease?

Choice A reason: Ischemia of the motor and sensory neurons in the brain is not the cause of multiple sclerosis, but a possible consequence of it. Ischemia is a lack of blood supply to the tissues, which may result from inflammation, thrombosis, or embolism. It may cause neuronal death, stroke, or dementia.

Choice B reason: Damage and scarring of the white matter in the brain is the best description of the cause of multiple sclerosis. Multiple sclerosis is an autoimmune disorder that causes the immune system to attack the myelin sheath, which is a protective layer that covers the nerve fibers. The damage and scarring of the myelin sheath, also called demyelination, disrupts the transmission of nerve impulses and causes various neurological symptoms.

Choice C reason: Infection of the parietal and temporal lobes of the brain is not the cause of multiple sclerosis, but a rare complication of it. Infection of the brain, also called encephalitis, may occur due to viral, bacterial, or fungal agents. It may cause fever, headache, confusion, seizures, or coma.

Choice D reason: Increased amounts of epinephrine and acetylcholine in the brain are not the cause of multiple sclerosis, but a possible effect of it. Epinephrine and acetylcholine are neurotransmitters that regulate the sympathetic and parasympathetic nervous systems, respectively. They may be affected by the demyelination of the nerve fibers, which may alter the autonomic functions such as heart rate, blood pressure, digestion, or bladder control.

Choice A reason: Shallow respirations and a smooth, beefy red tongue are not the expected findings because they are signs of pernicious anemia, not acute blood loss. Pernicious anemia is a condition where the body cannot produce enough red blood cells due to a lack of vitamin B12, which is needed for DNA synthesis and cell division. Pernicious anemia can cause shallow respirations due to hypoxia, which is a low level of oxygen in the tissues, and a smooth, beefy red tongue due to atrophy of the tongue papillae, which are the small projections that give the tongue its rough texture.

Choice B reason: Facial flushing with distended neck veins are not the expected findings because they are signs of polycythemia, not acute blood loss. Polycythemia is a condition where the body produces too many red blood cells, which increases the blood volume and the blood viscosity, making the blood thicker and harder to flow. Polycythemia can cause facial flushing due to increased blood flow to the skin, and distended neck veins due to increased pressure in the venous system.

Choice C reason: Bilateral numbness and tingling of the extremities are not the expected findings because they are signs of peripheral neuropathy, not acute blood loss. Peripheral neuropathy is a condition where the nerves that carry signals from the brain and spinal cord to the rest of the body are damaged or impaired, causing sensory and motor disturbances. Peripheral neuropathy can cause bilateral numbness and tingling of the extremities due to reduced nerve conduction and sensation.

Choice D reason: Increased heart rate and decreased mental alertness are the expected findings because they are signs of acute blood loss. Acute blood loss is a condition where the body loses a large amount of blood in a short period of time, which reduces the oxygen-carrying capacity of the blood and the tissue perfusion. Acute blood loss can cause increased heart rate due to the compensatory mechanism of the body to increase the cardiac output and maintain the blood pressure, and decreased mental alertness due to the reduced oxygen delivery to the brain.