Chapter 46 accessory organs.

The nurse is caring for a patient with cholecystitis associated with cholelithiasis. which statement by the nurse is most accurate when answering the patient questions?

"A heavy meal with high fat content may precipitate the signs and symptoms of the disease."

The patient had a hepatobiliary

"Give care as usual, there are no special considerations."

A nurse is reinforcing nutrition teaching with a client who has pancreatitis, which of the following statements by the client indicate an understanding of the instruction? select all that apply.

"I plan to eat small, frequent meals." "I will eat easy-to-digest foods with limited spice." "I will use skim milk when cooking."

the student nurse asks the nurse why a patient with advanced cirrhosis has an abdomen that is so swollen. Which response by the nurse is correct?

"Portal Hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space."

A nurse is reinforcing discharge teaching with a client who is postoperative following a laparoscopic cholecystectomy. Which of the following instructions should the nurse include in the teaching? Select all that apply.

"Resume a diet of choice." "Cleanse the puncture site using mild soap and water." "Report nausea and vomiting to the surgeon."

A client with a peptic ulcer is diagnosed with a H. Pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. Which statement by the client indicates the best understanding of the medication regimen?

"The medications will kill the bacteria and stop the acid production."

A patient with acute pancreatitis is refusing to have a nasogastric tube inserted and wants to leave the hospital. Which response is most likely to encourage the patient to accept the therapy?

"The tube will decrease the nausea, vomiting, pain, and abdominal distention."

A young woman who is pregnant is having symptoms of cholecystitis and the HCP informs her that diagnostic testing is required. Which educational brochure will the nurse prepare for this patient?

"What you need to know about Ultrasonography of the Gallbladder"

A nurse is reinforcing preoperative teaching for a client who is scheduled for a laparoscopic cholecystectomy, which of the following should be included in the teaching?

"You might have shoulder pain after surgery"

The HCP orders an IM immune serum globulin for a hosptial employee who was exposed to hepatitis A. A dosage of 0.2mL/kg of body weight is ordered. The employee is 155 lbs. How many ML would the nurse draw up?

14mL

A patient is scheduled for surgery for a common bile duct exploration. The nurse would expect the patient to return from surgery with which device in place?

A T tube connected to gravity drainage.

The client has an as needed prescription of loperamide hydrochloride. For which condition would the nurse administer this medication?

Acute Diarrhea.

The patient has symptoms of hepatic enecephalopathy and the HCP wants to be called about lab results. Which lab result would the nurse look for to validate the suspected condition?

Ammonia levels

A nurse is assisting with the plan of care for a client who has hepatic encephalopathy and has a prescription for lactulose. The nurse recognizes that this medication decreases which of the following substances?

Ammonia.

The patient has liver damage with loss of ability to metabolize protein, resulting in portal hypertension, hypoalbuminemia, and hyperaldosteronism. which assessment finding would the nurse expect to observe?

Ascites.

The nurse hears in report that the patient had lithotripsy for gallstones. Which postprocedural assessment is the nurse MOST likely to perform?

Assess level of pain and discomfort.

[NCLEX, GI MEDS] A client with Crohn's disease is scheduled to recieve an infusion of infliximab. the nurse assisting with caring for the clien would take which action to monitor the effectiveness of treatment?

Checking the frequency and consistency of bowel movements.

While caring for a patient with hepatitis A, the nurse expects the stools of the patient to appear what color?

Clay-Colored.

An older client has recently been taking cimetidine. The nurse needs to monitor the client for which MOST frequent central nervous system side effect of this medication?

Confusion

The nurse is preparing a presentation on hepatitis types B and C. What should the nurse include in the presentation regarding the most common methods of becoming infected by the disease?

Contaminated needles and instruments Direct contact with bodily fluids from infected people, such as through sexual contact

while discharging a patient after a laparoscopic cholecystectomy, the nurse hears the patient report mild shoulder pain. The nurse is aware that the pain is likely caused by which factor?

Diaphragmatic irritation secondary to residual carbon dioxide

The home health nurse sees that the patient's albumin level is 3.4g/dL (511.58 u mol/L). based on this information, which assessment is the nurse most likely to perform.

Dietary preferences and typical intake for 24-hour period.

A nurse in a clinic is reviewing the laboratory reports of a client who has suspected cholelithiasis, which of the following is an expected finding?

Direct Bilirubin 2.1 mg/dL

If a paitient is scheduled for an ultrasound of the pancreas, which situation would cause the examination to be postponed?

ERCP examination Recent barium enema examination

Which behavior places a person at GREATEST risk to contract hepatitis E

Eating raw shellfish or drinking water in Mexico

Which laboratory finding is the BEST indicator of acute pancreatitis in the later course of the disease?

Elevated Lipase

an older patient becomes confused and combative when stressed or during changes in routine. The nurse would contact the health care provider before scheduling which test?

Endoscopic retrograde cholangiopancreatography (ERCP)

A nurse is collecting data from a client who has Pancreatitis. Which of the following findings should the nurse expect?

Epigastric pain radiating to the left shoulder.

During a needle biopsy of the liver, which instruction will the patient receive?

Exhale and hold breath as the needle is inserted.

A nurse is collecting data from a client who has cirrhosis. Which of the following findings are manifestations of hepatic encephelopathy? Select all that apply

Fetor Hepaticus Asterix.

The nurse is assessing a newly admitted patient. which findings are most indicative of a liver abscess?

Fever accompanied by chills, abdominal pain, and tenderness in the right upper quadrant.

A nurse is collecting data from a client who has Pancreatitis, which of the following findings should the nurse identify as a manifestation of pancreatitis?

Gray-blue discoloration of the skin around the umbilicus.

A T-tube was inserted during a cholecystectomy. Which assessment finding does the nurse expect to observe?

Greenish-Yellow drainage from the tube.

Which patient is most likely to be prescribed gamma globulin or immune serum globulin?

Has recently been exposted to hepatitis A.

A patient with cirrhosis has been taking diphenhydramine. Which question would the nurse ask to evaluate the efficacy of the medication?

Has the medication helped decrease the itching?

A nurse is assisting with the care of a client who is post-procedure for a liver biopsy. Which of the following actions should the nurse take?

Have the client lie on their RIGHT side for 2 hours after the test.

The client has been taking omeprazole for 4 weeks. The nurse evaluates that the client is receiving the optimal intended effect of the medication of the client reports the absence of which symptom?

Heartburn

A nurse is reinforcing teaching about the route of transmission for hepatitis with a group of assistive personnel, the nurse should inform the group that which of the following types of hepatitis are transmitted primarily by the fecal-oral route.

Hepatitis A. Hepatitis E.

The nurse hears in report that the patient has hepatic enephalopathy and is receiving lactulose. which finding will the nurse observe if the medication therapy is successful?

Improved mental status.

The nurse is instructing the UAP about assisting several patients with morning hygiene. Which patient needs to use a soft toothbrush with very gentle brushing action?

In later stage cirrhosis of the liver.

A nurse is reviewing the admission laboratory results of a client who has acute pancreatitis. which of the following findings should the nurse expect?

Increased blood glucose level.

A patient's brother asks the nurse why the patient's pancreatic cancer is at stage IV so early after hearing the diagnosis. The nurse correctly identifies the late diagnosis and high mortality rates as being attributed to which factors? select all that apply.

It is difficult to diagnose pancreatic cancer at an early, curable stage. The majority of cancers have metastasized at the time of diagnosis. Early Tumors often remain asymptomatic, or silent until their growth is advanced Patients often attribute the vague early symptoms of pancreatic cancer to problems that do not warrant seeking medical attention.

The nurse hears in report that the patient has a total bilirubin of 2.8 mg/dL (47.88 u mol/L). What would the nurse expect to observe during the morning assessment?

Juandice of the sclera and mucous membranes.

Discharge teaching in relation to home management after a laparoscopic cholecystectomy should include which instructions?

Keeping the bandages on the puncture sites for 48 hours.

A nurse is assisting with the plan of care for a client who has fluid overload due to ascites, which of the following interventions should the nurse include in the plan of care? Select all that apply.

Measure abdominal girth. Weigh Daily Monitor intake and output Check for peripheral edema.

A patient has advanced cirrhosis of the liver with an acute exacerbation of hepatic enecphalopathy. What type of food may be limited for a short time in his diet?

Meats

The Alpha-Fetoprotein (AFP) level is elevated. The nurse prepares to give the patient and family emotional support because the HCP must order additional diagnostic testing for which medical problem?

Must rule out liver cancer.

The client has an as needed prescription for ondansetron. for which condition would the nurse administer this medication?

Nausea and vomiting.

The nurse hears in report that several patients are scheduled for diagnostic testing. The nurse plans to frequently take vital signs (every 15 minutes x 2, then every 30 minutes x 4, and then every hour x 4) After which test?

Needle Liver biopsy

A histimine (h2) receptor antagonist will be prescribed for a client. The nurse understands that which medications are h2-receptor antagonists? select all that apply

Nizatidine Famotidine Cimetidine

Which people should be advised to get the hepatitis b vaccine? Select all that apply.

Nurse who works in the emergency department Person who injects illicit substances groundskeeper who works at an inner-city park newborn who is having a 2-month well-baby examination Military person who is stationed in a developing country

[ATI BOOK] A nurse is reviewing a client's medical history for risk factors for Cholecystitis. The Nurse should identify which of the following is a risk factor?

Obesity.

A nurse is preparing to administer pancrelipase to a client who has pancreatitis, which of the following actions should the nurse take?

Offer a glass of water following medication administration.

The client with a gastric ulcer has a prescription for sucralfate 1g by mouth four times daily. the nurse would schedule the medication to be administered at which times?

One hour before meals and at bedtime.

The home health nurse is visitng a patient who has cirrhosis of the liver. which incident is cause for greatest concern?

Patient bumped his head on the doorway and now seems mildly confused.

The nurse is caring for a patient with hepatic encephalopathy. While assessing the patient, the nurse notes rapid, irregular flexion and extension (FLAPPING) of the wrist when the nurse requests that the patient stretch out the arm and hyperextend the wrist with fingers seperated. How should the nurse document this finding?

Patient demonstrates the presence of Asterixis

Several patients had diagnostic testing. The UAP reports that one of the patients is having shortness of breath, rapid, shallow breathing, and a rapid pulse. which patient is most likely to develop these signs/symptoms as a postprocedural complication?

Patient had a needle biopsy of the liver

Which patient is most likely to be prescribed a protein-restricted diet?

Patient is recovering from acute hepatic encephalopathy

The patient had a laparoscopic cholecystectomy yesterday and is scheduled to be discharged today. Which assessment finding would delay the discharge?

Patient notices bile leakage from the puncture site.

Which instructions would be given to the UAP about the care of a patient with viral hepatitis? Select all that apply.

Perform scrupulous hand hygeine. Wear gown and gloves when handling excreta Exercise caution when putting needles in the sharp box.

after a laparoscopic cholecystecomy, the patient reports shoulder pain. Which action would the nurse take?

Reassure that the pain is expected and give an analgesic as prescribed.

The client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?

Reduction of steatorrhea

The client who frequently uses NSAIDs has been taking misoprostol. The nurse determines that this medication is having the intended therapeutic effect if which is noted?

Relief of epigastric pain.

A first-semester nursing student ells the nurse that she would like to teach and coach coughing and deep-breathing to several patients. Which patients would be BEST for the nurse to recommend to the student. Select all that apply.

Scheduled to have a cholecystectomy in 2 days Looks forward to having a liver transplant from a living donor prescribed several weeks of bedrest for chronic hepatitis.

[TEXTBOOK] A patient is admitted with common dile buct obstruction related to cancer of the pancreas. Which clinical manifestations would the nurse expect to find? Select all that apply.

Scleral icterus Dark, Tea colored urine. Jaundice. Mid-epigastric pain

A patient has been admitted with right quadrant pain and has been placed on a low-fat diet. which tray would be acceptable for the patient?

Skim milk, lean fish, steamed carrots, and fruit

[STUDY GUIDE] Which patient has the greatest risk for drug toxicity due to physical changes in the gastrointestinal system related to aging?

Takes anticonvulsant medications

The nurse is caring for a postoperative open cholecystectomy patient. The nurse includes coughing and deep breathing in the patient's care plan based on what criteria?

The patient tends to take shallow breaths due to the location of the incision.

A nurse is reinforcing teaching with a client who has cholelithiasis and a new prescription for chenodiol, which of the following information should the nurse include?

This medication dissolves gallstones gradually over a period of up to 2 years.

When caring for a patient with acute exacerbation of hepatic enecephalopathy, the nurse may give a lactulose enema, provide a low-protein diet, and limit physical activity. The nurse explains to the patient that these measures are taken for what reason?

To decrease ammonia production

The surgical procedure for cancer of the pancrease involves resection of the antrum of the stomach, the gallblader, the duodenum, and varying ammounts of the pancreas. Anastomoses are constructed between the stomach, the common bile and pancreatic ducts, and the jejunum. the nurse correctly identifies this procedure with which name?

Whipple Procedure.

which signs/symptoms would occur in the early stages of cirrhosis of the liver?

flulike symptoms