Which of the following is a common lab finding in individuals with Crohn's disease during an exacerbation?

A. Strawberry yogurt: During exacerbations, clients are advised a low-residue, low-fiber diet to reduce bowel stimulation. Strawberry yogurt may contain seeds and fruit pieces that increase mechanical irritation of the intestinal mucosa. Some clients with inflammatory bowel disease experience secondary lactose intolerance, which can worsen diarrhea and cramping.

B. Tossed spinach salad: Raw vegetables such as spinach are high in insoluble fiber, which increases stool bulk and intestinal motility. In Crohn’s disease, especially during active inflammation, high-fiber foods can exacerbate abdominal pain, diarrhea, and cramping. Raw leafy greens may also be difficult to digest when the intestinal mucosa is inflamed.

C. Buttered popcorn: Popcorn is high in insoluble fiber and contains hulls that are poorly digested. These can irritate inflamed intestinal tissue and increase peristalsis, potentially worsening symptoms such as diarrhea and abdominal discomfort. High-residue foods are generally avoided during flare-ups of Crohn’s disease.

D. Grilled chicken: Lean protein sources such as grilled chicken are recommended because they are low in fiber and easier to digest. Adequate protein intake supports tissue repair and helps prevent malnutrition, which is common in Crohn’s disease due to inflammation and decreased intake. Prepared without heavy seasoning or frying, grilled chicken aligns with a low-residue dietary approach.

A. heart failure: While severe fluid loss and electrolyte imbalances can increase cardiac workload, heart failure is not a common direct complication of ulcerative colitis exacerbations. The primary concerns are related to volume depletion, electrolyte disturbances, and systemic inflammation rather than chronic cardiac dysfunction in the acute phase.

B. hypokalemia: Persistent diarrhea associated with ulcerative colitis results in significant loss of potassium through the stool. Hypokalemia can lead to muscle weakness, cardiac dysrhythmias, and decreased gastrointestinal motility. Monitoring serum potassium and initiating replacement therapy as needed are critical during prolonged diarrheal episodes.

C. deep vein thrombosis: Inflammatory bowel disease increases the risk of hypercoagulability, which can contribute to deep vein thrombosis. However, this is less immediate than electrolyte disturbances during an acute flare. DVT assessment is important but is not the first priority when evaluating a client with ongoing diarrhea.

D. hypocalcemia: Although malabsorption can eventually lead to calcium deficits, acute ulcerative colitis exacerbations rarely cause immediate hypocalcemia. Calcium loss is not directly linked to short-term diarrhea, making hypocalcemia a less likely acute complication.