A client with Crohn's disease is seen in the nursing clinic ...

[anjilletteb]

A client with Crohn's disease is seen in the nursing clinic following a recent flare-up. The client describes herself as married with no children and a hard-working elementary school teacher.
 
  Which questions asked by the nurse are an important part of this client's assessment? Standard Text: Select all that apply. 1. What sort of coping mechanisms do you usually use?
  2. Do you consider yourself to be hard-driving, ambitious, and competitive?
  3. How are things at work for you at present?
  4. What can you tell me about your relationship with your husband?
  5. How do you feel about yourself in general?

Question 2

Which of the following behaviors observed by the nurse will be important to disclose to the teacher of a child with a stereotypic movement disorder?
 
  1. An episode of self-mutilation
  2. Depression that results from feelings of inadequacy
  3. Tendency to be hypoactive
  4. Flexibility and ability to contribute to learning

[hollysheppard095]

Answer to Question 1

1,3,4,5
Rationale: What sort of coping mechanisms do you usually use? Crohn's disease is an inflammatory bowel disorder thought to be influenced by psychological factors. Assessment should focus on psychological factors such as the use of coping mechanisms that might contribute to the disorder. Some coping mechanisms might help feelings but aggravate the disorder.

Answer to Question 2

1
Rationale: Some children with a spectrum disorder have many associated behavioral problems such as hyperactivity, aggressiveness, self-injurious behaviors such as head banging, and temper tantrums. This is important and relevant to discuss with the child's teacher who is a member of the treatment team. Problems with socialization and communication difficulties are also common, evidenced by deficits in spontaneous, imaginative play. Stereotypic movement disorder involves repetitive nonfunctional motor behavior (i.e., hand waving, self-biting, body rocking, or head banging) that interferes with normal activity or risks self-inflicted bodily injury. The behavior lasts 4 weeks or longer. These behaviors are seemingly driven and protective measures are usually needed so that medical treatment will not be necessary. These children will have difficulty adapting to change, so they will have great difficulty, if able at all, to be flexible or contribute to their learning. The child's tendency would be toward hyperactivity rather than hypoactivity.