Author Question: A nurse reviews the chart of a client who has Crohn's disease and a draining fistula. Which ... (Read 116 times)

123654777 · **on:** Jun 25, 2018

A nurse reviews the chart of a client who has Crohn's disease and a draining fistula. Which documentation should alert the nurse to urgently contact the provider for additional prescriptions?

a. Serum potassium of 2.6 mEq/L
b. Client ate 20 of breakfast meal
c. White blood cell count of 8200/mm3
d. Client's weight decreased by 3 pounds

Question 2

A nurse assesses a client who has ulcerative colitis and severe diarrhea. Which assessment should the nurse complete first?

a. Inspection of oral mucosa
b. Recent dietary intake
c. Heart rate and rhythm
d. Percussion of abdomen

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

Answer to Question 1

ANS: A
Fistulas place the client with Crohn's disease at risk for hypokalemia which can lead to serious dysrhythmias. This potassium level is low and should cause the nurse to intervene. The white blood cell count is normal. The other two findings are abnormal and also warrant intervention, but the potassium level takes priority.

Answer to Question 2

ANS: C
Although the client with severe diarrhea may experience skin irritation and hypovolemia, the client is most at risk for cardiac dysrhythmias secondary to potassium and magnesium loss from severe diarrhea. The client should have her or his electrolyte levels monitored, and electrolyte replacement may be necessary. Oral mucosa inspection, recent dietary intake, and abdominal percussion are important parts of physical assessment but are lower priority for this client than heart rate and rhythm.