Assessment and Management of Patients with Biliary Disorders

A client with severe acute pancreatitis has been on nothing by mouth status for two days. Which nutrition will the nurse expect to be prescribed for this patient?

Enteral feedings

The nurse is assessing a client admitted with suspected pancreatitis. Which question will the nurse prioritize when assessing this client?

"How much alcohol do you consume in a day?"

Which is a clinical manifestation of cholelithiasis?

Clay-colored stools

Pharmacologic therapy frequently is used to dissolve small gallstones. It takes about how many months of medication with UDCA or CDCA for stones to dissolve?

6 to 12

The digestion of carbohydrates is aided by

Amylase

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is a character of this disorder?

Edema and inflammation

Which enzyme aids in the digestion of fats

Lipase

Which condition is most likely to have a nursing diagnosis of fluid volume defecit?

Pancreatitis

A client has a nasogastric (NG) tube for suction and is NPO after a pancreaticoduodenectomy. Which explanation made by the nurse is the major purpose of this treatment?

"The tube allows the gastrointestinal tract to rest"

A client discharged after a laparoscopic cholecystectomy calls the surgeon's office reporting severe right shoulder pain 24 hours after surgery. Which statement is the correct information for the nurse to provide to this client?

"This pain is caused from the gas used to inflate your abdominal area during surgery. Sitting upright in a chair, walking, or using a heating pad may ease the discomfort"

A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies to help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client?

Administering morphine IV as ordered

A nurse is teaching a client and the client's family about chronic pancreatitis. What are the major causes of chronic pancreatitis?

Alcohol consumption and smoking

A client seeks medical attention for a new onset of mid-back pain that is worse at night when lying supine. Which additional symptom(s) may the nurse use to determine if the client has pancreatic cancer? Select all that apply.

Ascites Jaundice Weight loss Epigastric pain

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client?

Assisting the client to turn, cough, and deep breathe every 2 hours

Total parenteral nutrition (TPN) should be used cautiously in clients with pancreatitis because such clients:

Cannot tolerate high-glucose concentration

A client with calculi in the gallbladder is said to have

Cholelithiasis

The nurse is caring for a client recovering from acute pancreatitis. Which menu item should the nurse remove from the client's breakfast tray?

Coffee

A preoperative client scheduled to have an open cholecystectomy says to the nurse, "The doctor said that after surgery, I will have a tube in my nose that goes into my stomach. Why do I need that?" What common reason for a client having a nasogastric tube in place after abdominal surgery should the nurse include in a response?

Decompression

Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes mellitus. Which of the following explains the cause of this secondary diabetes?

Dysfunction of the pancreatic islet cells

When the nurse is caring for a patient with acute pancreatitis with acute pancreatitis, what intervention can be provided in order to prevent atelectasis and prevent pooling of respiratory secretions?

Frequent changes of positions

Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels?

Frequent vomiting, leading to loss of fluid volume

Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods of the tray?

Hot roast beef sandwich with gravy

A client is scheduled for a cholecystogram for later in the day. What is the nurse's understanding on the diagnostic use of this exam?

It visualizes the gallbladder and bile duct

A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of TPN?

Measure blood glucose concentration every 4-6 hrs

A client diagnosed with acute pancreatitis is being transferred to another facility. The nurse caring for the client completes the transfer summary, which includes information about the client's drinking history and other assessment findings. Which assessment findings confirm the diagnosis of acute pancreatitis?

Pain with abdominal distention and hypotension

The nurse is caring for a client with acute pancreatitis who is admitted to the ICU to monitor for pulmonary complications. What is the nurse's understanding of the pathophysiology of pulmonary complications related to pancreatitis?

Pancreatitis can elevate the diaphragm and alter the breathing pattern

One difference between cholesterol stones (left) and the stones on the right are that the ones on the right account for only 10% to 25% of cases of stones in the US. What is the name of the stones on the right?

Pigment stones

When caring for a client with acute pancreatitis, the nurse should use which comfort measure?

Positioning the client on the side with the knees flexed

The nurse is caring for a client with acute pancreatitis. Which prescription will the nurse question before implementing?

Regular insulin infusion for blood glucose level greater than 126 mg/dL

A client with gallstones is diagnosed with acute pancreatitis and is requesting information about the physiology of the gallbladder. Which information will the nurse include about the function of this organ?

Releases bile in response to cholecystokinin

A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnosis acute pancreatitis. What is the primary goal of nursing care for this client?

Relieving abdominal pain

A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk?

Reposition the client every 2 hours

A client comes to the ED with severe abdominal pain, nausea, and vomiting. The physician plans to rule out acute pancreatitis. The nurse would expect the diagnosis to be confirmed by an elevated result on which laboratory test?

Serum amylase

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:

Yellow sclerae

The nurse should assess for an important early indicator of acute pancreatitis, which is a prolonged and elevated level of:

Serum lipase

A nurse cares for an older adult client and teaches the client about age-related changes of the biliary tract. What statements will the nurse include when discussing age-related changes that occur in the pancreas of the older adult? Select all that apply.

The pancreas develops fibrous material with age The pancreas develops fatty deposits with age The pancreas decreases secretion of enzymes with age The pancreas decreases bicarbonate secretion with age

A patient with acute pancreatitis puts the call bell on to tell the nurse about an increase in pain. The nurse observes the patient guarding; the abdomen is board-like and no bowel sounds are detected. What is the major concern for this patient?

The patient has developed peritonitis

The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason?

To reduce gastric and pancreatic secretions

A patient is admitted to the hospital with possible cholelithiasis. What diagnostic test of choice will the nurse prepare the patient for?

Ultrasonography

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery?

Vitamin K

A nurse should monitor blood glucose levels for a patient diagnosed with hyperinsulinism. What blood glucose level does the nurse recognize as inadequate to sustain normal brain function?

30 mg/dL

A client is admitted to the health care center with severe abdominal pain rated 10 on a 1-to-10 scale, tachycardia, hypertension, and muscle spasms. The nurse immediately administers morphine sulfate 4 mg slow intravenous pyelogram (IVP), as ordered. The nurse plans for which goal after administration of this medication?

To increase the client's pain threshold

A client with severe abdominal pain and an abdominal computed tomography (CT) scan, which shows an enlarged pancreas, has been admitted to a medical unit today. The nurse anticipates including which actions in the client's plan of care? Select all that apply.

Use a pain scale throughout treatment Administer pain relief measures Maintain nothing by mouth (NPO) diet

A 70-year-old client is admitted with acute pancreatitis. The nurse understands that the mortality rate associated with acute pancreatitis increases with advanced age and attributes this to which gerontologic consideration associated with the pancreas

Decreases in the physiologic function of major organs