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Irritable Bowel Syndrome
A client with IBS reports that symptoms worsen with stress. The nurse should encourage which of the following interventions to help manage the client's symptoms?
Correct Answer:
c) engage in stress reduction techniques
Rationale:
Stress is a known trigger for IBS symptoms. Encouraging stress reduction techniques, such as mindfulness, meditation, or cognitive-behavioral therapy, can help manage and potentially reduce symptom severity. Increasing dairy or caffeine intake may exacerbate symptoms, and a low-residue diet is not specifically recommended for IBS without constipation or diarrhea components (Ford et al., 2017).
A nurse is educating a client newly diagnosed with IBS about dietary modifications. Which recommendation is most appropriate?
Correct Answer:
b) eat small, frequent meals throughout the day
Rationale:
Eating small, frequent meals can help prevent bloating and discomfort often experienced in IBS. While some individuals with IBS may benefit from a gluten-free diet, it is not a blanket recommendation for all. Complete elimination of carbohydrates or an increase in fried and fatty foods can exacerbate symptoms (Moayyedi et al., 2015).
During a client’s education session about IBS, the nurse explains the role of the gut-brain axis. Which statement made by the client indicates understanding?
Correct Answer:
b) "stress and anxiety can impact my ibs symptoms."
Rationale:
The gut-brain axis refers to the complex communication between the gastrointestinal tract and the central nervous system. Stress and anxiety can significantly impact IBS symptoms. While diet can play a role, it is not the primary cause, and physical exercise alone is not a cure (Mayer et al., 2015).
A client with IBS-D (diarrhea-predominant IBS) is prescribed alosetron. What is the most important teaching point for the nurse to emphasize?
Correct Answer:
b) monitor for signs of severe constipation or ischemic colitis
Rationale:
Alosetron is prescribed for IBS-D, but it has potential side effects, such as severe constipation and ischemic colitis. Clients need to be aware of these serious adverse effects and should report them immediately. Increasing fiber, taking laxatives without guidance, or timing of meals are not emphasized as much as monitoring for complications (Ford et al., 2018).
A nurse is reviewing potential complications of IBS with a client. Which statement by the client requires further education?
Correct Answer:
b) "ibs can cause severe damage to my intestines over time."
Rationale:
IBS does not cause structural damage to the intestines or increase the risk for colon cancer, though it can significantly affect quality of life. Understanding that stress management and bowel habit variability are part of IBS is accurate (Ford et al., 2014).
The nurse is assessing a client with IBS-C (constipation-predominant IBS). Which dietary change should the nurse suggest to promote regular bowel movements?
Correct Answer:
b) incorporate whole grains, fruits, and vegetables into meals
Rationale:
Increasing fiber from whole grains, fruits, and vegetables can promote regular bowel movements in IBS-C. Dairy products may worsen symptoms, and limiting fluid intake can lead to dehydration and worsen constipation. Avoiding all fiber is not appropriate for constipation management (Bharucha et al., 2013).
A client with IBS is prescribed a low FODMAP diet. The nurse knows that this diet involves:
Correct Answer:
b) avoiding certain fermentable carbohydrates
Rationale:
A low FODMAP diet involves restricting fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are poorly absorbed in the small intestine and can exacerbate IBS symptoms. This diet is not necessarily gluten-free, dairy-free, or plant-based exclusively (Halmos et al., 2014).
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