Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
• Intestinal
• Appendicitis
• Peritonitis
• Bowel
• Gastroenteritis (acute)
• Crohn’s disease (chronic)
• Ulcerative colitis (chronic)
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
• Anal
• Anorectal abscess
• Anal fissure
• Parasitic infections
• Food poisoning
•
•
•
•
Salmonellosis
Staph
E. coli
Botulism
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1.
2.
3.
4.
5.
6.
Priority concern(s)
Common manifestations
Treatment options
Include collaborative health care team
Potential complications
Implications for older adults
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
• Individualized questions
• Appendicitis
• Signs/symptoms before and after rupture
• Peritonitis
• Teaching plan for surgical patient
• Gastroenteritis
• Medications used
• Ulcerative colitis
• Profile of “typical” patient; dietary teaching plan
• Crohn’s disease
• Teaching plan
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
 Diverticulosis vs. diverticulitis
• Compare/contrast
 Anorectal abscess, anal fissure, anal fistula
• Key differentiations
 Food poisoning
• Teaching plan regarding organisms
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
The patient is a 21-year-old who has recently been diagnosed with
ulcerative colitis. In the ED, she tells you that she has been having 7 to 8
bloody stools daily. Upon assessment, you find that her heart rate is
120/min, and she has abdominal pain upon palpation. Laboratory results
show a hemoglobin level of 9 g/dL.
How is the severity of the patient’s ulcerative colitis categorized?
A. Mild
B. Moderate
C. Severe
D. Fulminant
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
(cont’d)
The patient is admitted to the acute medical unit.
Which ordered medication would the nurse question?
A. Mesalamine (Asacol)
B. Prednisone (Deltasone)
C. Ibuprofen (Motrin)
D. Loperamide (Imodium)
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(cont’d)
Later in the afternoon, the patient states that the abdominal
pain is getting worse.
Which interventions would be implemented for her pain?
(Select all that apply.)
A. Administering analgesics as ordered
B. Assisting with frequent positioning
C. Providing sitz baths as needed
D. Teaching music therapy or guided imagery
E. Evaluating the diet for foods that cause pain
F. Providing antidiarrheal medications as needed
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
(cont’d)
The patient states, “I am afraid I’ll never get to go out with
my friends again because I can’t be away from the toilet.”
Which is the appropriate nursing response?
A. “What makes you say that?”
B. “Your friends will understand.”
C. “I wouldn’t worry about it if I were you.”
D. “It sounds like you are concerned about managing this
disorder when you are out.”
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
(cont’d)
The patient is preparing for discharge. She asks what is the
best way to keep her skin from breaking down.
What is the nurse’s best response?
A. “Wash with mild soap and warm water after each bowel
movement.”
B. “Apply a pectin-based skin barrier after each bowel
movement.”
C. “Add high-fiber or high-cellulose foods to your diet.”
D. “Take a laxative daily at bedtime to facilitate morning
bowel movements.”
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Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
21
An older patient diagnosed with bacterial gastroenteritis
reports abdominal cramping, diarrhea, nausea and vomiting,
and fatigue for the past 24 hours. The nurse should monitor
the patient for what priority assessment?
A. Dehydration
B. Hypokalemia
C. Hypernatremia
D. Perineal skin breakdown
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A patient has recently been placed on corticosteroids as
treatment for ulcerative colitis. The nurse should monitor the
patient’s laboratory results for evidence of which condition?
A. Hypernatremia
B. Hypercalcemia
C. Hyperglycemia
D. Hyperkalemia
Copyright © 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
What priority laboratory analysis should the nurse review
when caring for a patient with Crohn’s disease?
A. C-reactive protein
B. Serum albumin
C. Hemoglobin
D. Potassium
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