Clinical Manifestations

1.
The nurse anticipates that Loren will describe her diarrhea as:
A) Bloody.
Feedback: CORRECT
Clients with ulcerative colitis may experience as many as 10-20 liquid, bloody stools per day.

B) Green and frothy.
Feedback: INCORRECT
This description is not associated with the diarrhea of ulcerative colitis.

C) Gray with observable fat.
Feedback: INCORRECT
This describes stool often seen in pancreatitis.

D) Clay-colored.
Feedback: INCORRECT
Clay-colored stool indicates the absence of bile in the stool, which may be seen in clients with cirrhosis or cholecystitis.

Points Earned:
0.0/1.0

Correct Answer(s):
A

2.
Because rectal bleeding is a common finding in ulcerative
B) Abdominal guarding.
Feedback: CORRECT
Abdominal distention, tenderness, or guarding may indicate perforation of the intestine.

C) Concentrated urine.
Feedback: INCORRECT
Concentrated urine might be an indicator of dehydration secondary to hemorrhage following the procedure, but it is not likely to occur immediately post-procedure.

D) Inelastic skin turgor.
Feedback: INCORRECT
Inelastic skin turgor might be an indicator of dehydration secondary to hemorrhage, but it is not likely to occur immediately post-procedure.

Points Earned:
0.0/1.0

Correct Answer(s):
B

Therapeutic Communication

The diagnostic test results confirm that Loren has acute ulcerative colitis. During the acute phase, edema and ulceration of the bowel mucosa are seen, with resultant hemorrhage. Further changes in the colon occur as the disease progresses and becomes chronic.
After the healthcare provider explains to Loren her diagnosis and the necessary treatment, the nurse observes that she is visibly upset and trying to refrain from crying. When the nurse sits down next to her, Loren says, "My life is over. I'll have to quit college and move home with my parents to let them take care of me. My boyfriend won't want to spend time with someone who has diarrhea all the time."

8.
In responding to Loren, the nurse recognizes that Loren's remarks reflect which of Erikson's developmental stages?
A) Ego integrity versus despair.
Feedback: