Author Question: The nurse has instructed the patient who is experiencing diarrhea associated with irritable bowel ... (Read 83 times)

littleanan · **on:** Jun 25, 2018

The nurse has instructed the patient who is experiencing diarrhea associated with irritable bowel syndrome on dietary changes to prevent diarrhea. The nurse knows the patient understands the dietary changes if the patient selects which menu choices?

1. yogurt, crackers, and sweet tea
2. salad with chicken, whole wheat crackers
3. bacon, tomato, lettuce with mayonnaise, and a soft drink
4. tuna on white bread and green grapes

Question 2

The nurse is caring for a patient taking chenodiol (Chenix). Which patient statements indicate the need for immediate follow-up by the nurse?

Select all that apply.
1. I could see the big gallstone on the x-ray, but this medication doesn't seem to be helping at all. I don't feel better after taking it for 4 months.
2. My rectal area is tender from all the diarrhea I've been having.
3. My skin looks yellow.
4. I can't afford my medication and have been cutting pills in half to make it last longer.
5. I can see bits of gallstones in my stools.

Sammyo · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 2
Bacon, tomato, lettuce with mayonnaise and soft drink is high in fat and the soft drink is hyperosmolar, both contributing to diarrhea. Salad and whole wheat crackers may decrease diarrhea due to increased fiber. Dairy increases diarrhea. Foods high in carbohydrates increase diarrhea. Green grapes may increase diarrhea.

Answer to Question 2

Correct Answer: 1, 2, 3, 4
Chenodiol (Chenix) reduces the cholesterol content of gallstones, leading to their gradual dissolution. Chenodiol has a high incidence of diarrhea at therapeutic doses and is hepatotoxic, so periodic liver function studies are required during therapy. A primary disadvantage of pharmacologic treatment for gallstones is its cost. Because of the gradual rate at which the medication acts, pieces of gallstones are not visible in the patient's stools.