Increasing abdominal pain, distension, fever, or bloody stools may indicate worsening disease and must be reported.
Before you read
Test yourself first: 3 questions
Question 1 of 3
A client receiving radiation therapy to the abdomen for cancer reports several loose stools per day. Which dietary instruction is most appropriate for the nurse to provide?
Answer: A. Radiation enteritis causes diarrhea. A low-residue, low-fiber diet reduces stool bulk and bowel irritation. High-fiber foods, raw vegetables, and whole grains increase peristalsis and worsen diarrhea, so they should be limited during treatment.
Question 2 of 3
A client with gout is admitted with an acutely painful, red, swollen great toe. Which dietary instruction should the nurse provide to help prevent future attacks?
Answer: B. Gout results from hyperuricemia and urate crystal deposition. Clients should limit purine-rich foods such as organ meats, red meat, shellfish, and alcohol (especially beer), and increase fluid intake to promote uric acid excretion. High-purine diets worsen attacks.
Question 3 of 3
A nurse is caring for a client with a third-degree perineal laceration. Which intervention is contraindicated for this client?
Answer: A. A third- or fourth-degree laceration extends into or through the anal sphincter. Rectal interventions such as enemas, rectal suppositories, and rectal temperature measurement are contraindicated because they can disrupt the suture line and the healing sphincter. Stool softeners, sitz baths, and a high-fiber diet with fluids are appropriate to promote comfort and prevent straining.
Keep the streak going with more questions like these, each with a full rationale.
What is low-residue diet?
It is used in acute flares of inflammatory bowel disease, diverticulitis, bowel obstruction, and before and after bowel surgery. Less residue means less material reaching and irritating the colon.
Key points to remember
- Avoid whole grains, raw fruits and vegetables, nuts, seeds, beans, and tough meats.
- Allowed foods include refined white bread, white rice, cooked tender vegetables, and lean tender meats.
- Dairy is limited because it can increase residue and stool volume in some patients.
- The diet reduces stool frequency and volume, giving the inflamed bowel rest.
- It is the opposite of a high-fiber diet and is used during acute GI inflammation, not chronically.
Nursing priorities
- Teach which high-fiber foods to avoid during the flare.
- Monitor bowel movement frequency, consistency, and abdominal symptoms.
- Assess for resolution of the acute condition to plan diet advancement.
- Monitor for adequate nutrition, since the diet is restrictive.
- Coordinate with the provider on when to reintroduce fiber.
Patient teaching
- Choose white bread, white rice, and well-cooked peeled vegetables.
- Avoid nuts, seeds, raw produce, popcorn, and whole grains for now.
- This diet is temporary to rest your bowel during the flare.
- Reintroduce fiber slowly only when your provider says it is safe.
Red flags: report now
- Increasing abdominal pain, distension, fever, or bloody stools may indicate worsening disease and must be reported.
- Never advance to high fiber during an acute diverticulitis or obstruction flare.
- Signs of bowel obstruction such as vomiting and absent stool require immediate report.
References
Clinical references for this topic
