The nurse is aware that the most common assessment finding in a child with ulcerative colitis is:
A. Intense abdominal cramps
B. Profuse diarrhea
C. Anal fissures
D. Abdominal distention
Correct Answer: B. Profuse diarrhea
The most common assessment finding in a child with ulcerative colitis is profuse diarrhea. The main symptom of ulcerative colitis is bloody diarrhea, with or without mucus. Other symptoms include blood in the toilet, on toilet paper, or in the stool. Characteristically, it involves inflammation restricted to the mucosa and submucosa of the colon. Typically, the disease starts in the rectum and extends proximally in a continuous manner.
Option A: Ulcerative colitis causes intense abdominal cramps. Associated symptoms also include urgency or tenesmus, abdominal pain, malaise, weight loss, and fever, depending on the extent and severity of the disease. The onset of the disease is typically gradual, and patients will likely experience periods of spontaneous remission and subsequent relapses.
Option C: Ulcerative colitis causes anal fissures. There are some extraintestinal manifestations (EIMs) that are also present in 10% to 30% of patients with ulcerative colitis. Extraintestinal manifestations associated with disease activity include episcleritis, scleritis, and uveitis, peripheral arthropathies, erythema nodosum, and pyoderma gangrenosum.
Option D: Abdominal distensions are more common in Crohn’s disease. Patients with flare-ups of Crohn’s disease typically present with abdominal pain (right lower quadrant), flatulence/bloating, diarrhea (can include mucus and blood), fever, weight loss, anemia. In severe cases, perianal abscess, perianal Crohn’s disease, and cutaneous fistulas can be seen.