IBD Meds
A patient with mild to moderate ulcerative colitis is prescribed mesalamine.
What is the primary therapeutic effect of this medication?
Reduction of intestinal inflammation
Mesalamine is a 5-ASA anti-inflammatory medication used to maintain remission and reduce colonic inflammation in IBD.
A patient with diverticulitis is prescribed metronidazole.
What important teaching should the nurse provide about this medication?
Avoid alcohol during therapy
Metronidazole can cause a disulfiram-like reaction with alcohol, leading to severe nausea, vomiting, and flushing.
A patient with severe diarrhea from ulcerative colitis develops:
tachycardia
hypotension
dry mucous membranes
Which IV medication is most appropriate to restore intravascular volume?
0.9% Sodium Chloride (Normal Saline)
Isotonic fluids restore circulating volume and perfusion in dehydration from GI fluid losses.
A patient receiving tube feeding suddenly begins coughing and develops oxygen desaturation.
What is the priority nursing action?
Stop the feeding immediately
Coughing during tube feeding indicates possible aspiration, which is the most dangerous complication of enteral feeding.
A nurse assesses a newly created ileostomy stoma.
Which finding indicates a healthy stoma?
Pink/red and moist
A healthy stoma should appear pink to red and moist, indicating adequate blood flow.
A patient with a severe ulcerative colitis flare is started on prednisone.
What priority adverse effects should the nurse monitor for?
Hyperglycemia and infection
Corticosteroids suppress immune response and increase glucose levels, so nurses must monitor blood glucose and signs of infection.
A patient taking ciprofloxacin for diverticulitis reports sudden Achilles tendon pain while walking.
What is the priority nursing action?
Hold the medication and notify the provider
Ciprofloxacin can cause tendonitis and tendon rupture, especially in the Achilles tendon.
A patient with Crohn’s disease has frequent diarrhea and hypokalemia.
Which medication should the nurse anticipate administering?
Potassium chloride
Chronic diarrhea causes potassium loss, which must be replaced to prevent weakness and dysrhythmias.
Which position should the nurse maintain for a patient receiving enteral tube feedings to prevent aspiration?
Head of bed elevated 30–45°
Elevating the head of the bed reduces the risk of aspiration pneumonia during feeding.
A patient with a new ileostomy begins to experience:
dizziness
decreased urine output
fatigue
What complication should the nurse suspect?
Dehydration
Ileostomies can produce large fluid losses (up to ~1 L/day early after surgery), increasing risk for dehydration and electrolyte imbalance.
A patient with Crohn’s disease receiving azathioprine develops:
fever
sore throat
fatigue
What serious complication should the nurse suspect?
Bone marrow suppression
Azathioprine suppresses immune function and can cause leukopenia and increased infection risk.
A patient receiving ciprofloxacin develops severe watery diarrhea and abdominal cramping several days after starting therapy.
What complication should the nurse suspect?
Clostridioides difficile infection
Broad-spectrum antibiotics like ciprofloxacin can disrupt normal gut flora and lead to C. diff infection.
A nurse prepares to administer IV potassium chloride to a patient with severe hypokalemia.
What is the most important safety rule when administering IV potassium?
Never IV push potassium
IV potassium must be diluted and infused slowly, because rapid administration can cause fatal cardiac arrhythmias.
A patient receiving TPN develops a fever and chills.
What complication should the nurse suspect first?
Catheter-related bloodstream infection (CRBSI)
TPN solutions contain high glucose levels, which increase the risk of central line infections
A patient with an ileostomy has severe skin irritation around the stoma.
What is the priority nursing intervention?
Apply a skin barrier and ensure the wafer fits properly
Ileostomy effluent is caustic, so protecting peristomal skin with barrier products is essential
A patient receiving infliximab infusion suddenly develops:
dyspnea
chest tightness
hypotension
rash
What is the priority nursing action?
Stop the infusion immediately and notify the provider
These symptoms indicate an infusion reaction, which can progress to anaphylaxis.
A patient with diverticulitis is hospitalized with:
fever
leukocytosis
severe abdominal pain
Which medication class should the nurse anticipate administering?
IV antibiotics
Severe diverticulitis requires IV antibiotic therapy to treat infection and prevent complications like abscess or perforation.
A patient receiving large volumes of IV normal saline develops:
edema
crackles in lungs
shortness of breath
What complication should the nurse suspect?
Fluid overload
Excess IV fluids can lead to pulmonary edema and worsening respiratory status.
A malnourished patient begins parenteral nutrition and develops:
muscle weakness
dysrhythmias
seizures
Lab results show low phosphorus.
What complication is occurring?
Refeeding syndrome
Rapid nutrition causes electrolyte shifts (especially hypophosphatemia) that can lead to serious cardiac and neurologic complications.
A patient with an ileostomy suddenly develops:
nausea
abdominal distention
decreased stoma output
What complication should the nurse suspect?
Bowel obstruction
Reduced stoma output with distention and nausea may indicate intestinal obstruction
Before starting infliximab therapy, which screening test is essential?
Tuberculosis screening
Infliximab suppresses TNF-alpha, which can reactivate latent tuberculosis, so TB screening is required prior to therapy.
A patient with suspected peritonitis is started on broad-spectrum IV antibiotics before culture results return.
What is the rationale for this intervention?
Early antibiotic therapy reduces the risk of sepsis and improves survival
Peritonitis can rapidly progress to systemic infection and septic shock, so treatment must begin before culture confirmation.
A patient with severe inflammatory bowel disease has:
persistent diarrhea
weakness
cardiac palpitations
Labs show potassium 2.9 mEq/L.
What life-threatening complication is the nurse trying to prevent by administering potassium replacement?
Cardiac dysrhythmias
Severe hypokalemia disrupts cardiac conduction, increasing the risk of dangerous arrhythmias.
A patient’s TPN infusion is suddenly stopped when the IV pump malfunctions.
What immediate intervention should the nurse perform to prevent complications?
Start D10 infusion at the same rate
Stopping TPN abruptly can cause rebound hypoglycemia, so dextrose must be administered until TPN resumes.
A patient reports that their new ileostomy stoma appears dark purple and dry.
What is the priority nursing action?
Notify the surgeon immediately
A dark or dusky stoma suggests ischemia or impaired blood supply, which requires urgent evaluation.