Inflammation

Question 1

Inflammatory Bowel Disease is an umbrella term that includes what two disease processes?

Answer 1

Ulcerative Colitis

Crohn’s disease

Question 2

Ulcerative colitis and Crohn’s Disease typically are characterized by how many episodes of diarrhea/day?

Answer 2

up to 20 episodes of diarrhea/day with exacerbations

Question 3

Ulcerative colitis and Crohn’s disease patients frequently report pain where?

Answer 3

abdominal pain that is crampy

Question 4

(T or F) Ulcerative colitis and Crohn’s disease are characterized by periods of exacerbation and remission

Answer 4

True

Question 5

diverticulitis occurs when….

Answer 5

Diverticulitis occurs when fecal matter becomes trapped in the diverticula resulting in inflammation and infection

Question 6

Ulcerative colitis usually begins where?

Answer 6

Ulcerative colitis usually begins in the rectum and distal colon

Question 7

Ulcerative colitis involves which part of the colon (layers)?

Answer 7

mucosa and submucosa

Question 8

Acute complications of ulcerative colitis include?

Answer 8

Toxic megacolon
hemorrhage
colon perferation

Question 9

Patients with ulcerative colitis are at greater risk for developing what kind of cancer?

Answer 9

Higher risk for colon cancer

Question 10

Patients with ulcerative colitis lack sufficient production of ________ ________ which is necessary to absorb vitamin B12

Answer 10

Intrinsic factor

Question 11

Insufficient absorption of Vit B12 can lead to anemia (T or F)

Answer 11

true

Question 12

risk factors for ulcerative colitis

Answer 12

Caucasian
Jewish
Male gender
smoking 
stress
autoimmune
infection

Question 13

Where is pain localized in ulcerative colitis

Answer 13

LLQ

Question 14

Where is pain localized in crohn’s disease

Answer 14

RLQ

Question 15

In a patient with an exacerbation of ulcerative colitis what will be in their stool and how many times/day will they use the restroom

Answer 15

Diarrhea of 15-20 stools/day with mucus, blood, or pus

Question 16

A patient with ulcerative colitis may have a fever (T or F)

Answer 16

true

Question 17

Upon palpation of the abdomen, the RN taking care of patient with ulcerative colotis will present with…?

Answer 17

abdominal distension
abdominal tenderness
abdominal firmness

Question 18

What type of bowel sounds will be heard in patient with ulcerative colitis

Answer 18

high pitched bowel sounds

Question 19

Crohns disease is unique in that the lesions are NOT….?

Answer 19

lesions are not continuous

Question 20

Crohns disease can occur anywhere from mouth to anus

Answer 20

True

Question 21

Crohns disease may require supplemental Vit B12

Answer 21

True

Question 22

Risk factors for Chron’s disease

Answer 22

genetics
stress
autoimmune
infection

Question 23

Steatorrhea is unique to Crohns disease assessment?

Answer 23

True

Question 24

What are the diagnostic tests for IBD?

Answer 24

Abdominal Xray and CT
Barium Enema (to dx UC)
Colonoscopy-Sigmoidoscopy
Upperendoscopy

Question 25

What are potential complications of IBD?

Answer 25

Bleeding Fluid/electrolyte imbalance (K and Na low) Fistula's with Crohns

Question 26

What are some extraintestinal s/sx associated with Crohns

Answer 26

uveitis arthritis erythema nodosum

Question 27

What are some extraintestinal s.sx associated with Ulcerative Colitis

Answer 27

``` Skin lesions (erythema nodosum) Eye lesions (uveitis) Joint abnormalities (arthitis) liver disease ```

Question 28

``` A nurse is caring for a hospitalized patient with a dx of Ulcerative colitis. Which finding, if noted on assessment, would the RN report to the MD? Bloody diarrhea hypotension a hemoglobin level of 12mg/dL rebound tenderness ```

Answer 28

rebound tenderness

Question 29

``` A nurse is caring for a client postop following a creation of a colostomy. Which of the following nursing dx would the nurse include in the plan of care Alt. Nutrition: more than body req Body image disturbance Fear related to poor prognosis Sexual dysfunctioni ```

Answer 29

body image disturbance

Question 30

A nurse is doing preop teaching with a client who is about to undergo the creation of a Kock pouch. the nurse interprets that the client has the best understandnig of the nature of the surgery if the client says....? "I will need to drain the pouch regularly with my catheter" "I will need to wear a drainage bag for the rest of my life" "The drainage from this type of osmotic will be formed" "I will be able to pass stool by the rectum eventually"

Answer 30

"I will need to drain the pouch regularly with a catheter"

Question 31

``` Extraintestinal sx that are seen with both UC and CD are osteoporosis and conjunctivitis peptic ulcer disease and uvetitis erythema nodosum and arthritis gluten intolerance and gallstone ```

Answer 31

erythema nodosum and arthritis

Question 32

An important RN intervention for the patient with a SBO who has an NG tube is offer ice hips to suck PRNl Provide mouth care q1-2h irrigate the tube with NS q8H keep the patient supine with HOB elevated 30 deg

Answer 32

Provide mouth care q1-2h

Question 33

a patient with IBD has a nursing dx of imbalanced nutrition: less than body requirements r.t. decreased nutritional intake and decreased intestinal absorption. Assessment data that support this nursing dx are: Pallor and hair loss Frequent diarrhea stools anorectal excoriation and pain hypotension and urine output below 30mL/h

Answer 33

Pallor and hair loss

Question 34

Define: volvus

Answer 34

twisting of bowel on itself

Question 35

define: intussusception

Answer 35

medical emergency where the bowel is folding on itself

Question 36

What are nursing care for patient with IBD

Answer 36

``` Monitor for K imbalance monitor for dehydration Monitor weight Assess for signs of FVD Monitor for s.sx of bowel obstruction instruct patient to report rectal bleeding Monitor H&H values ```

Question 37

In the case of UC surgery is curative?

Answer 37

true

Question 38

in the case of CD surgery is curative

Answer 38

false