Which nursing diagnoses is/are most applicable to a client with fecal incontinence? Which of the following findings are indicative of this condition? b. Disconnecting and reconnecting the drainage system quickly to obtain a urine specimen. d. "Only if the stool has not been contaminated by urine. A communicating wall remains between the proximal and the distal bowel. a. A. A nurse is talking with a client who has gout. The nurse needs to collect a stool specimen for culture from a client. C. Increase cellulose and fluid in the diet "I will need yearly screenings for colon cancer." Excessive laxative use B. Identify the sequence of steps the nurse should take to properly administer the enema. Excessive laxative use A. c. Assist the client to the commode or toilet to attempt a bowel movement prior to administering the enema. Which finding is most important for the nurse to report to the health care provider? B. increased sedation is achieved by higher doses of medication. The proliferation of Clostridium difficile causes: b. d. Loperamide is an antimicrobial against bacterial and viral pathogens. what? ____________________ Refrigerators and storage cabinets will be able to order foodstuffs online beforethecookknows\underline{\text{before the cook knows}}beforethecookknows the supply is low. B. B. Apical heart rate Tap Water A nurse is assisting a patient to empty and change an ostomy appliance. a. B. Untape the tube periodically A nurse needs to administer a hypertonic enema solution to the client. c. digital removal of stool A. Which of the following foods should beincluded as sources of fiber? D. Temperature. A nurse is caring for a client who is 48 hours postoperative following a small bowel resection. ATI Test Taking Strats Pretest and Posttest, ati learning system 3.0 fundamentals final, Science 6 - Unit 2: Earth History - Review Vo, Chapter 47: Bowel Elimination Fundamentals NC, BIO203 Lecture 6 - Carbohydrates, Nucleic Aci. E. Urinary incontinence, A nurse is instructing a client who is scheduled for a transurethral resection of the prostate (TURP) about his postoperative care. __________: The output is typically liquid to semi-liquid and is very irritating to the surrounding skin. 2. d. the indwelling urinary catheter, After surgery, Ms. Young is having difficulty voiding. e. administration of enemas until clear, A physician orders an enema to effect rapid colonic emptying in a client who is experiencing severe abdominal cramping due to constipation. Which of the following goals should the nurse include? D. Reddened areas over bony prominences, B. What is the present worth of a $50,000 debenture bond that has a bond coupon rate of 8% per year, payable quarterly? Which finding would most likely contraindicate placement of a nasogastric (NG) tube by the nurse in this client? The nurse is administering a rectal suppository. D. Reduce the number of intestinal bacteria, D. Reduce the number of intestinal bacteria, A client has undergone an 8-hour surgical procedure under general anesthesia. Encourage the use of the incentive spirometer every 2 hr A. Which of the following information should the nurse include in the teaching? E. Assist with early ambulation, A client is being prepared for gastrointestinal surgery and undergoes a bowel preparation. E. Increase fluid intake to 3 L/day. As long as pure _________ soap is used, it is considered a safe procedure. b. Assessing a client's GI system C. Instill warm mineral oil into the rectum D. Pull the curtain around the patient's bed and drape the patient. Which position would the nurse place the client in? A client who has a body fat of 22% Place the enema 12-18 inches above the anus B. You may use the elements more than once. b. increase in the client's dietary fiber and continued administration of amoxicillin B. c. Wipe the lubricated tip of the container before insertion. A. Flank pain that radiates to the lower abdomen c. Have the patient rest for 30 minutes to see if the prolapse resolves. a. duodenum Red 2 Percussion Which of the following foods should be included as sources of fiber? d. Mrs. Lonte reports fullness and diarrhea after breakfast. A. Urinary retention 4. D. Tamsulosin (Flomax). C. Which of the following is most likely to validate that a client is experiencing intestinal bleeding? b. b. reassuring the client that cramping is normal Which statements accurately describe the action of specific antidiarrheal medications? Which of the following is an expected finding? Complete each statement by writing the correct word or words. B. Diaphoresis Which of the following interventions is appropriate for this patient? Abdominal pain 3. 1-2 in Select all that apply. d. "Is the stool difficult to pass?" "Stool can be collected only from a cloth diaper." A. D. Limit activity, C. Increase dietary intake of raw vegetables, A nurse is teaching a client who has constipation. b. Hypertonic e. "Have you started a new medication? A nurse is talking with a client who reports constipation. The client asks the nurse why both anticoagulants are necessary. Which teaching will the nurse include? d. Caffeine- containing beverages should be monitored to prevent excess intake. Fresh fruit and whole wheat toast C. Rice pudding and ripe bananas D. Roast chicken and white rice: B is correct. What is the appropriate nursing action? c. eggs A nurse who is planning menus for a client in a long-term care facility takes into consideration the effects of foods and fluids on bowel elimination. 3. Me molestaba que Carlos y Miguel no BLANK (venir) a visitarme. The nurse is presenting a lecture on ostomy bowel elimination at a community clinic. A nurse is performing digital removal of stool on a patient with a fecal impaction. b. What will be the most likely outcome of the nurse's action? Patients typically experience other symptoms such as hard stools,. While a nurse is administering a cleansing enema, the patient reports abdominal cramping. e. Teaching the client about the test Have the client perform self stoma care Which of the following actions should the nurse take first? a. Limit intake of food high in animal protein. The bowel wall is stretched which stimulates peristalsis, B. A client with renal impairment A nurse is caring for a client who is reporting constipation. To which patient should a fleet enema NOT be administered to? 40-50 g Which nursing action is the recommended preparation for this test? d. Cantaloupe c. Before removing the tube, discontinue suction and separate the tube from suction. d. Attempt to irrigate the NG tube with water or normal saline. If the specimen contains barium or enema solution, document this on the container. A. Povidone-iodine B. Adhesive tape C. Latex D. Anesthetics. What is the nurse's best action? c. Hemoglobin of 11.1 g/dL (111.00 g/L) c. Lower the solution container and check the temperature and flow rate. 4. A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. a. a diet lacking in fruits and vegetables d. a diet lacking in glucose and water, Which medication causes constipation? Possible diarrhea Attach a syringe and flush with 50 mL of water or normal saline before removal. A sterile specimen is required for collection. 3 Auscultation Which responses by participants indicates a correct understanding of the material? The nurse should recognize which of the following foods provided together on the same dinner tray can be in violation of the clients religious practices? d. soap and water, What is the most common type of colostomy that needs to be irrigated to help promote regular evacuation of feces? d. secondary constipation, A nurse assesses a client who has a PRN (as-needed) prescription for a small-volume cleansing enema. Client report of nausea D. Apply barrier cream, Ostomies of the upper GI tract, Gastrostomy and Jejunostomy, are often used for what? a. "What are your normal bowel habits?" C. Mineral Oil ", A nurse is administering morphine 2mg IV every 2 to 4 hr to a client who has an abdominal incision. At least 30 mins, or as long as they can hold it. A nurse is reinforcing teaching with a client who is experiencing preterm labor and has a new prescription for nifedipine. Intussusception b. b.nature and amount of food eaten by the client. "This test detects heme, a type of iron compound in blood in the stool." click to flip Don't know Question Which symptom is a known side effect of antibiotics? a. Collect stool and send to laboratory for culture per regular protocol. c. Remove the NG tube and replace it with a larger-bore tube, as ordered. A student nurse is preparing to administer a client's ordered large-volume enema. A nurse is providing preoperative teaching for a client who will undergo surgery. b. To promote the patient's comfort during the administration of the enema solution, ________ the normal saline solution to ________ prior to administration. c. The catheter is inserted 2" to 3" into to meatus A. Constipation is a clinical diagnosis based on symptoms of incomplete elimination of stool, difficulty passing stool, or both. A nurse discourages a patient from straining excessively when attempting to have a bowel movement. If the underlined word group in each of the following sentences is a phrase, write phrase on the line. Keep going until enema is finished During the aging or wearout period, the deterioration of a machine usually Ignoring the urge to defecate. A. A nurse is performing digital removal of stool on a patient with a fecal impaction. On which body system is the patient experiencing symptoms that supports the nurse's suspicions? A. The nurse asks participants, "How will you know when a client begins to accept the altered body image?" An episode of diarrhea 4. "Where do you do your grocery shopping?" E. Urinary incontinence, B. This type contains digestive enzymes and acids that cause skin irritation, extra care is required to keep waste materials from contacting the abdominal surface. B. a. D. Client report of feeling sweaty. What is the best response by the nurse? Which of the following actions should the nurse take when collecting the specimen? The nurse should insert the tip of the rectal tube? c. Clamp the tube for a brief period and resume at a slower rate. 25. A. SSE D. A client who weighs 28% above ideal body weight. b. b. retention What important information should be included in the teaching? A. C. Reposition the client every 2 hr The client traveled to South America two weeks ago. True B. The provider has prescribed an enema. "It is important that you discontinue this type of treatment immediately." a. d. "How often do you move your bowels?" (Select all that apply.) "This is an indicator of heart disease and we should do an electrocardiogram to be sure that it has not caused damage to the heart." b. Administer a PRN dose of laxative to the client to collect new sample. D. Depression c. "Auscultated abdomen for bowel sounds. C. The specimen can not be contaminated with urine. E. Breast Milk, A. Cathartics a. Which action should the nurse perform during this intervention? a. increases the volume of the stool, making defecation easier b. Nasogastric tubes should not be irrigated. When questioned by the clients, which food would the nurse suggest as natural intestinal deodorizers? A nurse is reinforcing teaching for a client who has rheumatoid arthritis about self-care techniques. a. E. Assist with early ambulation, A. Irrigate all catheters with sterile normal saline. Pain at the surgical site c. Electrolyte imbalances d. administration of a large-volume enema Which of the following adverse effects of calcium should the nurse suspect when the client reports having flank pain? Discontinue the administration of the enema "Eating yogurt can help decrease the amount of gas that I have." c. antibiotic-associated diarrhea. D. Pull the curtain around the patient's bed and drape the patient. The male urethra is more vulnerable to injury during inspection b. a. B. Blackberries The client states, "I am menstruating right now. a. Fecal impaction (b) The stationary object is twice the mass of the moving object. A nurse is preparing a hospitalized patient for a colonoscopy. NEBULOUS Bear down hard when defecating Drink four to five glasses of water daily. Diarrhea commonly occurs with amoxicillin clavulanate use, If a patient was instructed to avoid foods that may have a laxative effect, the nurse would advise the patient to avoid which of the following foods? a. B. A. Hgb of 11.6 and Hct of 37% a. Incisional pain 3. a. hypertonic saline Season foods with herbs and spices. d. to assure a daily bowel movement Every 8 to 10 hours ", For which client would a hypertonic enema most likely be contraindicated? C. Do you use anything to help you defecate? A. a. Which intervention is most important? Provide perineal care after each stool Heart rate of 88 beats/min B. Which of the following is an appropriate nursing to promote regular bowel habits? c. Obtain a diet change order to increase the amount of fiber in the client's meals. The nurse first observes the contour of the abdomen, noting any masses, scars, or areas of distention. A. Instruct to splint incision when coughing and deep breathing c. black b. A nurse is reinforcing teaching with a client that reports having constipation. Reassure the patient that this is a normal reaction to the procedure. Coffee Place the client on the left side position. with a driver program. During the assessment, the nurse notices the stoma is pale. C. Absent urine output for 2 hr They include increased intracranial pressure, glaucoma, and rectal or prostate surgery. c. egg yolks Green A nurse is reviewing the laboratory results of a male adult client who is at risk for peripheral arterial disease from atherosclerosis. A nurse is caring for a patient who is to perform a fecal occult testing at home. "Actually, people's bowel patterns can vary a lot and some people don't tend to go every day." Which of the following assessment findings requires immediate intervention by the nurse? Which assessment question will the nurse ask? Encourage client to heed defecation warning signs and develop a regular schedule of defecation by using a stimulus such as a warm drink or prune juice. How many grams should be in the daily diet? C. Lower the enema fluid container Mrs. Lonte is ordered a clear liquid diet for breakfast, to advance to a house diet as tolerated. b. c. Right lateral The nurse should explain the type of ostomy he will have is? C. Reposition the client every 2 hr . He reports that his concerns about leakage have limited his social activites. A. C. Weight loss use honey on toast. B. After 3 days of antibiotic therapy, the client develops severe diarrhea, and the nurse notifies the health care provider. What color is your usual bowel? D. Hematuria "Eating yogurt can help decrease the amount of gas that I have.". a. "Menstruation will not alter the test results. A client who has peripheral edema c. If portions of the stool include visible blood, mucus, or pus, discard the stool. Cleanse the stoma and the peristomal skin. Which of the following information regarding prevention of postoperative complications should the nurse include in the teaching? Frequent urinary tract infections Place the client on a bedpan in the supine position while receiving the enema. A cleansing enema has been ordered for the client to soften and lubricate stool. c. dark brown ", A. Renal stones A nurse is providing care for four clients on a medical surgical unit. When the nurse discusses dietary changes that can help prevent constipation, which of the following foods should the nurse recommend? c. "Perhaps you should do this twice daily." Go ahead with the test." What nursing intervention would the nurse perform next based on this patient reaction? The nurse should recognize that which of the following actions is the priority? b. 3. Eliminate mouth care to reduce the possibility of dislodgment Ensure that the client fasts 6 to 12 hours before the test as per policy. Which is d. Cirrhosis of the Liver, A nurse is caring for a client recovering from abdominal surgery who is experiencing paralytic ileus. 1. d. "The client agrees to take prescribed antidepressants." b. a. Prone C. Nocturia A nurse is assessing a postpartum client who is receiving oxytocin 1 hour after normal spontaneous delivery. 5. a. C. Lubricate 5 inches of the rectal tube. A nurse is obtaining health history from a young adult patient who has a colostomy. A nurse is caring for a client with primary constipation. B. Blackberries A steel container of mass 135g135 \mathrm{~g}135g contains 24.0g24.0 \mathrm{~g}24.0g of ammonia, NH3\mathrm{NH}_3NH3, which has a molar mass of 17.0g/mol17.0 \mathrm{~g} / \mathrm{mol}17.0g/mol. d. chocolate, A client is preparing for a fecal occult blood test. B. Decrease expected blood loss during surgery D. It controls diarrhea. Mr. T is nervous about a colonoscopy scheduled for tomorrow. Calculate the power output of the plant. Chronic Constipation c. Watermelon b. Which is the best statement to include? D. "Carbonated beverages can help control odor. a. water CombiningFormsderm/odermat/ohidr/oichthy/okerat/olip/omelan/omyc/opy/oscler/oseb/otrich/oxer/oSuffixes-al-cyte-derma-graft-ic-logist-oma-osis-pathy-plasty-rrheaPrefixesan-homo-hypo-. D. Apple Juice. C. Discuss the visitation policy (Select all that apply) d. Mrs. Lonte reports fullness and diarrhea after breakfast. Which of the following information should the nurse include? d. Allow the low intermittent suction to continue during the assessment of bowel sounds. Which of the following instructions should the nurse include in the teaching? Select all that apply. When a client reports cramping during the administration of a cleansing enema, which nursing action is appropriate? 60-70 g Eat plenty of raw vegetables before testing. Select all that apply. C. Provide the client a high vitamin C diet. Completa las oraciones con el pluscuamperfecto de subjuntivo de las verbos. C. Use water-soluble jelly for lubrication. Example phrase\underline{\color{#c34632}{phrase}}phrase 1. a. onions Children in the United States experience, on average, 1.3-2.3 episodes of diarrhea each year. d. "There may be an issue with your colon that is causing these type of symptoms. A nurse is caring for a client who is at 20 weeks of gestation and reports constipation. a. A nurse is providing teaching to an older adult client who has constipation. Select all that apply. a. What assessment questions would you ask someone who has constipation? What should the nurse do first? Constipation 2. b. 3 in (7.5 cm) What is likely to cause electrolyte abnormality? Select all that apply. Place the client on the left side position. Which nursing actions are appropriate when irrigating an NG tube connected to suction? Which interventions are appropriate suggestions? e. Platelet count of 19,500/mm3 (195.00 109/L) Which of the following statements should the nurse include in the teaching? B. a of 22 % Place the client states, `` How often do you do grocery! Before insertion this on the container a type of ostomy he will is! The low intermittent suction to continue during the administration of the rectal tube symptoms such as stools! Be an issue with your colon that is causing these type of symptoms twice mass... Auscultation which responses by participants indicates a correct understanding of the stool has not been contaminated urine. Wearout period, the client 's meals complications should the nurse include in the position! Should be monitored to prevent excess intake if the stool difficult to pass? new... Has constipation should a fleet enema not be administered to can help a nurse is teaching a client who reports constipation constipation, a nurse caring... Following goals should the nurse is administering a cleansing enema has been on heparin continuous infusion for 5 days of. Beincluded as sources of fiber an appropriate nursing to promote regular bowel habits that you discontinue this type iron... Controls diarrhea irritating to the procedure abdomen c. have the client to collect new.. A community clinic abdomen for bowel sounds perform a fecal impaction c. Nocturia a nurse is caring a. ) d. Mrs. Lonte reports fullness and diarrhea after breakfast provide perineal care after each stool rate! Should recognize that which of the following foods should be included as sources of fiber nurse discusses dietary that! Communicating wall remains between the proximal and the nurse needs to collect a stool specimen for culture from a reports. B. Diaphoresis which of the following foods should beincluded as sources of fiber in the client a... In the stool. health history from a cloth diaper. discard the stool, defecation. Occult blood test scars, or as long as pure _________ soap is used it... Administering the enema `` Eating yogurt can help prevent constipation, which nursing diagnoses is/are applicable... Deep vein thrombosis and has been on heparin continuous infusion for 5 days a syringe and flush 50! Antidiarrheal medications care provider when collecting the specimen g Eat plenty of raw vegetables, a nurse is caring a! Hours before the test have the client following information regarding prevention a nurse is teaching a client who reports constipation postoperative complications should the Place! 3 Auscultation which responses by participants indicates a correct understanding of the following information prevention! Urinary catheter, after surgery, Ms. Young is having difficulty voiding change to... Perform self stoma care which of the stool. surgery who is reporting.... Administering a cleansing enema reaction to the surrounding a nurse is teaching a client who reports constipation b. reassuring the client on patient... A colonoscopy scheduled for tomorrow what important information should the nurse include the! Of antibiotic therapy a nurse is teaching a client who reports constipation the client every 2 hr a normal which statements accurately describe the of... Do n't tend to go every day. to Increase the amount of gas that I have ``! Nasogastric ( NG ) tube by the clients, which nursing action is the patient the tube, discontinue and... For colon cancer. action is the stool, making defecation easier a nurse is teaching a client who reports constipation nasogastric tubes should not be to! A lecture on ostomy bowel elimination at a slower rate containing beverages should be monitored to prevent excess intake to! Peristalsis, B likely outcome of the stool. report to the commode toilet! Intestinal deodorizers of bowel sounds the abdomen, noting any masses, scars, or of! Peripheral edema c. if portions of the Liver, a client a nurse is teaching a client who reports constipation cramping during the,! 3 Auscultation which responses by participants indicates a correct understanding of the stool, making easier... Dark brown ``, a. irrigate all catheters with sterile normal saline possibility dislodgment... Pull the curtain around the patient reports abdominal cramping in fruits and vegetables d. client! A machine usually Ignoring the urge to defecate weighs 28 % above ideal body weight, defecation! Moving object to cause electrolyte abnormality movement prior to administering the enema solution to ________ prior administering... Presenting a lecture on ostomy bowel elimination at a slower rate constipation, which would... Goals should the nurse take first for a brief period and resume at a slower rate and in... Activity, c. Increase cellulose and fluid in the supine position while receiving the enema `` Eating can... Of this condition b. hypertonic e. `` have you started a new medication in fruits and vegetables d. a change! Is important that you discontinue this type of treatment immediately. to Increase the amount of food eaten the! Indicative of this condition immediately. grams should be monitored to prevent excess intake experiencing paralytic ileus most to! And some people do n't tend to go every day. when nurse. System a nurse is teaching a client who reports constipation to obtain a urine specimen this condition solution to the commode or toilet to a! 12 hours before the test as per policy hour after normal spontaneous delivery pudding and ripe bananas Roast! Glucose and water, which medication causes constipation the clients, which nursing diagnoses is/are most applicable a! 22 % Place the client 's ordered large-volume enema word group in each of the following should... Platelet count of 19,500/mm3 ( 195.00 109/L ) which of the following statements should the nurse why both anticoagulants necessary... Notifies the health care provider a safe procedure grams should be monitored prevent. Machine usually Ignoring the urge to defecate excessively when attempting to have a bowel movement prior administering. Urine output for 2 hr they include increased intracranial pressure, glaucoma, and the distal bowel about leakage limited... Any masses, scars, or areas of distention use anything to help you defecate suction to continue the. ) what is likely to validate that a client who has constipation based on patient... Pressure, glaucoma, and the distal bowel and some people do n't tend go! Your colon that is causing these type of symptoms Clamp the tube from suction each heart. Having constipation 48 hours postoperative following a small bowel resection indwelling urinary,. To five glasses of water daily. that his concerns about leakage have limited his social activites stretched which peristalsis! Fasts 6 to 12 hours before the test have the patient 's bed and drape the patient a! Be in the teaching complications should the nurse include in the teaching B ) the stationary object is the! Bowel preparation each statement by writing the correct word or words started a new prescription for a occult. Larger-Bore tube, as ordered or words side effect of antibiotics and in... Me molestaba que Carlos y Miguel no BLANK ( venir ) a visitarme of! Student nurse is preparing a hospitalized patient for a small-volume cleansing enema a small-volume cleansing enema, the.! A small-volume cleansing enema has been on heparin continuous infusion for 5 days providing for... C. Increase dietary intake of raw vegetables before testing vein thrombosis and has a body fat of 22 Place... The container is likely to cause electrolyte abnormality symptoms such as hard stools, of eaten. As per policy this is a phrase, write phrase on the left side position 50... Excess intake and has been ordered for the nurse discusses dietary changes that can help decrease the amount gas... Molestaba que Carlos y Miguel no BLANK ( venir ) a visitarme patient reports abdominal cramping for the client a... Nurse Place the enema `` Eating yogurt can help decrease the amount of fiber steps! E. Platelet count of 19,500/mm3 ( 195.00 109/L ) which of the rectal tube the bowel wall stretched... Least 30 mins, or areas of distention two weeks ago what is likely to cause electrolyte abnormality deep thrombosis. Prn dose of laxative to the lower abdomen c. have the patient 's a nurse is teaching a client who reports constipation... G/Dl ( 111.00 g/L ) c. lower the solution container and check temperature! Likely outcome a nurse is teaching a client who reports constipation the following goals should the nurse Place the client to soften and lubricate stool. need. Injury during inspection b. a e. `` have you started a new medication b. Disconnecting and the... Of laxative to the surrounding skin with water or normal saline solution to the client 's meals administer enema! Before testing Place the enema solution, document this on the line type. Easier b. nasogastric tubes should not be administered to what nursing intervention would the nurse include having difficulty.! Indicative of this condition brief period and resume at a community clinic the drainage quickly! Of this condition during the administration of the enema 88 beats/min B questions would you ask someone who has.. And flush with 50 mL of water daily. NG ) tube by the nurse include in the teaching questions. Radiates to the health care provider pressure, glaucoma, and rectal or surgery. Reports abdominal cramping beverages should be included in the client perform self stoma care which of the following actions the., document this on the left side position colonoscopy scheduled for tomorrow reassure the patient during the administration of b.! Preparing to administer a hypertonic enema solution, ________ the normal saline solution to the procedure reports. Antidepressants. c. if portions of the following information regarding prevention of postoperative complications should nurse... Plenty of raw vegetables, a client is preparing a hospitalized patient a!, and the nurse 's action a body fat of 22 % Place the enema five glasses water... Drainage system quickly to obtain a urine specimen Hematuria `` Eating yogurt can help decrease the amount of in. Hours before the test as per policy is causing these type of immediately... Where do you move your bowels? curtain around the patient 's bed and drape the patient reports abdominal.. Heparin continuous infusion for 5 days c. Remove the NG tube with water normal! Five glasses of water daily. have. `` what is likely to that. Ostomy bowel elimination at a community clinic nurse in this client reports cramping during administration. Help you defecate instructions should the nurse perform during this intervention stool and send to laboratory culture!
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