Chapter 50 study guide questions

A

A nurse should monitor blood glucose levels for a patient diagnosed with hyperinsulinism. What blood value does the nurse recognize as inadequate to sustain normal brain function? A. 30 mg/dL B. 50 mg/dL C. 70 mg/dL D. 90 mg/dL

Gallbladder

Bile is stored in what

Analgesics and antibiotics, intravenous fluids, and nasogastric suctioning

Brenda, an obese mother of four, is diagnosed as having acute gallbladder inflammation. She is 5 feet 4 inches tall and weighs 190 pounds. The physician decides to delay surgical intervention until Brenda's acute symptoms subside. What does the nurse anticipate that Brenda's initial course of treatment will probably consist of?

C

The nurse is caring for a patient with acute pancreatitis. The patient has a prescription for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason? A. To decrease metabolism B. To depress the central nervous system and increase the pain threshold C. To reduce gastric and pancreatic secretions D. To relieve nausea and vomiting

B

The nurse should assess for an. Important early indicator of acute pancreatitis. What prolonged and elevated level would the nurse determine is an early indicator? A. Serum calcium B. Serum lipase C. Serum bilirubin D. Serum amylase

D

The patient is admitted with pancreatitis has passed the acute stage and is now able to tolerate solid foods. What type of diet will increase caloric intake without stimulating pancreatic enzymes beyond the ability of the pancreas to respond? A. Low-sodium, high-potassium, low-fat diet B. High-carbohydrate, high protein, low-fat diet C. Low-carbohydrate, high-potassium diet D. High-carbohydrate, low-protein, low fat diet

Laparoscopy

Visualizes the pancreas via endoscopy

B

What is a major concern for the nurse when caring for a patient with chronic pancreatitis? A. Pain B. Weight loss C. Nausea D. Mental status changes

C

A patient is diagnosed with gallstones in the bile ducts. What laboratory results should the nurse review? A. Serum ammonia concentration of 90 mg/dL B. Serum albumin concentration of 4.0 g/dL C. Serum bilirubin level greater than 1.0 mg/dL D. Serum globulin concentration of 2.0 g/dL

A

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder? A. Edema and inflammation B. Pleural effusion C. Sepsis D. Disseminated intravascular coagulopathy

D

A patient is receiving pharmacologic therapy with ursodeoxycholic acid or chenodeoxycholic acid for treatment of small gallstones. The patient asks the nurse how long the therapy will take to dissolve the stones. What is the best answer the nurse can give? A. 1 to 2 months B. 3 to 5 months C. 6 to 8 months D. 6 to 12 months

B,C,D

A patient is admitted to the hospital with a possible common bile duct obstruction. What symptoms assessed by the nurse are indicators of this problem? (Select all that apply) A. Amber-colored urine B. Clay-colored feces C. Pruritis D. Jaundice E. Pain in the left upper abdominal quadrant

D

A patient is admitted to the hospital with with possible cholelithiasis. What diagnostic test of choice will the nurse prepare the patient for? A. X-ray B. Oral cholecystography C. Cholecystography D. Ultrasonography

Pancreatic necrosis

A major cause of morbidity and mortality in patients with acute pancreatitis

A,B,C

A patient is suspected to have a pancreatic carcinoma and is having diagnostic testing to determine insulin deficiency. What would the nurse determine is an indicator for insulin deficiency in this patient? (Select all that apply) A. An abnormal glucose tolerance B. Glucosuria C. Hyperglycemia D. Elevated lipase level E. Hypoglycemia

C

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? A. The patient requires more pain medication B. The patient is developing a paralytic ileus C. The patient has developed peritonitis D. The patient has developed kidney disease

Foods high in fat, as well as eggs, cream, pork, fried foods, cheese, rich dressings, gas-forming vegetables, and alcohol

Brenda, an obese mother of four, is diagnosed as having acute gallbladder inflammation. She is 5 feet 4 inches tall and weighs 190 pounds. The physician decides to delay surgical intervention until Brenda's acute symptoms subside. As foods are added to Brenda's diet, she needs to know that she should avoid what type of foods?

Chenodeoxycholic acid may not be effective if taken with dietary cholesterol, estrogens, or oral contraceptives

Brenda, an obese mother of four, is diagnosed as having acute gallbladder inflammation. She is 5 feet 4 inches tall and weighs 190 pounds. The physician decides to delay surgical intervention until Brenda's acute symptoms subside. Brenda is being medicated with chenodeoxycholic acid. What education should the nurse provide to Brenda about the decreased effectiveness of the drug when taken inn conjunction with certain items?

Amylase

Digestive enzymes are secreted by the pancreas: ______________ aids in the digestion of carbohydrates, trypsin aids in protein digestion, and lipase aids in the digestion of fats

Endoscopic ultrasound (EUS)

Identifies small tumors and facilitates fine needle aspiration biopsy

Obese

Statistics show that there is a greater incidence of gallbladder disease for women who are multiparous, __________, and over 40.

30

The capacity of the gallbladder for bile storage is ______ to 50 mL

Calculous cholecystitis

The cause of more than 90% of cases of acute cholecystitis

Insulin

The endocrine secretions of the pancreas are __________, glucagon, and somatostatin

Secretin

The major stimulus for increased bicarbonate secretion from the pancreas

Bile duct injury

The most serious complication after a laparoscopic cholecystectomy

A

The nurse is admitting a patient to the intensive care unit with a diagnosis of acute pancreatitis. What does the nurse expect was the reason the patient came to the hospital? A. Severe abdominal pain B. Fever C. Jaundice D. Mental agitation

Endoscopic retrograde cholangiopancreatography

Visualizes the biliary structure

Cholecystogram, cholangiogram

Visualizes the gallbladder and bile duct

Celiac axis arteriography

Visualizes the liver and pancreas

A,C,D

When caring for the patient with acute pancreatitis, the nurse must consider pain relief measures. What nursing interventions could the nurse provide? (Select all that apply) A. Encouraging bed rest to decrease the metabolic rate B. Assisting the patient into the prone position C. Withholding oral feeding to the limit the release of secretin D. Administering parenteral opioid analgesics as ordered E. Administering prophylactic antibiotics

A

When the nurse is caring for a patient with acute pancreatitis, what intervention can be provided in order to prevent atelectasis and prevent pooling of respiratory secretions? A. Frequent changes of positions B. Placing the patient in the prone position C. Perform chest physiotherapy D. Suction the patient every 4 hours