The nurse suspects that the client, hospitalized with severe ulcerative colitis, is experiencing the complication of toxic megacolon. Which assessment finding would support this suspicion?

A. Keeping the client NPO (nothing by mouth) helps to rest the gastrointestinal tract, reduces the risk of further obstruction, and prevents exacerbation of symptoms such as vomiting.
B. Measuring abdominal girth is an important nursing assessment for a client with a possible small bowel obstruction. An increase in abdominal girth can indicate abdominal distension, which is a common sign of bowel obstruction.
C. Severe abdominal pain is a common symptom of bowel obstruction, and opioids may be necessary to manage pain effectively. However, opioids should be used cautiously due to the risk of exacerbating bowel obstruction by reducing bowel motility.
D. Fluid replacement therapy is important for clients with small bowel obstruction, especially if they are vomiting or have fluid loss due to intestinal secretions. Intravenous fluids may be administered to maintain hydration, correct electrolyte imbalances, and prevent dehydration.
E. Radiologic studies, such as abdominal X-rays or computed tomography (CT) scans, are often used to confirm the diagnosis of small bowel obstruction and assess its severity.

C. Medication adherence is vital for controlling inflammation and preventing flare-ups in ulcerative colitis. Therefore, ensuring that the client is taking their medications as prescribed is a primary focus of disease management, regardless of how well they have learned to manage the condition.
A. Stress can exacerbate symptoms of ulcerative colitis and may contribute to flare-ups. Therefore, understanding how the client manages stress is important. However, given that the client has lived with ulcerative colitis for close to 15 years and has learned to manage it well, this question may be less of a primary focus compared to other aspects of disease management.
B. Regular monitoring through colonoscopy is essential for detecting any changes or complications associated with ulcerative colitis, such as inflammation, dysplasia, or colon cancer.
D. While rest and adequate sleep are important for overall health and well-being, they may not be as directly related to ulcerative colitis management as medication adherence, monitoring, and stress management.