Exemplar 4.3: Malabsorption Disorders

Description

-I have 2 problems about Anna and Danny. Anna is the young mother of Danny, an elementary-age child diagnosed with celiac disease. You have to educate Anna about what celiac disease is and why she needs to have her son avoid gluten. You also need to give her information of pharmacologic therapy and dietary changes.
Olivia McRitchie
Quiz by Olivia McRitchie, updated more than 1 year ago
Olivia McRitchie
Created by Olivia McRitchie over 6 years ago
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Resource summary

Question 1

Question
You have a young mother (Anna) whose elementary-age son (Danny) has just been diagnosed with celiac disease. Anna knows nothing about it, and believes Danny to simply be gluten intolerant, kind of like lactose intolerance. Select the correct educational statements you can give to Anna.
Answer
  • "The normal intestine contains finger-like projections called villi and microvilli. These 2 things, in combination with intestinal folding, play a major role in nutrient absorption."
  • "Your son's immune system overreacts to gluten, causing an inflammatory response."
  • "The inflammatory response destroys villi and microvilli, decreasing the intestine's ability to absorb nutrients."
  • "The severity of celiac disease depends purely on genetics."
  • "Doctors know the cause of celiac disease. I simply cannot remember them."
  • "Genetics and immune factors play a role in the development of the disease."

Question 2

Question
Now that you have explained it to her, Anna understands how serious celiac disease is. Now she wants to know everything there is to know about celiac disease so she can better help Danny. Select the educational statements you can give to Anna. *In case you can't see the description, Anna is the young mother of an elementary-school aged boy named Danny. Danny is newly diagnosed with celiac disease, but his mother knew little about it.*
Answer
  • "People with celiac disease suffer from malabsorption in the small intestine, which results in nutrient deficiency."
  • "Danny should grow up at a normal pace, and end up being a normal size."
  • "If gluten is not removed from the diet, Danny could suffer from tetany, vitamin deficiency, muscle wasting, and impaired bone development."
  • "Anemia is common in celiac disease patients."
  • "The only long-term complications of celiac are the potential for ulceration and a predisposition to certain GI cancers."
  • "Danny should still be fine without having to take supplements."
  • "In addition to avoiding gluten, Danny may need to restrict both fats and lactose."
  • "Consult with a dietitian about how to avoid gluten and plan meals for Danny,"

Question 3

Question
You are caring for a client with celiac disease in a long-term elder care facility. Select an INCORRECT intervention for this patient.
Answer
  • Weigh the patient daily
  • Monitor intake and output
  • Assessing skin and mucous membranes for dehydration
  • Assess perianal region during toileting
  • Maintain accurate dietary records
  • Document whenever the patient has a diarrhea-consistency bowel movement.
  • Encourage increased fluid intake.
  • Monitor lab results for emergence of secondary conditions.

Question 4

Question
Select the patients that display a risk factor having celiac disease.
Answer
  • A morbidly obese, female, African American patient with no family members with the disease
  • A young Asian woman with iron deficiency anemia
  • A Caucasian male of European descent that has an uncle with celiac disease.
  • A Native American adult female with insulin-independent diabetes.
  • A Mexican female with Turner Syndrome
  • A Caucasian, European child with insulin-dependent diabetes.

Question 5

Question
Select the individual that does NOT display a risk factor for having, or later developing, lactose intolerance.
Answer
  • A young, Caucasian male patient with celiac disease.
  • A young, Caucasian female patient with Crohn disease.
  • A young, African American male
  • An older, Caucasian male that had radiation for abdominal cancer.
  • A premature Hispanic infant.
  • A young, Caucasian female with anorexia.

Question 6

Question
You have an older adult female patient that is concerned that she may be lactose intolerant. You decide to briefly run down the list of symptoms for lactose intolerance with her. Which of the following is a symptom of lactose intolerance?
Answer
  • Bloating and flatulence.
  • Nausea and vomiting,
  • Anemia,
  • Osteoporosis.

Question 7

Question
Most people with lactase deficiency are highly symptomatic.
Answer
  • True
  • False

Question 8

Question
There is nothing that a severely lactose intolerant patient can do to help them tolerate lactose better.
Answer
  • True
  • False

Question 9

Question
You are speaking with a patient that was recently diagnosed as lactose intolerant. You have discussed with him dietary restrictions to reduce discomfort from lactose intolerance. Select the statements made by the patient that indicates that he understands this teaching.
Answer
  • "Aged cheese and yogurt contain larger amounts of lactose than milk, ice cream, and cottage cheese do."
  • "Lactose can be hidden in sherberts, chocolate desserts, sauces and gravies, and cream soups."
  • "The only thing I can do is avoid lactose."
  • "Since I should cut back on milk, I should get my protein from meats, eggs, legumes, and grains,"
  • "I can get my calcium from sardines, oysters, salmon, beans, cauliflower, rhubarb, and green leafy vegetables."

Question 10

Question
You are caring for a patient who has just had large amounts of his intestine removed as part of a surgery for Crohn's disease. He is now suffering from short bowel syndrome. Select the intervention that would be INAPPROPRIATE for this patient.
Answer
  • Closely monitor vitals
  • Closely monitor intake and output
  • Closely monitor condition of mucous membranes.
  • Provide ordered nutritional supplements with enteral feedings.
  • Maintain any central lines
  • Utilize clean technique when handling the patient's nutritional supplements and central lines.
  • Document the number and characteristics of stool, if diarrhea is present.
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