The nurse is providing a teaching session to a client who has ulcerative colitis. The nurse will instruct the client for which diet?

Appeared in: GMCH Chandigarh - 2019

Explanation

A low-residue, low-fiber diet is prescribed for ulcerative colitis to reduce the volume and frequency of stools, which helps to rest the bowel.
This diet minimizes mechanical irritation to the inflamed and ulcerated colon, thereby alleviating symptoms like abdominal cramping, diarrhea, and bleeding during an acute exacerbation.
Foods in this diet are easily digestible and leave minimal residue in the intestinal tract.

Option A: A carbohydrate-consistent diet is designed to manage blood glucose levels by distributing carbohydrate intake evenly throughout the day.
Option B: While important, this is a nutritional goal, not the primary dietary modification. During a flare-up, the main priority is to reduce bowel irritation. High-calorie, high-protein foods must be selected from low-residue options.
Option C: This is not a foundational diet plan. It addresses specific electrolyte imbalances that can be a complication of UC but is not the primary dietary strategy for managing the disease itself.

Clinical Relevance

Nursing practice connection: Use the key finding related to Dietary management for ulcerative colitis to guide bedside assessment, documentation, and the next nursing action.
Nurses play a crucial role in educating clients with UC about their diet, as it is a cornerstone of symptom management and can significantly impact quality of life.
Encouraging clients to keep a food and symptom diary is a key nursing intervention. This helps identify individual trigger foods, as tolerance can vary greatly from person to person.
What if? If the client were in a state of remission (asymptomatic), the nurse would instruct them to gradually reintroduce fiber-containing foods to their tolerance level. A varied diet with adequate fiber is beneficial for long-term gut health when the disease is not active.

How to Approach the Question

First, identify the key diagnosis in the question stem: 'ulcerative colitis'.
Recall the pathophysiology of ulcerative colitis, which involves inflammation and ulceration of the colon.
Consider the primary goal of dietary therapy during an active disease phase (flare-up): to reduce irritation and rest the bowel.
Evaluate each option based on this goal. A 'low-residue, low-fiber' diet is specifically designed to decrease stool bulk and frequency, thus resting the bowel.
Differentiate this from the other options. Recognize that a high-calorie/protein diet is a nutritional goal, not a diet type itself in this context, and the other diets are for different medical conditions (diabetes, electrolyte imbalance).

Concept Tested & Keywords

Concept Tested: Dietary management for ulcerative colitis
Stem keywords: ulcerative colitis, teaching session, diet
Lead-in keywords: which diet
Clinical cues: The diagnosis of ulcerative colitis is the key factor determining the appropriate dietary intervention.
Negative lead-in flag: false

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E6 Nutrition Kumud Khanna 2e pp. 261-263, 262-264

Practise the full GMCH Chandigarh - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.