Which nursing actions are essential for a patient with Crohn's disease experiencing complications such as an intestinal stricture? (Select all that apply)

Choice A reason: ASSESSING for signs of perforation, such as a rigid, board-like abdomen and sudden severe pain, is essential because strictures can lead to increased proximal pressure and rupture. Early detection of peritonitis is a life-saving nursing responsibility when managing patients with known intestinal narrowings. Choice B reason: PREPARING the patient for surgical intervention is necessary because strictures often represent fibrotic tissue that does not respond to medication. If the stricture leads to a complete bowel obstruction that cannot be managed conservatively, surgical resection or strictureplasty becomes the required definitive treatment. Choice C reason: ADVISING against OTC laxatives is critical. In the presence of a mechanical stricture, laxatives can cause increased peristalsis against a narrowed opening, leading to severe cramping, increased pressure, and a higher risk of bowel perforation. Patients must avoid any medication that forcefully stimulates bowel contractions. Choice D reason: MONITORING for fatigue and weight loss is essential for tracking the systemic impact of Crohn's disease and chronic obstruction. These symptoms often indicate malabsorption, chronic inflammation, or a decreased oral intake due to "food fear" associated with postprandial pain caused by the stricture. Choice E reason: ADMINISTERING biologic therapy is essential to manage the underlying inflammatory process of Crohn's disease. By reducing transmural inflammation, these medications can prevent the progression of existing strictures and reduce the formation of new ones, potentially delaying or avoiding the need for surgical intervention. Choice F reason: ENCOURAGING a diet high in whole grains and fresh vegetables is inappropriate for a patient with a known stricture. High-fiber "roughage" can become trapped at the site of the narrowing, leading to a mechanical bolus obstruction. Patients with strictures are usually advised to follow a low-residue or "low-fiber" diet.