Gastrointestinal chapter 5

The pt who had surgery for a peptic ulcer several weeks ago reports experiencing an episode of diaphoresis, nausea, vomiting, epigastric pain, explosive diarrhea, and dyspepsia. Which question is the most relevant to the symptoms and the surgical hx?

"Did you eat before the symptoms? And if so, what did you eat?"

The nurse is teaching a postgastrectomy pt about dumping syndrome. Which statement indicates that the pt needs further instruction?

"I will avoid fats and increase carbohydrates."

A nurse is reinforcing discharge teaching with a client who is postoperative following fundoplication. Which of the following statements by the client indicates understanding?

"I will elevate the head of my bed on blocks."

A nurse in a clinic is reinforcing teaching with a client who has ulcerative colitis. Which of the following statements by the client indicates understanding of the teaching?

"I will plan to limit fiber in my diet."

A nurse is reinforcing discharge teaching with a client who has an infection due to H. pylori. Which of the following statements by the client indicates understanding?

"I will take a combination of medications for treatment."

A nurse is reinforcing teaching with a client who has a new prescription for famotidine. Which of the following statements by the client indicates understanding?

"I will take my pill 1 hr before meals."

A nurse is reinforcing teaching with a client who has a new prescription for sulfasalazine. Which of the following instructions should the nurse include in the teaching?

"Notify the provider if you experience a sore throat."

A nurse is reinforcing teaching with a client who has a hiatal hernia. Which of the following client statements indicates understanding?

"Peppermint tea will increase my digestion."

A nurse in the clinic is instructing a client about a fecal occult blood test, which requires mailing three specimens. Which of the following client statements indicates understanding of the instructions?

"This is an easy way to screen for colon cancer."

A pt has been prescribed infliximab (Remicade) for tx of Crohn's dx. What info should the nurse include in pt teaching regarding this medication?

"This medication is given to suppress your immune system's overactive response."

A nurse is reviewing preoperative teaching with a client scheduled for a laparoscopic cholystectomy. Which of the following should the nurse include?

"You might have shoulder pain after surgery."

The pt confides in the nurse that she feels angry because the health care provider has hinted that irritable bowel syndrome (IBS) might be the problem but offers no definitive medical diagnosis. What is the most therapeutic response?

"You seem really frustrated. What has the provider told you so far?"

A nurse is reinforcing teaching with a client who has chronic gastritis and is scheduled for a selective vagotomy. Which of the following should the nurse include about the purpose of the procedure?

"You will have a reduction of gastric acid secretions."

What is peptic ulcer disease (PUD)?

A condition characterized by acid in the digestive tract eroding the mucosal lining of the stomach, esophagus, or duodenum.

What are treatments for diverticulitis?

A diet high in fiber, mainly from fresh fruits and veggies, and decreased intake of fat and red meat are recommended. In acute diverticulitis the goal of treatment is to allow the colon to rest and the inflammation to subside.

What is dumping syndrome?

A rapid gastric emptying of undigested food from the stomach to the small intestine. Increased intestinal motility and peristalsis and changes in blood glucose occurs.

A nurse is caring for a client who has a new dx of gastroesophageal reflux disease (GERD). The nurse should anticipate prescriptions for which of the following medications? sata:

Antacids; Histamine2 receptor antagonists; & Proton pump inhibitors

Which type of medication order should the nurse question when caring for a pt with E. coli O157:H7?

Antilipidemic agents

A nurse is providing care to a client who is 1 day postoperative following a paracentesis. The nurse observes clear, pale-yellow fluid leaking from the operative site. Which of the following is an appropriate nursing intervention?

Apply a dry, sterile dressing

What nursing intervention is most appropriate to decrease postoperative edema and pain in a male pt after an inguinal herniorraphy?

Applying a truss to the hernial site

The pt had an esophagogastroduodenoscopy several hours ago and now reports abdominal pain and tenderness. What should the nurse do first?

Assess the abdominal pain

The pt is admitted for acute diverticulitis. The nurse would intervene if a nursing student performed which action?

Assists with a meal tray

Mechanical obstruction early stages:

Auscultation of the abdomen reveals loud, frequent, high-pitched sounds. Later stages bowel sounds will likely be absent. Other objective data include vomiting; signs of dehydration caused by the fluid shift; abdominal distention, tenderness, and muscle guarding; and decreased BP.

A nurse is reinforcing discharge teaching with a client who has IBS. Which of the following instructions should the nurse include?

Avoid foods that trigger exacaberation

The pt needs to have a series of test of the GI system. Which test must be scheduled last?

Barium studies

The large intestine is the site of bacterial action that produces vitamin K. Potentially, loss of the large colon or disruption of this bacterial action could disrupt which body function?

Blood clotting

A pt had a partial gastrectomy. Because this surgery creates an increased risk for pernicious anemia, which teaching point is important to emphasize?

Blood serum vitamin B12 level should be measured every 1 to 2 years

A nurse is reviewing nutrition teaching for a client who has cholecystitis. The nurse should identify that which of the following food choices is most likely to trigger the dx?

Brownie with nuts

A nurse is having difficulty arousing a client following an esophagogastroduodenoscopy (EGD). Which of the following actions is the nurse's priority?

Check the client's airway

A nurse is reinforcing teaching with a client about a bowel prep using polyethylene glycol who will undergo a colonoscopy.Which of the following instructions should the nurse reinforce?

Check with the provider about taking current medications during the bowel prep

After a transverse loop colostomy, the nurse inspects the pt's stoma. The stoma appears pale pink with some dusky discoloration at the lower border. What is the most appropriate action by the nurse?

Clean the area around the stoma, apply a clean pouch, and notify the health care provider about the discoloration

A nurse is collecting data from a client who has been taking prednisone following an exacerbation of IBD. The nurse should identify which of the following findings as the priority?

Client reports having an elevated body temp

Gastrojejunostomy:

Closure of the duodenum, and anastomosis of the fundus of the stomach into the jejunum, used to remove ulcers or cancer located in the body of the fundus.

A pt is being treated with sucralfate for gastroesophageal reflux disease. Which teaching point would the nurse emphasize?

Coating action may interfere with the absorption of other drugs-- separate by 2 hours.

The nurse is talking to a neighbor who says that she has had a sore on her lip for about 3 weeks. What advice should the nurse give?

Consult the health care provider because of the duration of the sore

Which medical diagnosis requires that the nurse be extra vigilant for concurrent Urinary Tract Infections?

Crohn's disease

When caring for a pt diagnosed with Crohn's disease, what S/S does the nurse expect to observe? sata:

Diarrhea and abdominal pain; Weight loss and malnutrition; & Fatigue and fever

Gastroduodenostomy:

Direct anastomosis of the fundus of the stomach to the duodenum, used to remove ulcers or cancer located in the antrum of the stomach.

A nurse in a clinic is reviewing the lab reports of a client who has suspected cholelithiasis. Which of the following is an expected finding?

Direct bilirubin 2.1 mg/dL

What is the most common cause of lower GI hemorrhage?

Diverticulitis

A nurse is reinforcing discharge teaching with a client who has Crohn's dx. Which of the following instructions should the nurse include in the teaching?

Drink canned protein supplements

A pt was admitted during the evening shift with a tentative diagnosis of cancer of the esophagus. What complaint does the nurse anticipate finding in the initial assessment of the pt?

Dysphagia

A nurse is caring for a group of clients. Which of the following client findings should the nurse identify as an indication to recommend enteral feedings?

Dysphagia secondary to Parkinson's dx

During assessment of a pt with esophageal achalasia, what does the nurse expect the pt to report when the health hx is obtained?

Dysphagia, especially with liquids

Treating for dumping syndrome?

Eating 6 small meals that are high in protein and fat and low in carbs, eating slowly, and avoiding fluids during meals.

The pt is admitted for an exacerbation of ulcerative colitis and the nurse hears in report that the pt had 20 liquid stools within the past 24 hrs. Which lab result is the most important to follow up on?

Electrolyte levels

A pt has undergone numerous diagnostic tests to determine whether a gastric malignancy is present. The pt asks the nurse what test will be most definitive for dx. Which response by the nurse is correct?

Endoscopy with biopsy

A nurse is reviewing the serum lab data of a client who has an acute exacerbation of Crohn's dx. Which of the following lab tests should the nurse expect to be elevated? sata:

Erythrocyte & WBC

A nurse is reinforcing teaching about pernicious anemia with a client who has chronic gastritis. Which of the following info should the nurse include in the teaching?

Expect a monthly injection of vitamin B12

NI for appendicitis?

Explain diagnostic tests and possible surgical procedures to relieve anxiety; maintain bed rest and NPO status; provide comfort measures for pain relief; replace fluids and electrolytes; monitor vitals and documented every hr; can provide ice bag but no heat (heat increases circulation to the appendix and could lead to rupture).

S/S of septic shock:

Fever, hypothermia, tachycardia, & rapid breathing.

NI/teachings for diverticulitis?

First few days pt will have NG tube and IV fluids. Teach pt about the disease process and surgery, if planned; assess pt nutritional status and reinforce the prescribed diet; assess pt pain so comfort measures or meds can be administered; include pt and family in setting goals for the teaching plan; when colostomy is performed, ask pt or family member to verbalize and demonstrate understanding of ostomy care.

A nurse is reviewing the health record of a client who might have a tumor of the jejunum. The nurse should anticipate a prescription for which of the following tests? sata:

GI x-ray with contrast & Small bowel capsule endoscopy (M2A)

A nurse is collecting data from a client who has acute pancreatitis. Which of the following finding is the priority to report?

Hand spasms when BP is checked

The risk of cancer of the stomach is associated with which factors? sata:

Hypochlorhydria; Chronic atrophic gastritis; Diet high in smoked and preserved foods; Gastric ulcers; & Diet low in fresh fruits and whole grains

According to research, removal or disease of the appendix could theoretically affect which function?

Immunologic response

When planning care for a pt with a motor paralysis, which intervention is the most important as a long-term solution for the pt's defecation?

Include the pt and family in planning a bowel training program

An obese male truck driver comes to the clinic and reports intense rectal itching. The health care provider determines that the pt has hemorrhoids. What nonsurgical approach can the nurse teach the pt to help manage the condition?

Increase fluid intake

What is the most important post procedure instruction to give to a pt who has had an upper gastrointestinal study with barium?

Increase fluid intake

A nurse is reinforcing teaching with a client who has a new dx of dumping syndrome following gastric surgery. Which of the following info should the nurse include?

Increase protein in the diet

Appendicitis:

Inflammation of the appendix

What are common causes of fecal incontinence? sata:

Injury during anal intercourse; Surgical trauma to internal sphincter; Injury during childbirth; & Spinal cord lesions

A nurse is collecting data from a client who has pancreatitis. Which of the following actions should the nurse take to check for the presence of Cullen's sign?

Inspect the skin around the umbilicus

The nurse inserts a nasogastric tube so a pt can undergo the Bernstein test to determine the cause of esophageal pain. Which outcome is considered a positive test result?

Instilling hydrochloric acid causes pain

Patient teaching for PUD?

Instruct pt to seek medical attention if severe and sudden pain occurs; if antibiotic is prescribed instruct pt importance of taking meds entirely; teach pt preventative teachings including identifying high risk behaviors, such as tobacco, alcohol, and caffeine use; emphasize pt should eat 6 small meals daily and avoid foods that cause stomach discomfort.

The pt is admitted for hemorrhagic colitis caused by the E. coli pathogen. Which order would the nurse question?

Loperamide 2mg after unformed stool

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

Loss of tooth enamel

What is considered an early sign of mechanical obstruction of the intestines?

Loud, frequent, high-pitched bowel sounds

The nurse is providing care to a pt suspected of having acute appendicitis. Which interventions may be included in the care? sata:

Maintain bedrest and NPO; Monitor vital signs including temperature; & Administer antibiotics as prescribed

The student nurse is teaching a pt about his Crohn's dx. The student is correct in identifying what complication as a result of granulomatous cobblestone lesions of the small intestine?

Malabsorption of nutrients

Mechanical obstruction:

May be caused by an occlusion of the lumen of the intestinal tract. Most obstructions happen in the ileum, which is the narrowest segment of the small intestine. Adhesions from previous abdominal surgeries account for 60% of all intestinal obstructions. Other mechanical obstructions include incarcerated hernias. Additional causes include impacted feces, diverticular disease, tumor of the bowel, intussusceptions, volvulus (twisting of bowel onto itself)., or the strictures of inflammatory bowel disease. Residues from foods high in fiber, such as raw coconut or fruit pulp, also can obstruct the small bowel.

Nonmechanical obstruction:

May result from a neuromuscular or vascular disorder, or it may be the result of a general anesthetic during surgery. The cause is something that decreases the muscle action of the bowel and effects the ability of fecal matter and fluid to move through the intestines. Paralytic (adynamic) ileus (lack of intestinal peristalsis and bowel sounds) is the most common form of nonmechanical obstruction. It occurs in some degree after any abdominal surgery. Other causes include inflammatory responses, electrolyte abnormalities (esp hypokalemia), and thoracic or lumbar spinal trauma from either fractures or surgical intervention.

Nursing interventions for PUD?

NG or intestinal tube placement, irrigation, intermittent suctioning, administer meds, assess frequently, monitor vitals.

What possible complications and nursing interventions when caring for a patient with a NG tube?

NG placement is new and frightening for most pt's, explain the rationale for this therapy to the anxious pt and family, and help them understand the advantages far outweigh the discomfort. Pt may be afraid that moving will dislodge the tube, implement frequent position changes to enhance tube functioning and prevent complications of immobility.

When caring for a pt admitted with a bleeding peptic ulcer, the nurse will include what intervention in the pt's acute plan of care?

Observing the vomitus for color, consistency, and volume

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

Offer 8oz water following med administration

S/S of appendicitis?

Pain in RLQ, accompanied by nausea and anorexia. Objective: vomiting, fever, elevated WBC count, rebound tenderness, a rigid abdomen, and decreased or absent bowel sounds.

S/S of PUD?

Pain, nausea, weight loss, eructation (belching), and distention

GOOGLE:

Partial gastrectomy removal of part of the stomach. The lower half is usually removed.

S/S of diverticulitis?

Pt complains of mild to severe pain in left lower quadrant of abdomen, fever, elevated WBC and erythrocyte sedimentation rate.

Which pt situation most strongly indicates the need for further investigation as a potential public health problem?

Pt has bloody diarrhea after eating a grilled hamburger that was served at a fundraiser

Which pt is the best candidate for a bowel training program that will incorporate biofeedback?

Pt has structural damage to the rectum, secondary to a fistula

S/S of dumping syndrome?

Pt may report diaphoresis, nausea, vomiting, epigastric pain, explosive diarrhea, borborygmi (rumbling noises made by gas passing through the liquid of the small intestine), and dyspepsia.

The nurse is planning care for several pt's who will be undergoing diagnostic testing for disorders of the GI system. Which pt is going to require the most time for postprocedural care?

Pt needs an esophagogastroduodenoscopy for evaluation of an ulcer

Which sign/symptom should be investigated as an early warning sign for colorectal cancer?

Rectal bleeding

Full gastrectomy:

Removal of entire stomach.

Total gastrectomy:

Removal of the entire stomach, rarely used for pt with gastric cancer. Regardless of the procedure selected, postoperative complications are possible. Bleeding may occur up to 7 days after gastric surgery. Abdominal rigidity. Abdominal pain, restlessness, elevated temp., increased pulse, decreased BP, and leukocytosis are possible indications of postoperative bleeding.

Sleeve gastrectomy:

Removal of the left side of the stomach.

The nursing student reports seeing a pearly, bluish-white "milk-curd" on the mucous membrane of the older pt's mouth. The nurse would intervene if the student performs which action?

Removes the plaques with a soft toothbrush

A nurse is collecting data from a client who has suspected stomach perforation due to a peptic ulcer. Which of the following findings should the nurse expect? sata:

Rigid abdomen, tachycardia, & rebound tenderness

What is the most common cause of deaths in the ICU?

Sepsis

If left untreated diverticulitis can cause what?

Septicemia and septic shock can occur, causing abdominal distention, nausea, and vomiting.

A parent says, "I think my son has an appendicitis. He won't eat and he says he has pain just to the right of his belly button." If the nurse places the child on an examination table, which position is the child most likely to assume if the mother is correct about appendicitis?

Side-lying with knees flexed

The nurse enters the room of a young woman and sees that she is crying. The pt states, "The doctor told me I need surgery and an Ileostomy. I'll be pooping into a bag! I'm leaving the hospital right now!" What should the nurse do first?

Sit with the pt and have her verbalize her fears and concerns

The nurse is assisting a pt who is newly diagnosed with celiac disease. Which lunch tray would be the best choice?

Stir-fry vegetables with rice and orange slices

A nurse is reinforcing discharge teaching with a client who is 3 days postoperative following a transverse colostomy. Which of the following should the nurse include in the teaching?

Stoma should be moist and pink

Assessment findings of nonmechanical obstruction:

Subjective date include the pattern of the pt's pain, including onset, frequency, and characteristics. Nausea and the inability to pass flatus is common symptoms.

The health care provider has recommended a conservative approach to manage the pt's gastroesophageal reflux disease. What would be included in the nurse's instructions to support the provider's recommendation?

Suggest methods for elevating the head of the bed at home

A pt sustained blunt trauma to the abdomen. Several hours after being admitted for observation, the pt reports severe abdominal pain with exquisite tenderness to light palpitation. What should the nurse do first?

Take vital signs and perform additional assessment of the abdomen.

A nurse is monitoring a client following a paracentesis. Which of the following findings indicates bowel perforation?

Temperature elevation

The pt had capsule endoscopy. Which discharge instruction should the nurse give the pt?

The capsule will pass with bowel movement in 2-3 days; no need to retrieve

A nurse is collecting data from an older adult client. The nurse should identify which of the following findings as a manifestation of an obstruction of the large intestine due to a fecal impaction?

The client is having small, frequent liquid stools

What is diverticulitis?

The inflammation of one or more of the diverticular sacs. This inflammation can lead to perforation, abscess, peritonitis, obstruction, and hemorrhage.

The nurse is caring for several pt's on the medical-surgical unit. Which pt is the nurse most concerned may develop a paralytic (adynamic) ileus?

The pt with an electrolyte imbalance, or acute inflammatory reactions

The pt reports a substernal burning sensation that radiates into the neck and jaw. He says, "I think it's heartburn." The nurse decides to check vital signs and conduct further assessments of the pain. What is the best rationale for the nurse's decision?

The subjective sensations mimic angina and a potential cardiac condition should not be overlooked

A nurse is reviewing a new prescription for ursodiol with a client who has cholelithiasis. Which of the following info should the nurse include?

This med dissolves gallstones gradually over a period of up to 2 yrs

A pt is scheduled for a hemicolectomy for removal of a cancerous tumor of the ascending colon. the pt asks the nurse why he is taking intestinal antibiotics preoperatively. Which response by the nurse is correct?

To reduce the bacteria content of the colon

The nurse is discharging a pt after a hemorrhoidectomy. Which teaching point should the nurse include in the discharge instructions?

Use a prescribed analgesic before a bowel movement

The older adult pt has been put into contact isolation because of watery diarrhea. Laboratory results are pending, but the C. difficile pathogen is suspected. What instruction should the nurse give to the UAP?

Use soap and water to wash hands, rather than the antiseptic hand rub

A nurse is caring for a client newly admitted with bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications?

Vasopressin

Objective S/S of appendicitis?

Vomiting, fever, elevated WBC count, rebound tenderness, a rigid abdomen, and decreased or absent bowel sounds.

The nurse is caring for a pt who was admitted for peptic ulcer disease. Which abnormal finding is the greatest concern?

WBC count is elevated

A nurse is reinforcing discharge teaching with a client who has a new prescription for aluminum hydroxide. Which of the following info should the nurse include?

Wait 1 hr before taking other oral meds

What is sepsis?

When a pt experiences a significant drop in BP that can lead to respiratory or heart failure, stroke, failure of other organs and death.

What are the appropriate methods of collecting stool samples?

When a pt is suspected of having a parasitic infection, the stool is examined for O&P (ova and parasites). Usually at least 3 stool specimens are collected on consecutive days. If an enema is administered to collect specimens, only normal saline or tap water is used. Soapsuds or any other substance could affect the viability of the organisms collected. Stool samples for O&P are obtained before barium examinations. Be sure the urine is not mixed with feces in the sample. Wear gloves and take specimen to lab within 30 min.

The pt is practicing a bowel training program. Which food will the nurse encourage the pt to eat?

Whole-grain cereal

If appendicitis is left undiagnosed, it leads rapidly to ______.

perforation and peritonitis

A pt has been admitted with a dx of peptic ulcers. Which drugs would the nurse expect this pt to be prescribed to decrease gastric acid secretion? sata:

ranitidine (Zantac) & famotidine (Pepcid)

The primary tx of PUD is to ______.

reduce s/s by decreasing or neutralizing normal gastric acidity with drug therapy. (Antacids, Antisecretory and cytoprotective agents, Histamine receptor blockers, Mucosal receptor blockers, PPI's and antibiotics to treat the H. pylori)

A nurse is completing preprocedure instructions for a client who will undergo a sigmoidoscopy. Which of the following information should the nurse include? sata:

•"Expect more flatulence following the procedure." & •"Consume no fluid or food before the procedure."

A nurse is reinforcing nutrition teaching with a client who has pancreatitis. Which of the following statements indicates understanding? sata:

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

A pt has recently been diagnosed with celiac dx. What pt statement indicates the need for further teaching regarding the dx? sata:

•"There is no cure for my disease, but I can manage it well with my diet." •"My children are at a higher risk of developing celiac because I have it." & •"I will need to eliminate foods containing wheat and flour from my diet.

A nurse is reviewing discharge instructions with a client who is postoperative following open cholecystectomy with T-tube placement. Which of the following instructions should be included in the teaching? sata:

•Clamp the T-tube for 1 hr before and after meals & •Expect brown-green drainage from the tube

A nurse is collecting data from a client who has a gastric ulcer. Which of the following findings should the nurse expect? sata:

•Client reports a sensation of bloating •Client states that pain occurs before meals & •Client experiences pain upon palpation of the epigastric region

What are four major functions of the large intestine?

•Completion of absorption of water •Manufacture of certain vitamins (Such as vitamin K and B7) •Formation of feces & •Expulsion of feces

A nurse is contributing to the plan of care for a client who has a small bowel obstruction and a NG tube in place. Which of the following interventions should the nurse recommend? sata:

•Document the NG drainage with the client's output •Check bowel sounds •Provide oral hygiene every 2 hr & •Monitor NG tube for placement

A nurse is caring for a client who has a small bowel obstruction from adhesions. Which of the following findings should the nurse expect? sata:

•Emesis greater than 500mL with a fecal odor •Report of spasmodic abdominal pain & •High-pitched bowel sounds

The nurse is caring for a pt scheduled for an esophagogasroduodenoscopy. Which intervention should the nurse include in the pt's plan of care? sata:

•Encourage the pt not to smoke before the examination •Maintain NPO status until the gag reflex returns post procedure & •Instruct the pt to contact the health care provider if intense abdominal pain occurs post procedure

A nurse assisting with the plan of care for a client who has acute gastritis. Which of the following nursing actions should the nurse recommend? sata:

•Evaluate I&O •Monitor electrolytes & •Observe stool characteristics

While obtaining the pt's health hx and reviewing the medical records, which information will alert the nurse that the pt has an increased risk of developing peptic ulcer dx? sata:

•Excess of gastric acid or a decrease in the natural ability of the GI mucosa to protect itself from acid and pepsin •Invasion of the stomach and/or duodenum by Helicobactor pylori & •Taking certain drugs, including corticosteroids and anti-inflammatory medications

What are the most common causes of PUD?

•H. pylori •Regularly taking NSAID's •Smoking or chewing tobacco & •Excessive alcohol intake.

A nurse is assisting with the plan of care for a client who has a prescription for total parenteral nutrition (TPN). Which of the following interventions should the nurse include? sata:

•Measure capillary blood glucose four times daily •Monitor vital signs three times during the 12-hr shift & •Change the TPN IV tubing every 24 hr

The nurse is caring for a pt who had a right hemicolectomy for colorectal cancer. Which postoperative interventions will the nurse use in the care of this pt? sata:

•Monitor vital signs, pain level, and return of bowel sounds •Check dressings for drainage and bleeding and change as ordered •Encourage the pt to cough, deep-breathe, and turn & •Keep accurate I&O records to monitor fluid balance

What are the functions of the liver?

•Produces bile •Manages blood coagulation •Metabolizes proteins, fats, and carbs •Manufactures cholesterol & albumin (for normal blood volume) •Filters out old RBC's & bacteria •Detoxifies poisons (alcohol, nicotine, drugs) •Converts ammonia to urea •Provides main source of body heat at rest •Stores glycogen for later use & •Activates Vitamin D

What are three functions of saliva?

•Salivary amylase (ptyalin) initiates carb metbolism; •Lysozyme protects the mucous membrane from infections and teeth from decay by destroying the bacteria & •After food has been ingested, continued secretion of saliva, & cleans the mouth

A nurse is reinforcing teaching with a client who has a duodenal ulcer and a new prescription for esomeprazole. Which of the following info should the nurse include? sata:

•Take the med 1 hr before a meal & •Limit NSAIDs when taking this med

The nurse is preparing a presentation on the differences between ulcerative colitis and Crohn's dx. What should the nurse include in the presentation? sata:

•Ulcerative colitis is confined to the mucosa and the submucosa of the colon •The intestinal dx of ulcerative colitis is curable with a colectomy, whereas Crohn's dx often recurs after surgery & •Blood is often present in the stools with ulcerative colitis; fat is usually present in the stools with Crohn's dx

A nurse is reviewing the medical record of a client who has a small bowel obstruction. Which of the following findings should the nurse report to the provider? sata:

•Urine specific gravity 1.040 •Hematocrit 60% & •Serum potassium 3.0 mEq/L