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1. Question
A client with Crohn’s disease is scheduled to receive an infusion of infliximab. What intervention by the nurse will determine the effectiveness of treatment?
Correct
Option B is the correct answer:
Rationale: The principal manifestations of Crohn’s disease are diarrhea and abdominal pain. Infliximab is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
Test-Taking Strategy: Focus on the subject, treatment for Crohn’s disease, and note the strategic word, effectiveness. Eliminate option 4, because gastric bleeding is not a characteristic of Crohn’s disease. Monitoring the leukocyte count and liver enzyme levels is appropriate when infliximab is given but not to evaluate the effectiveness of treatment, eliminating options 1 and 3.
Incorrect
Option B is the correct answer:
Rationale: The principal manifestations of Crohn’s disease are diarrhea and abdominal pain. Infliximab is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
Test-Taking Strategy: Focus on the subject, treatment for Crohn’s disease, and note the strategic word, effectiveness. Eliminate option 4, because gastric bleeding is not a characteristic of Crohn’s disease. Monitoring the leukocyte count and liver enzyme levels is appropriate when infliximab is given but not to evaluate the effectiveness of treatment, eliminating options 1 and 3.
Crohn’s disease is a chronic inflammatory disease of the small intestine, usually affecting the terminal ileum. It also sometimes affects the large intestine, usually in the ascending colon. It’s slowly progressive with exacerbations and remissions.
INTERVENTIONS AND RATIONALES
Assess GI status (note excessive abdominal distention) and monitor stools for blood to determine baseline and detect changes in the client’s condition.
Monitor and record vital signs and intake and output, laboratory studies, daily weight, urine specific gravity, and fecal occult blood to detect bleeding and dehydration.
Monitor the number, amount, and character of stools to detect deterioration in GI status.
Administer TPN to rest the bowel and promote nutritional status.
Administer medications, as prescribed, to maintain or improve the client’s condition.
Maintain the client’s diet; withhold food and fluids as necessary to minimize GI discomfort.
Minimize stress and encourage verbalization of feelings to allay the client’s anxiety.
