Medical Surgical Crohn’s vs Ulcerative Colitis #2

Question

The nurse is caring for a female client with Crohn’s disease and imbalanced nutrition, less than body requirements. Which lab values below reflect these nursing diagnoses?

Answers

  1. Potassium 2.9 mmol/L, serum calcium 7.4 mg/dL, B12 118 pg/mL, albumin 1.7 g/dl
    • Rationale:

      This answer is correct because the lab values are abnormal and indicative of imbalanced nutrition. The potassium, serum calcium, B12, and albumin are all low. Severe diarrhea and intestinal malabsorption from Crohn’s disease depletes nutrients and electrolytes.

  2. Potassium 3.5, mmol/L, serum calcium 9.0 mg/dL, B12 450 pg/mL, albumin 3.7 g/dL
    • Rationale:

      This answer is not correct because these labs are normal. There is no indication of imbalanced nutrition or evidence of malabsorption.

  3. Rheumatoid Factor 20 IU/ml, ESR 30 mm/hr, CRP 10 mg/L, anti-CCP 20 EU/ml
    • Rationale:

      This answer is not correct because this is a rheumatoid panel, which gives no information for imbalanced nutrition. Biomarkers for Crohn’s disease would be related to malnutrition and include serum proteins, electrolytes, and vitamins.

  4. Hemoglobin 12 g/dL, hematocrit 44 percent, BUN 7 mg/dL creatinine 0.6 mg/dL
    • Rationale:

      This answer is not correct because these values are too low. A Crohn’s client struggling with imbalanced nutrition would most likely be hypovolemic, raising the hemoglobin and hematocrit, as well as the BUN, and creatinine levels.

Overview

Crohn’s disease puts the client at risk for imbalanced nutrition, less than body requirements. Decreased intake due to poor appetite, diarrhea, and malabsorption can cause an electrolyte imbalance and vitamin deficiencies.

Explanation

Learning Outcomes

Crohn’s disease puts the client at risk for imbalanced nutrition, less than body requirements. Decreased intake due to poor appetite, diarrhea, and malabsorption can cause an electrolyte imbalance and vitamin deficiencies. Intestinal inflammation prevents nutrients from being absorbed. Additionally, diarrhea depletes nutrients and electrolytes. Biomarkers for Crohn’s disease would be related to malnutrition and include serum proteins, electrolytes, and vitamins. In malnutrition, potassium, serum calcium, vitamin K, B12, folic acid, and zinc will be decreased. Hemoglobin/hematocrit and BUN/creatinine levels will be increased due to dehydration.

Test Taking Tip

Know lab value normals and how each relates to fluid volume.

Video Rationale