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Chapter 046

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Potter & Perry: Fundamentals of Nursing, 7th Edition Test Bank Chapter 46: Bowel Elimination MULTIPLE CHOICE 1. Which of the following would the nurse expect as a normal change in the bowel elimination as a person ages? 1. Absorptive processes are increased in the intestinal mucosa. 2. Esophageal emptying time is increased. 3. Changes in nerve innervation and sensation cause diarrhea. 4. Mastication processes are less efficient. ANS: 4 An expected change in bowel elimination is decreased chewing
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  Potter & Perry: Fundamentals of Nursing, 7 th  Edition Test Bank Chapter 4: Bo!el Elimination #$T%P$E C'%CE 1.Which of the following would the nurse expect as a normal change in the bowel elimination as a person ages?1.Absorptive processes are increased in the intestinal mucosa.2.Esophageal emptying time is increased.3.hanges in nerve innervation and sensation cause diarrhea.!. astication processes are less efficient.A#$%!An expected change in bowel elimination is decreased chewing and decreased salivation& resulting in less efficient mastication. 'here is decreased nutrient absorption of the small intestine in the older adult. Esophageal emptying slows& as a result of reduced motility& especially in the lower third of the esophagus. With decreased peristalsis and wea(ened musculature& the older adult is more prone to constipation. )uller nerve sensations may  place the older adult at increased ris( for fecal incontinence.)*+%A,E+%11--/0%omprehension'%#ursing rocess% Assessment $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5Elimination2.An 67month7old infant is hospitali8ed with severe diarrhea. 'he nurse (nows that the ma9or problem associated with severe diarrhea is%1.ain in the abdominal area2.Electrolyte and fluid loss3.resence of excessive flatus!.*rritation of the perineal and rectal areaA#$%2Excess loss of colonic fluid because of diarrhea can result in serious fluid and electrolyte or acid7base imbalances. *nfants and older adults are particularly susceptible to associatedcomplications. ain from abdominal cramping may occur with diarrhea& but it is not the ma9or problem associated with severe diarrhea. Excessive flatus is not the ma9or problem associated with severe diarrhea. /ecause repeated passage of diarrhea stools exposes the s(in of the perineum and buttoc(s to irritating intestinal contents& meticulous s(in care and containment of fecal drainage are needed to prevent s(in brea(down. 'he greatest danger of severe diarrhea is a fluid and electrolyte or acid7base imbalance.)*+%A,E+%116:/0%omprehension'%#ursing rocess% Assessment $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5Elimination osby items and derived items ; 2::<& 2::= by osby& *nc.& an affiliate of Elsevier *nc.  'est /an( 3.A =:7year7old male client is having a screening colonoscopy. 'he nurse instructs the client that%1.#o special preparation is re>uired2.ight sedation is normally used3.#o metallic ob9ects are allowed!.$wallowing of an opa>ue li>uid is re>uiredA#$%2ight sedation is re>uired for a colonoscopy. $pecial preparation is re>uired before a colonoscopy. lear li>uids are given the day before and then some form of bowel cleanser& such as oytely& is administered. Enemas until clear may also be ordered. 'here is no restriction of metallic ob9ects for a colonoscopy& not does it re>uire swallowing an opa>ue li>uid.)*+%A,E+%11-6/0%omprehension'%#ursing rocess% *mplementation $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5Elimination!.A client is to have a stool test for occult blood. 'he nurse is instructing the nursing assistant in the correct procedure for the test. 'he nursing assistant is correctly informed that%1.$terile techni>ue is used for collection2.$tool should be collected over a 37day period3.'he specimen should be (ept warm!.A 17inch sample of formed stool is neededA#$%!'ests performed by the laboratory for occult blood in the stool and stool cultures re>uire only a small sample. 'he nurse uses clean techni>ue to collect about 1 inch of formed stool or 1= to 3: m of li>uid stool. @nli(e testing for occult blood& tests for measuring the output of fecal fat re>uire a 37 to =7day collection of stool& and tests that measure for ova and parasites re>uire the stool to be warm.)*+%A,E+%1166/0%omprehension'%#ursing rocess% *mplementation $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5Elimination=.A client who recently underwent surgery and now has a colostomy is correctly instructed  by the nurse that for the next few wee(s the clients diet will include foods such as%1.Begetables2.+resh fruit3.Whole grain breads!.oached eggs and riceA#$%! osby items and derived items ; 2::<& 2::= by osby& *nc.& an affiliate of Elsevier *nc. !C72  'est /an( )uring the first wee(s after surgery& many health care providers recommend low7fiber diets because the bowel re>uires time to adapt to the diversion. ow7fiber foods include  bread& noodles& rice& cream cheese& eggs Dnot fried& strained fruit 9uices& lean meats& fish& and poultry. oached eggs and rice would be appropriate for this client. After the ostomy heals& the client is allowed to eat whole grains& fruits& and vegetables. Figh7fiber foods such as fresh fruits and vegetables help ensure a more solid stool needed to achieve success at irrigation. stomy clients may benefit from avoiding foods that cause gas and odor& including broccoli& cauliflower& dried beans& and /russels sprouts.)*+%A,E+%121:/0%omprehension'%#ursing rocess% lanning $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5EliminationC.'he client has been admitted to an acute care unit with a diagnosis of biliary disease. 'he nurse suspects that the feces will appear%1./loody2.us filled3./lac( and tarry!.White or clay coloredA#$%!$tool that is white or clay colored indicates an absence of bile. /loody feces is not an indication of biliary disease. us7filled feces indicate infection. /lac( or tarry feces may indicate upper gastrointestinal D* bleeding or iron ingestion.)*+%A,E+%1166711<:/0%omprehension'%#ursing rocess% Assessment $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5Elimination-.'he client as(s the nurse to recommend bul(7forming foods that may be included in the diet. Which of the following should be recommended by the nurse?1.Whole grains2.+ruit 9uice3.,are meats!. il( productsA#$%1/ul(7forming foods& such as grains& fruits& and vegetables& absorb fluids and increase stool mass. +ruit 9uice& rare meats& and mil( products are not bul(7forming foods.)*+%A,E+%11--/0%omprehension'%#ursing rocess% *mplementation $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5Elimination osby items and derived items ; 2::<& 2::= by osby& *nc.& an affiliate of Elsevier *nc. !C73  'est /an( 6.'he client is ta(ing medications to promote defecation. Which of the following instructions should be included by the nurse in the teaching plan for this client?1.*ncreased laxative use often causes hyper(alemia.2.$alt tablets should be ta(en to increase the solute concentration of the extracellular fluid.3.Emollient solutions may increase the amount of water secreted into the bowel.!./ul(7forming additives may turn the urine pin(.A#$%3Emollient solutions are stool softeners that may increase the amount of water secreted into the bowel. axative overuse can cause serious diarrhea that can lead to dehydration and hypo(alemia. $alt tablets should not be ta(en to increase the solute concentration of extracellular fluid. /ul(7forming additives do not turn the urine pin(. henolphthalein or danthron stimulant cathartics De.g.& )oxidan& orrectol& Ex7ax may cause pin( or red urine.)*+%A,E+%11<6/0%omprehension'%#ursing rocess% lanning $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5Elimination<.While undergoing a soapsuds enema& the client complains of abdominal cramping. 'he nurse should%1.*mmediately stop the infusion2.ower the height of the enema container 3.Advance the enema tubing 2 to 3 inches!.lamp the tubingA#$%2'he nurse should lower the container if the client complains of abdominal cramping. ramping may prevent the client from retaining all of the fluid& which would alter the effectiveness of the enema. *f the nurse stops the infusion& the client will not receive all of the fluid& and the enema will be less effective. 'he nurse may slow the infusion until the abdominal cramping passes. 'he enema tubing should not be advanced further. 'he tubing may be clamped temporarily if fluid escapes around the rectal tube. 'he instillation should be slowed in the instance of abdominal cramping.)*+%/,E+%12:2/0%Application'%#ursing rocess% *mplementation $%#E4 test plan designation% hysiological *ntegrity5/asic are and omfort5Elimination1:.A nurse who is caring for postoperative clients on a surgical unit (nows that for 2! to !6 hours postoperatively& clients who have undergone general anesthesia may experience%1.olitis2.$tomatitis3.aralytic ileus osby items and derived items ; 2::<& 2::= by osby& *nc.& an affiliate of Elsevier *nc. !C7!

Chapter 048

Jul 23, 2017

Chapter 045

Jul 23, 2017
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