Exam 4 - Chapter 23 Patients with Gastric & Duodenal Disorders

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed? A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum. A sectioned portion of the stomach is joined to the jejunum. The antral portion of the stomach is removed and a vagotomy is performed. The vagus nerve is cut and gastric drainage is established.

A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum. A Billroth I procedure involves removal of the lower portion of the antrum of the stomach (which contains the cells that secrete gastrin) as well as a small portion of the duodenum and pylorus. The remaining segment is anastomosed to the duodenum. A vagotomy severs the vagus nerve; a Billroth I procedure may be performed in conjunction with a vagotomy. If the remaining part of the stomach is anastomosed to the jejunum, the procedure is a Billroth II.

A client is admitted to the hospital with an exacerbation of chronic gastritis. When assessing the client's nutritional status, the nurse should expect to find what type of deficiency? vitamin A vitamin B6 vitamin B12 vitamin C

vitamin B12 The nurse should expect vitamin B12 deficiency. Injury to the gastric mucosa causes gastric atrophy and impaired function of the parietal cells. These changes result in reduced production of intrinsic factor, which is necessary for the absorption of vitamin B12. Eventually, pernicious anemia will occur. Deficiencies in vitamins A, B6, and C aren't expected in a client with chronic gastritis.

After a client received a diagnosis of gastric cancer, the surgical team decides that a Billroth II would be the best approach to treatment. How would the nurse explain this procedure to the family? Limited resection in the distal portion of the stomach and removal of about 25% of the stomach Wide resection of the middle and distal portions of the stomach with removal of about 75% of the stomach Proximal subtotal gastrectomy Total gastrectomy and esophagogastrectomy

Wide resection of the middle and distal portions of the stomach with removal of about 75% of the stomach The Billroth I involves a limited resection and offers a lower cure rate than the Billroth II. The Billroth II procedure is a wider resection that involves removing approximately 75% of the stomach and decreases the possibility of lymph node spread or metastatic recurrence. A proximal subtotal gastrectomy may be performed for a resectable tumor located in the proximal portion of the stomach or cardia. A total gastrectomy or an esophagogastrectomy is usually performed in place of this procedure to achieve a more extensive resection.

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist? Barium study of the upper gastrointestinal tract Endoscopy Gastric secretion study Stool antigen test

Endoscopy

The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10% to 20% of clients is: Hemorrhage Intractable ulcer Perforation Pyloric obstruction

Hemorrhage

A 58-year-old man who leads a busy lifestyle managing his own business has been diagnosed with a gastric ulcer. The man has told the nurse, "My wife warned me that my job stress would eventually catch up with me!" How should the nurse best respond to the patient's statement? "Actually, it's been found that stress doesn't really cause ulcers." "Researchers have found that your environment is the most significant cause of ulcers." "Ulcers aren't caused by anything specific; some people develop them for no particular reason." "Most ulcers are a consequence of the different medications that you take."

"Actually, it's been found that stress doesn't really cause ulcers."

Which of the following appears to be a significant factor in the development of gastric cancer? Diet Age Ethnicity Gender

Diet

A client with gastric cancer is scheduled to undergo a Billroth II procedure. The client's spouse asks how much of the client's stomach will be removed. What would be the most accurate response from the nurse? Approximately 25% Approximately 50% Approximately 75% The amount will depend on the client's weigh

Approximately 75%

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply. Nizatidine Lansoprazole Famotidine Cimetidine Esomeprazole

Nizatidine Famotidine Cimetidine

A client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond? Notify the health care provider. Reposition the tube. Irrigate the tube. Increase the suction level.

Notify the health care provider.

Peptic ulcer disease occurs more frequently in people with which blood type? A B AB O

O People with blood type O are more susceptible to peptic ulcers than those with blood type A, B, or AB.

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer. Nizatidine Cimetidine Famotidine Omeprazole

Omeprazole

A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect? Vasomotor symptoms associated with dumping syndrome Dehiscence of the surgical wound Peritonitis A normal reaction to surgery

Vasomotor symptoms associated with dumping syndrome Early manifestations of dumping syndrome occur 15 to 30 minutes after eating. Signs and symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, diarrhea, nausea, and the desire to lie down. Dehiscence of the surgical wound is characterized by pain and a pulling or popping feeling at the surgical site. Peritonitis presents with a rigid, board-like abdomen, tenderness, and fever. The client's signs and symptoms aren't a normal reaction to surgery.

Endoscopy of a 60-year-old woman has revealed the presence of an esophageal peptic ulcer. The nurse who is providing this woman's care is assessing for risk factors that may have contributed to the development of this disease. What question most directly addresses these risk factors? "Have you ever been diagnosed with reflux?" "Do you consider yourself to have a healthy diet?" "Have you been prone to infections over the past few years?" "Do you ever find it difficult to swallow certain foods?"

"Have you ever been diagnosed with reflux?" Gastroesophageal reflux disease (GERD) is a significant risk factor for peptic ulcer disease. Poor diet, general infections, and dysphagia are less closely associated with etiology of esophageal ulcers.

A 70-year-old woman with a complex medical history made an appointment with her primary care provider because she has recently been experiencing heartburn, abdominal pain, and nausea. The clinician has identified that the woman's symptoms are characteristic of acute gastritis. Which of the woman's following statements is suggestive of the etiology of her problem? "I remember my father often complaining about heartburn and indigestion." "I've been taking glucosamine supplements because I've been told they'll help my arthritis." "My endocrinologist recently increased my dose of metformin that I take for my diabetes." "I've changed from taking Tylenol for my arthritis pain to taking aspirin."

"I've changed from taking Tylenol for my arthritis pain to taking aspirin."

An obese male patient has sought advice from the nurse about the possible efficacy of medications in his efforts to lose weight. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity? "Medications are usually reserved for people who have had unsuccessful bariatric surgery." "Medications may be of some use, but they don't tend to resolve obesity on their own." "Medications are an excellent option for individuals who prefer not to exercise or reduce their food intake." "Medications have the potential to reduce hunger but they rarely result in weight loss."

"Medications may be of some use, but they don't tend to resolve obesity on their own." Medications for obesity rarely result in loss of more than 10% of total body weight. They are not intended as a substitute for exercise or a healthy diet. They are not solely intended for those individuals who have undergone bariatric surgery.

A client with morbid obesity and a history of severe sleep apnea and severe diabetes is being considered for bariatric surgery. When reviewing the client's medical record, the nurse would identify that which body mass index (BMI) would meet the criteria for such surgery? 30kg/m2 32 kg/m2 34 kg/m2 36 kg/m2

36 kg/m2 To meet the criteria for bariatric surgery, the client must have a BMI of at least 35 kg/m2 with obesity-associated comorbidity (e.g., severe sleep apnea, hypertension, cardiomyopathy related to obesity, severe diabetes mellitus, and serious musculoskeletal or neurologic disorders).

An older adult patient with a diagnosis of chronic gastritis has achieved acceptable control of his condition with the use of an H2 receptor antagonist. This patient's symptom control is a result of what therapeutic action of this drug? The occlusion of parietal cells An increase in the pH of gastric secretions A decrease in HCl production by parietal cells Activation of the gastric buffer system and release of alkaline gastric secretions

A decrease in HCl production by parietal cells Histamine-2 receptor antagonists decrease the amount of HCl produced by stomach by blocking action of histamine on histamine receptors of parietal cells in the stomach. They do not directly increase the pH of gastric secretions, and they do not activate a buffer system or occlude parietal cells.

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems? Acute gastritis Duodenal ulcer Gastric cancer Gastric ulce

Acute gastritis

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer? Vomiting Hemorrhage Awakening in pain Constipation

Awakening in pain

Which ulcer is associated with extensive burn injury? Cushing ulcer Curling ulcer Peptic ulcer Duodenal ulcer

Curling ulcer

Which of the following appears to be a significant factor in the development of gastric cancer? Diet Age Ethnicity Gender

Diet Diet seems to be a significant factor: a diet high in smoked, salted, or pickled foods and low in fruits and vegetables may increase the risk of gastric cancer. The typical patient with gastric cancer is between 50 and 70 years of age. Men have a higher incidence than women. Native Americans, Hispanic Americans, and African Americans are twice as likely as European Americans to develop gastric cancer.

A patient comes to the bariatric clinic to obtain information about bariatric surgery. The nurse assesses the obese patient knowing that, in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate what? Knowledge of the causes of obesity and its associated risks Emotional stability and understanding of required lifestyle changes. Positive body image and high self-esteem Insight into why their past weight loss efforts failed

Emotional stability and understanding of required lifestyle changes.

A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event? Gastric outlet obstruction Dumping syndrome Bile reflux Celiac disease

Dumping syndrome Dumping syndrome is an unpleasant set of vasomotor and GI symptoms that occur in up to 76% of patients who have had bariatric surgery. Early symptoms include a sensation of fullness, weakness, faintness, dizziness, palpitations, diaphoresis, cramping pains, and diarrhea. These symptoms resolve once the intestine has been evacuated (i.e., with defecation).

Which medication is classified as a histamine-2 receptor antagonist? Famotidine Lansoprazole Metronidazole Esomeprazole

Famotidine

A client has been taking famotidine at home. What teaching should the nurse include with the client? Famotidine will inhibit gastric acid secretions. Famotidine will neutralize acid in the stomach. Famotidine will shorten the time required for digestion in the stomach. Famotidine will improve the mixing of foods and gastric secretions.

Famotidine will inhibit gastric acid secretions. Famotidine is useful for treating and preventing ulcers and managing gastroesophageal reflux disease. It functions by inhibiting the action of histamine at the H-2 receptor site located in the gastric parietal cells, thus inhibiting gastric acid secretion. Famotidine will not neutralize acid in the stomach, but inhibits acid secretion. Famotidine will not shorten digestion time and will not improve food mixing with gastric secretions.

The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage? Hematemesis Bradycardia Hypertension Polyuria

Hematemesis

During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of gastritis would be the: Immediacy of the occurrence. Presence of vomiting. Frequency of abdominal discomfort. Incidence of anorexia.

Immediacy of the occurrence.

Computed tomography of a patient with a sudden onset of severe nausea and vomiting has revealed the presence of a pyloric obstruction. Which of the following interventions is the nurse's priority in the immediate care of this patient? Insertion of a nasogastric (NG) tube to suction to decompress the stomach Insertion of a central line for parenteral nutrition Administration of a saline enema to purge the lower bowel Gastric lavage

Insertion of a nasogastric (NG) tube to suction to decompress the stomach

Which is a true statement regarding gastric cancer? Most clients are asymptomatic during the early stage of the disease. Women have a higher incidence of gastric cancer. The prognosis for gastric cancer is good. Most cases are discovered before metastasis.

Most clients are asymptomatic during the early stage of the disease. Most clients are asymptomatic during the early stage of the disease. Men have a higher incidence of gastric cancer. The prognosis is poor because the diagnosis is usually made late because most clients are asymptomatic during the early stage. Most cases of gastric cancer are discovered only after local invasion has advanced or metastases are present.

Which of the following manifestations are associated with a deficiency of vitamin B12? Select all that apply. Pernicious anemia Macrocytic anemia Thrombocytopenia Loss of hair Lethargy

Pernicious anemia Macrocytic anemia Thrombocytopenia page 705

Which of the following is the most successful treatment for gastric cancer? Removal of the tumor Chemotherapy Radiation Palliation

Removal of the tumor

A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal? Slows gastric emptying Provides much needed rest Allows for better absorption of vitamin B12 Removes tension on internal suture line

Slows gastric emptying

The nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data below should the nurse consider most significantly related to the etiology of the patient's health problem? Consumes one or more protein drinks daily Takes over-the-counter antacids frequently Smokes two packs of cigarettes daily Reports a history of social drinking on a weekly basis

Smokes two packs of cigarettes daily Smoking is a significant risk factor for chronic gastritis. Alcohol ingestion can lead to gastritis; however, this generally occurs in patients with a history of daily consumption of alcohol. Protein drinks do not result in gastric inflammation. Antacids do not contribute to the etiology of chronic gastritis.

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: a sedentary lifestyle and smoking. a history of hemorrhoids and smoking. alcohol abuse and a history of acute renal failure. alcohol abuse and smoking

alcohol abuse and smoking

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience vomiting. hemorrhage. pain 2 to 3 hours after a meal. weight loss.

pain 2 to 3 hours after a meal.

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: restrict fluid intake to 1 qt (1,000 ml)/day. drink liquids only with meals. don't drink liquids 2 hours before meals. drink liquids only between meals.

drink liquids only between meals.

A nurse assesses the stools of a client diagnosed with peptic ulcer disease. Inspection reveals black, tarry stools. The nurse would use which term to document this finding? melena hematemesis pyrosis achlorhydria

melena

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? "I should stop all my medications if I develop any side effects." "I should continue my treatment regimen as long as I have pain." "I have learned some relaxation strategies that decrease my stress." "I can buy whatever antacids are on sale because they all have the same effect."

"I have learned some relaxation strategies that decrease my stress."

A client is admitted with a new onset of pyloric obstruction. What client symptoms should the nurse anticipate? Select all that apply. Anorexia Nausea and vomiting Diarrhea Weight loss Epigastric fullness

Anorexia Nausea and vomiting Diarrhea Pyloric obstruction, also called gastric outlet obstruction (GOO), occurs when the area distal to the pyloric sphincter becomes scarred and stenosed from spasm or edema or from scar tissue that forms when an ulcer alternately heals and breaks down. The client may have nausea and vomiting, constipation, epigastric fullness, and anorexia. A later sign will be weight loss. The client will not have diarrhea with the obstruction.

An older adult patient had a gastrectomy performed several weeks ago and is being followed closely by the care team. Due to potential complications of this surgery, the nurse should closely monitor the patient's levels of: Iron and vitamin B12 Prealbumin and bilirubin Ionized calcium and C-reactive protein Creatinine and blood urea nitrogen (BUN)

Iron and vitamin B12

A 32-year-old man who has a body mass index of 32 (morbidly obese) is considering bariatric surgery. In the time leading up to this surgery, which of the following nursing diagnoses will be the primary focus of interventions? Knowledge deficit related to the implications of bariatric surgery Altered growth and development related to obesity Risk for injury related to obesity Spiritual distress related to low body image

Knowledge deficit related to the implications of bariatric surgery Patient teaching is a priority in the preparation for bariatric surgery. Necessary counseling and education would be prioritized over growth and development and spiritual distress, although each may emerge and be addressed accordingly. In seeking bariatric surgery, the patient is likely already aware of the risks associated with obesity.

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: restrict fluid intake to 1 qt (1,000 ml)/day. drink liquids only with meals. don't drink liquids 2 hours before meals. drink liquids only between meals.

drink liquids only between meals. A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to ingest liquids between meals rather than with meals. Taking fluids between meals allows for adequate hydration, reduces the amount of bulk ingested with meals, and aids in the prevention of rapid gastric emptying. There is no need to restrict the amount of fluids, just the time when the client drinks fluids. Drinking liquids with meals increases the risk of dumping syndrome by increasing the amount of bulk and stimulating rapid gastric emptying. Small amounts of water are allowable before meals.

A patient comes to the clinic complaining of pain in the epigastric region. The nurse suspects that the patient's pain is related to a peptic ulcer when the patient states the pain is relieved by what? Eating Drinking milk Suppressing emesis Having a bowel movement

Eating

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply. Ingestion of strong acids Irritating foods Overuse of aspirin DASH diet Participation in highly competitive sports

Ingestion of strong acids Irritating foods Overuse of aspirin Acute gastritis is often caused by dietary indiscretion-a person eats food that is irritating, too highly seasoned, or contaminated with disease-causing microorganisms. Other causes of acute gastritis include overuse of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), excessive alcohol intake, bile reflux, and radiation therapy. A more severe form of acute gastritis is caused by the ingestion of strong acid or alkali, which may cause the mucosa to become gangrenous or to perforate. A DASH diet is an acronym for Dietary Approaches to Stop Hypertension, which would not cause gastritis. Participation in competitive sports also would not cause gastritis.

A client sustained second- and third-degree burns over 30% of the body surface area approximately 72 hours ago. What type of ulcer should the nurse be alert for while caring for this client? Curling's ulcer Peptic ulcer Esophageal ulcer Meckel's ulcer

Curling's ulcer Curling's ulcer is frequently observed about 72 hours after extensive burns and involves the antrum of the stomach or the duodenum. Peptic, esophageal, and Meckel's ulcers are not related to burn injuries.

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.) "It can be caused by ingestion of strong acids." "You may have ingested some irritating foods." "Is it possible that you are overusing aspirin." "It is a hereditary disease." "It is probably your nerves."

"It can be caused by ingestion of strong acids." "You may have ingested some irritating foods." "Is it possible that you are overusing aspirin." Acute gastritis is often caused by dietary indiscretion—the person eats food that is irritating, too highly seasoned, or contaminated with disease-causing microorganisms. Other causes of acute gastritis include overuse of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), excessive alcohol intake, bile reflux, and radiation therapy. A more severe form of acute gastritis is caused by the ingestion of strong acid or alkali, which may cause the mucosa to become gangrenous or to perforate.

A nurse is caring for a patient who has had bariatric surgery and is developing a teaching plan for the patient. Which information is essential for the nurse to include in this teaching? Drink a minimum of 90 mL (3 oz) of fluid with each meal. Eat six small meals daily spaced at equal intervals. Choose foods high in simple carbohydrates. Limit calories to no more than 3,000 daily.

Eat six small meals daily spaced at equal intervals. Due to decreased stomach capacity, the patient must consume small meals at intervals to meet nutritional requirements while avoiding a feeling of fullness and complications such as dumping syndrome. The patient should not consume fluids with meals. This practice, as well as consumption of foods high in carbohydrates, contributes to the development of dumping syndrome. The patient should maintain a low-calorie diet.

A 70-year-old woman with a complex medical history made an appointment with her primary care provider because she has recently been experiencing heartburn, abdominal pain, and nausea. The clinician has identified that the woman's symptoms are characteristic of acute gastritis. Which of the woman's following statements is suggestive of the etiology of her problem? "I remember my father often complaining about heartburn and indigestion." "I've been taking glucosamine supplements because I've been told they'll help my arthritis." "My endocrinologist recently increased my dose of metformin that I take for my diabetes." "I've changed from taking Tylenol for my arthritis pain to taking aspirin."

"I've changed from taking Tylenol for my arthritis pain to taking aspirin." Overuse of aspirin is frequently implicated in cases of acute gastritis. Family history and the use of glucosamine and metformin are not common contributors to acute gastritis.

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse? Notify the health care provider. Irrigate the client's NG tube. Place the client in the high-Fowler's position. Assess the client's abdomen and vital signs.

Assess the client's abdomen and vital signs. Signs and symptoms of perforation includes sudden, severe upper abdominal pain (persisting and increasing in intensity); pain may be referred to the shoulders, especially the right shoulder, because of irritation of the phrenic nerve in the diaphragm. The nurse should assess the vital signs and abdomen prior to notifying the physician. Irrigation of the NG tube should not be performed because the additional fluid may be spilled into the peritoneal cavity, and the client should be placed in a position of comfort, usually on the side with the head slightly elevated.

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed? Hemorrhage Penetration Perforation Pyloric obstruction

Hemorrhage Signs of hemorrhage following surgery include cool skin, confusion, increased heart rate, labored breathing, and blood in the stool. Signs of penetration and perforation are severe abdominal pain, rigid and tender abdomen, vomiting, elevated temperature, and increased heart rate. Indicators of pyloric obstruction are nausea, vomiting, distended abdomen, and abdominal pain.

A critical care nurse is closely monitoring a patient who has recently undergone surgical repair of a bleeding peptic ulcer. The nurse should prioritize assessments of which of the following signs and symptoms of a recurrence of hemorrhage? Restlessness and cyanosis Hypotension and tachycardia Bradypnea and pursed lip breathing Peripheral and pulmonary edema

Hypotension and tachycardia Rebleeding has multiple manifestations. However, an increase in heart rate and decrease in blood pressure are key signs of a hemorrhage that are present in nearly all patients who are experiencing rebleeding.

A nurse is teaching a client about the need to use mineral supplements along with a multivitamin daily after bariatric surgery. Which minerals would the nurse include in the teaching? Select all that apply. Iron Folic acid Copper Sodium Potassium

Iron Folic acid Copper Client teaching includes taking two chewable multivitamins plus mineral (iron, folic acid, thiamine, copper, zinc) supplements daily and a dietary intake or supplementation of 1,200-1,500 mg of elemental calcium. Sodium and potassium supplements are not indicated.

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? Ineffective treatment for the peptic ulcer A reaction to the medication given for the ulcer Gastric penetration Perforation of the peptic ulcer

Perforation of the peptic ulcer Signs and symptoms of perforation include the following: Sudden, severe upper abdominal pain (persisting and increasing in intensity), which may be referred to the shoulders, especially the right shoulder, because of irritation of the phrenic nerve in the diaphragm; vomiting; collapse (fainting); extremely tender and rigid (board-like) abdomen; and hypotension and tachycardia, indicating shock.

A 30-year-old obese female patient who underwent gastric banding 3 days ago is getting ready to go home. Essential postoperative teaching for this patient should include instruction related to the importance of abstaining from what for the next 2 years? Multivitamin supplements Pregnancy Antidepressants Control-top panty hose

Pregnancy Women of childbearing age who have had bariatric surgery should avoid pregnancy for approximately 2 years until their weight stabilizes, and it is evident that their nutritional needs are being adequately met. Multivitamins are generally recommended for the patient to supplement dietary sources of nutrients. Antidepressants may be taken if clinically indicated. Control-top pantyhose may be uncomfortable postoperatively; however, they are not contraindicated.

The nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data below should the nurse consider most significantly related to the etiology of the patient's health problem? Consumes one or more protein drinks daily Takes over-the-counter antacids frequently Smokes two packs of cigarettes daily Reports a history of social drinking on a weekly basis

Smokes two packs of cigarettes daily