Question

The nurse is assessing two clients. One client has ulcerative colitis, and the other client has Crohn disease. Which is more likely to be identified in the client with ulcerative colitis than in the client with Crohn disease?

A. Inclusion of transmural involvement of the small bowel wall
B. Higher occurrence of fistulas and abscesses from changes in the bowel wall
C. Pathology beginning proximally with intermittent plaques found along the colon
D. Involvement starting distally with rectal bleeding that spreads continuously up the colon

Answer 1

Rectal bleeding that spreads continuously up the colon is characteristic of ulcerative colitis, whereas Crohn's disease can involve any part of the GI tract and is more likely to cause fistulas and abscesses.

Step-by-step explanation:

Among the options provided, rectal bleeding that starts distally and spreads continuously up the colon is more likely to be identified in the client with ulcerative colitis rather than in a client with Crohn disease. In ulcerative colitis, inflammation begins in the rectum and usually extends continuously up the colon in a proximal direction. This is in contrast to Crohn's disease, which can affect any part of the GI tract and often involves 'skip lesions,' meaning it can involve different areas with normal tissue in between. Crohn's disease also tends to involve the entire thickness of the bowel wall, leading to potential complications like fistulas and abscesses, whereas ulcerative colitis affects the mucosal layer of the colon only.