Chapter 13 Diarrhea
A patient with Crohn’s disease complains of extreme muscle weakness, fatigue, diarrhea, bruising, 10-pound
weight loss over the last few weeks, and dypnea on exertion. On physical examination, the patient is
afebrile, pulse 110, resps 20/min, and BP 100/ 50. BMI is 15. The patient is pale and frail looking, with
bilateral ankle edema and bruises noted on cachetic thighs. Which of the following diagnostic tests is most
helpful in the diagnosis of intestinal malabsorption?
A. Liver enzymes
B. Vitamin B12 assay
C. Stool for fat
D. INR
ANS: C
The signs and symptoms vary according to the underlying problem, but common symptoms include weight
loss, flatulence, abdominal bloating, edema in the lower extremities resulting from protein deficiency,
muscle weakness, possibly diarrhea or steatorrhea, dehydration, glossitis, and bruising. A variety of
abnormal findings can be associated with malabsorption syndromes, including iron, folic acid, or B12
deficiency anemia; calcium deficiency; vitamins A, B, C, and D deficiencies; and niacin deficiency. A
combination of weight loss, diarrhea, and anemia should raise the possibility of malabsorption. A variety of
abnormal findings can be associated with malabsorption syndromes, including iron, folic acid, or B12
deficiency anemia; calcium deficiency; vitamins A, B, C, and D deficiencies; and niacin deficiency. There
are as many diagnostics as there are causes of malabsorption. Measurement of fat in the stool is the most
valuable diagnostic for diagnosing malabsorption, and a 3- to 4-day stool collection is advised. Stool
specimens for ova, parasites and culture, and sensitivity will help to rule out infectious causes. Absorption
tests, flat plate of the abdomen, upper GI with small bowel follow- through, endoscopy, and small bowel
biopsy may be necessary for definitive diagnosis.
2.A patient has hypoactive bowel sounds. The nurse knows that a potential cause of hypoactive bowel
sounds is:
a. Diarrhea.
b. Peritonitis.
c. Laxative use.
d. Gastroenteritis. ANS: B
Diminished or absent bowel sounds signal decreased motility from inflammation as exhibited
with peritonitis, with paralytic ileus after abdominal surgery, or with late bowel obstruction.
, 3. The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by
increased flatulence, diarrhea, and nausea. Which of the following is the most appropriate suggestion to
lessen these symptoms?
a. Eat a diet high in fiber content
A patient with Crohn’s disease complains of extreme muscle weakness, fatigue, diarrhea, bruising, 10-pound
weight loss over the last few weeks, and dypnea on exertion. On physical examination, the patient is
afebrile, pulse 110, resps 20/min, and BP 100/ 50. BMI is 15. The patient is pale and frail looking, with
bilateral ankle edema and bruises noted on cachetic thighs. Which of the following diagnostic tests is most
helpful in the diagnosis of intestinal malabsorption?
A. Liver enzymes
B. Vitamin B12 assay
C. Stool for fat
D. INR
ANS: C
The signs and symptoms vary according to the underlying problem, but common symptoms include weight
loss, flatulence, abdominal bloating, edema in the lower extremities resulting from protein deficiency,
muscle weakness, possibly diarrhea or steatorrhea, dehydration, glossitis, and bruising. A variety of
abnormal findings can be associated with malabsorption syndromes, including iron, folic acid, or B12
deficiency anemia; calcium deficiency; vitamins A, B, C, and D deficiencies; and niacin deficiency. A
combination of weight loss, diarrhea, and anemia should raise the possibility of malabsorption. A variety of
abnormal findings can be associated with malabsorption syndromes, including iron, folic acid, or B12
deficiency anemia; calcium deficiency; vitamins A, B, C, and D deficiencies; and niacin deficiency. There
are as many diagnostics as there are causes of malabsorption. Measurement of fat in the stool is the most
valuable diagnostic for diagnosing malabsorption, and a 3- to 4-day stool collection is advised. Stool
specimens for ova, parasites and culture, and sensitivity will help to rule out infectious causes. Absorption
tests, flat plate of the abdomen, upper GI with small bowel follow- through, endoscopy, and small bowel
biopsy may be necessary for definitive diagnosis.
2.A patient has hypoactive bowel sounds. The nurse knows that a potential cause of hypoactive bowel
sounds is:
a. Diarrhea.
b. Peritonitis.
c. Laxative use.
d. Gastroenteritis. ANS: B
Diminished or absent bowel sounds signal decreased motility from inflammation as exhibited
with peritonitis, with paralytic ileus after abdominal surgery, or with late bowel obstruction.
, 3. The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by
increased flatulence, diarrhea, and nausea. Which of the following is the most appropriate suggestion to
lessen these symptoms?
a. Eat a diet high in fiber content
