326 GI
A client had part of the ileum surgically removed. The nurse monitors the client closely for anemia. What is the rationale for the nurses action. 1. folic acid is absorbed in the ileum 2. cobalamin is absorbed in the ileum 3. Iron absorption is dependent on simultaneous bile salt absorption in the ileum. 4. Copper, cobalt, and nickel are dependent on simultaneous bile salt absorption in the ileum
2. cobalamin is absorbed in the ileum vit B12 combines with intrinsic factor secreted by the parietal cells and is absorbed by the ileum
A client is about to have a blood transfusion and asks the nurse which type of hepatitis is most frequently transmitted through food. Which type of hepatitis should the nurse teach the client about being most associated with food?
A - also known as infectious hepatitis is caused by RNA virus transmitted via the fecal oral route
After gastrointestinal surgery, a client's condition improves, and a regular diet is prescribed. Which food, included on a regular diet, should the nurse encourage the client to consume to decrease discomfort? fresh fruit baked fish bran cereal whole milk
baked fish low residue low fat high protein non gas producing food
A nurse is caring for a client after surgical creation of an ostomy. The nurse observes that the stool is formed. In which part of the colon should the nurse assess the ostomy? ileum ascending transverse descending
descending
One month after abdominal surgery, a client is readmitted to the hospital with recurrent abdominal pain and fever. The medical diagnosis is fistula formation with peritonitis. The nurse should maintain the client in what position? supine right sims semi-fowler the position the client prefers
semi- fowlers promotes localization of purulent material and inflammation and prevents ascending infection
A nurse is evaluating a client who has been receiving medical intervention for a diagnosis of crohns disease. which expected outcomes is most important for the client 1. does skin care 2. takes oral fluids 3. experiences less abdo. cramping 4. Gains half a pound per week
4. gains half a pound per week Weight loss usually is severe with crohns disease therefor weight gain is a priority the goal is SMART
The nurse is developing a list of appropriate foods for a client who has a prescribed low sodium diet. The nurse reviews the list with the client. Which food listed shows the client understands the diet well. 1. Boiled scallops 2. bologna on rye bread 3. shredded wheat cereal 4. Beef and cheese enchilada
Shredded wheat cereal It has low sodium content
A client has a tentative diagnosis of primary biliary cirrhosis. What skin change does the nurse expect to observe when performing a physical assessment? 1. vitiligo 2. hirsutism 3. melanomas 4. telangiectasis
Telangiectasis a vascular lesion associated with cirrhosis; it is thought to be related to increased estrogen levels.
A health care provider prescribes intermittent enteral tube feeds for a client with an NG tube what order should you implement
Verify prescription elevate head of bead at least to 30 degrees check the volume of residual against the parameters prescribed administer the volume of feed as prescribed flush 30ml water post feed
An obese client asks the nurse how to lose weight. what should the nurse include in the response that explains when long-term weight loss occurs best. 1. fats are completely eliminated 2. eating patterns are altered 3. carbohydrates are restricted 4. Exercise is a major component
2. Eating patterns are altered a new diet regimen with a balance of foods following MyPlate must be established and continued for weight reduction to occur and be maintained
A client is diagnosed with celiac disease. Which foods should the nurse teach the client to avoid? Select all that apply. corn cheese oatmeal rye bread juice
oatmeal and rye bread
A nurse is caring for a client with severe gastritis who vomited a large amount of blood. A lavage is prescribed by the healthcare provider. which response is expected with a room temperature irrigating solution. 1.coagulation of blood 2. neutralization of acid 3. constriction of blood vessels 4. stimulation of vagus nerve
3. constriction of blood vessels Lavage removes blood from the stomach and the irrigating solution produces vascular constriction which helps control bleeding by limiting blood flow to the area.
A client is scheduled for a pyloroplasty and vagotomy because of strictures caused by ulcers unresponsive to medical therapy. What information about the purpose of a vagotomy should the nurse include when reviewing the healthcare provider's discussion with the client? increase the heart rate hastens gastric emptying eliminates pain sensation decreases acid in the stomach
decreases acid in the stomach vagus nerve stimulates the stomach to secrete hydrochloric acid when its served this neural pathway is interrupted and stomach acid is decreased
A client appears depressed since the surgical creation of a colostomy five days ago. The nurse determines that there is some movement toward adaptation to the change in body image when the client exhibits which behavior? discusses the necessity of the colostomy requests the nurse to change the dressing looks at the face of nurse during care stares at the stoma during dressing change
stares at the stoma during dressing changes is a sign of acceptance
A client with a parotid tumor expresses anxiety about the surgery to remove the tumor. The client states that perhaps surgery should be performed soon, even if the preoperative radiotherapy is not completed. What response by the nurse is the best? 1. are you concerned about delay of surgery 2. you are anxious about the effects of radiotherapy 3. i think you do not have confidence in your health care providers decisions 4. i can understand your anxiety concerning the delay of your surgery
you are concerned about the delay of your surgery
A client is admitted to the hospital for a needle biopsy of the liver. A diagnosis of cancer of the liver is suspected. What should the nurse include in the client's preoperative teaching plan? 1. midline abdominal incision will be used 2. bedrest must be maintained after the procedure 3. general anesthesia will be used during the biopsy 4. supine position will be maintained after the procedure
2. bedrest must be maintained after the procedure bedrest while laying on the right side for two hours after the procedure applies pressure to the insertion site and reduces the risk of bleeding
Optimal discharge teaching with regard to dumping syndrome following gastroduodenostomy should include what information 1. encouraging the client to plan for light walk immediately after meals 2. encourage client to drink adequate fluids with and between meals 3. instructing the client to follow a high carb low fat low protein diet 4. assuring the client that symptoms generally resolve a year after surgery
4. assuring the client that symptoms generally resolve a year after surgery Dumping syndrome symptoms generally resolve within a year including this information may increase cooperation and compliance with treatment plan The client should rest for 30 minutes after each meal to decrease the sweating, palpitations, and dizziness that result from the stimulation of the sympathetic nervous system that accompanies dumping syndrome. To decrease the volume of chyme entering the small intestine after eating, meals should be small and dry. Fluids should be consumed between rather than with meals. To decrease the hyperosmolar composition of chyme, the client should follow a low carbohydrate, low refined sugar, moderate protein, and moderate fat diet.
When inserting a catheter to irrigate a client's colostomy, the nurse meets some resistance. What should the nurse do? 1. Probe with irrigating catheter to determine contour of the bowel 2. obtain a more ridgid tip for the irrigating catheter to insert into the stoma 3. apply pressure to irrigating catheter to overcome the spasm in the bowel 4. instill a small amount of solution form the irrigating container into the stoma
4. instill a small amount of solution from the irrigating container into the stoma helps to distend the bowel ahead of the catheter and eases insertion.
A nurse is assessing a client with severe liver disease. Which assessment finding will the nurse expect to observe? 1. icterus 2. urticatia 3. Uremic frost 4. Hemangioma
Icterus Bile deposits will impart a yellowish tinge (jaundice or icterus) to the skin, often first observed in the sclerae. Urticaria (or hives) generally is characteristic of an allergic response. Uremic frost is characteristic of kidney failure. Hemangioma is a benign lesion composed of blood vessels.
Following a major abdominal surgery, a client has a nasogastric tube attached to continuous low suction. The nurse caring for the client postoperatively monitors the client for what signs of hypokalemia? Select all that apply. Irritability dysrythmias muscle weakness abdominal cramps acidosis
Dysrhythmias and muscle weakness Dysrhythmias are a sign of potassium depletion in cardiac muscles. Other cardiovascular effects include irregular, rapid, weak pulse; decreased blood pressure; flattened and inverted T waves; prominent U waves; depressed ST segments; peaked P waves; and prolonged QT intervals. Muscle weakness is a symptom of potassium depletion in skeletal muscles; potassium facilitates the conduction of nerve impulses and muscle activity. Irritability, as a result of heightened neuromuscular activity, is a sign of hyperkalemia. Abdominal cramps, as a result of heightened neuromuscular activity, is a symptom of hyperkalemia. In acidosis (metabolic), over half of the excess hydrogen ions are buffered in the cells. Electroneutrality is sustained partly by the passage of intracellular potassium into the extracellular fluid. Thus, metabolic acidosis results in a plasma potassium concentration that is elevated in relation to total body stores causing hyperkalemia.
A nurse is caring for a client who recently is diagnosed with a gastric ulcer. The nurse expects that the plan of care will include a prescription for which type of diet? soft diet lowfat, high protein liquid diet hourly feeding of dairy products regular diet with foods that are tolerated
Regular diet with foods that are tolerated No specific diet is recommended; the client is encouraged to avoid meals that overdistend the stomach and foods that cause gastrointestinal (GI) distress. There is no need for a soft diet; a soft diet is appropriate for those who have difficulty with chewing and swallowing. The client does not require a liquid diet. High-fat dairy products increase GI secretions and may not be tolerated by some clients.
A client progresses to a regular diet after a gastrectomy for gastric cancer. After eating lunch the client becomes diaphoretic and has palpitations. What probable cause of this response does the nurse recognize? intolerance to fatty foods dehiscence of surgical incision extracellular fluid shift into the bowel diminished peristalsis in the small intestine
extracellular fluid shift into the bowel hypertonic food increases osmotic pressure and pulls fluid from the intravascular compartment into the intestine
A client is discharged the same day after ambulatory surgery for a laparoscopic cholecystectomy. The nurse is providing discharge teaching about how many days the client should wait to engage in certain activities. Place in order the activities from the first to the last in which the client may engage.
getting out of bed in a chair preforming light excersie showering driving a car lifting objects more than 10lbs (4.5kg) Getting out of bed is the activity that should be implemented first. It allows the client to adjust to the upright position before ambulating. Light exercise, such as walking, can begin after tolerating sitting in a chair. A client may shower or bathe one to two days after surgery. A client may drive three to four days after surgery. Objects exceeding 10 lb (4.5 kg) may be lifted one week after surgery.
A client is admitted with a diagnosis of acute pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolytes, and decreasing anxiety. Which interventions should the nurse implement? Select all that apply. Provide low fat diet administer analgesic teach relaxation encourage walking in hall monitor cardiac rate and rhythm observe for signs of hypercalcemia
Admin analgesic teach relaxation monitor cardiac rate and rhythm Analgesics, histamine-receptor antagonists, and proton pump inhibitors may be administered to decrease gastrointestinal activity and the secretion of pancreatic enzymes. Relaxation will decrease the metabolic rate, which will decrease gastrointestinal activity, including the secretion of pancreatic enzymes. Monitoring cardiac rate and rhythm is necessary to assess for hypokalemia and fluid volume changes. The client would be kept nothing by mouth to decrease gastrointestinal activity and the secretion of pancreatic enzymes.
