C.W., a 36-year-old woman, was admitted several days ago with a diagnosis of recurrent inflammatory boweldisease (IBd) and possible small bowel obstruction (sBO)
C.W. is married, and her husband and 11-year-old son are supportive, but she has no extended family in the state. she has had IBd for 15 years and has been taking mesalamine (Asacol) for 15 years and prednisone 40mg/day for the past 5 years. she is very thin; at 5
feet 2 inches, she weighs 86 pounds and has lost 40 pounds over the past 10 years. she averages 5 to 10 loose
stools per day. C.W.'s life has gradually become dominated by her disease, with anorexia, lactase deficiency,
profound fatigue, frequent nausea and diarrhea, frequent hospitalizations for dehydration, and recurring,
crippling abdominal pain that often strikes unexpectedly. The pain is incapacitating and relieved only by a
small dose of diazepam (Valium), oral electrolyte solution (Pedialyte), and total bed rest. she confides in you
that sexual activity is difficult: "It always causes diarrhea, nausea, and lots of pain. It's difficult for both of us."
she is so weak she cannot stand without help. You indicate complete bed rest on the nursing care plan.
Identify six priority problems for C.W.
• Chronic pain
• Diarrhea
• Malnutrition or poor absorption of all nutrients
• Potential fluid and electrolyte imbalances
• Risk for skin breakdown (perianal and pressure areas)
• Fatigue
• Possible problems with coping (individual or family)
• Lactase deficiency
• Possible osteoporosis related to (R/T) long-term steroid use
• Potential for depression R/T chronic illness
• Sexual dysfunction
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A) Referral for nursing home placement B) Questions about insurance status C) Referral to psychiatry for evaluation D) Referral to multidisciplinary rehabilitation team
The nurse is assessing the client's head and neck. The nurse provides the client with a glass of water. Which structure is the nurse assessing while observing the client drinking the water?
1. Temporomandibular joint. 2. Lymph nodes. 3. Temporal artery. 4. Trachea.
Which of the following is an early warning sign of hypertrophic pyloric stenosis?
a. the infant looking and acting somewhat sick b. the infant being hungry and wanting to feed again very soon after vomiting c. milk running out of the infant's mouth periodically during the feeding d. unusually loud burping sounds
An older adult is sore from "doing too much in the yard yesterday." Which statement by the nurse best promotes healthy aging?
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