An adolescent with irritable bowel syndrome comes to see the ...

[nevelica]

An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?
 
  a. A low-fiber diet is required.
  b. Stress management may be helpful.
  c. Milk products are a contributing factor.
  d. Pantoprazole (a proton pump inhibitor) is effective in treatment.

Question 2

What clinical manifestation should be the most suggestive of acute appendicitis?
 
  a. Rebound tenderness
  b. Bright red or dark red rectal bleeding
  c. Abdominal pain that is relieved by eating
  d. Colicky, cramping, abdominal pain around the umbilicus

[cassie_ragen]

Answer to Question 1

ANS: B
Irritable bowel syndrome is believed to involve motor, autonomic, and psychologic factors. Stress management, environmental modification, and psychosocial intervention may reduce stress and gastrointestinal symptoms. A high-fiber diet with psyllium supplement is often beneficial. Milk products can exacerbate bowel problems caused by lactose intolerance. Antispasmodic drugs, antidiarrheal drugs, and simethicone are beneficial for some individuals. Proton pump inhibitors have no effect.

Answer to Question 2

ANS: D
Pain is the cardinal feature. It is initially generalized, usually periumbilical. The pain becomes constant and may shift to the right lower quadrant. Rebound tenderness is not a reliable sign and is extremely painful to the child. Bright or dark red rectal bleeding and abdominal pain that is relieved by eating are not signs of acute appendicitis.

[nevelica]

TYSM

[bblaney]

Gracias!