Gastrointestinal Disorder

inhibits contraction of the bile duct and gallbladder.

A client with cholecystitis is receiving propantheline bromide. The client is given this medication because it:

yellow sclerae.

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

The client is free from esophagitis and achalasia.

A client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge?

Albumin is an abnormal finding in a routine urine specimen

A client with liver and renal failure has severe ascites. On initial shift rounds, his primary nurse finds his indwelling urinary catheter collection bag too full to store more urine. The nurse empties more than 2,000 ml from the collection bag. One hour later, she finds the collection bag full again. The nurse notifies the physician, who suspects that a bladder rupture is allowing the drainage of peritoneal fluid. The physician orders a urinalysis to be obtained immediately. If the physician's suspicion is correct, the urine will abnormally contain

A serum potassium level of 3 mEq/L is below normal, indicating hypokalemia. Because hypokalemia may cause cardiac arrhythmias and asystole, it's the most significant finding.

A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant?

Monitoring the client's weight every day

A client with pancreatitis has been receiving total parenteral nutrition (TPN) for the past week. Which nursing intervention helps determine if TPN is providing adequate nutrition?

hyperglycemia.

A client with severe inflammatory bowel disease is receiving total parenteral nutrition (TPN). When administering TPN, the nurse must take care to maintain the prescribed flow rate because giving TPN too rapidly may cause:

It has a short duration of action.

A client takes 30 ml of magnesium hydroxide and aluminum hydroxide with simethicone (Maalox TC) P.O. 1 hour and 3 hours after each meal and at bedtime for treatment of a duodenal ulcer. Why does the client take this antacid so frequently?

Duodenal ulcers are more common in people with type O blood, suggesting a genetic basis

A client is undergoing an extensive diagnostic workup for a suspected GI problem. The nurse discovers that the client has a family history of ulcer disease. Which blood type also is a risk factor for duodenal ulcers?

Avoid aspirin and products that contain aspirin."

A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine (Pepcid). Before the client is discharged, the nurse should provide which instruction?

Paregoric starts to act within 1 hour after administration. Onset of action isn't as rapid as 5 or 20 minutes or as slow as 2 to 4 hours.

A client with acute diarrhea is prescribed paregoric, 5 ml by mouth up to four times daily, until acute diarrhea subsides. The client asks the nurse how soon the medication will start to work after the first dose is taken. How should the nurse respond?

Young women with Chronic low self esteem are at highest risk for anorexia nervosa because they perceive being thin as a way to improve their self-confidence.

An adolescent girl with severe malnutrition is admitted to an acute care facility. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the care plan for this client, the nurse is most likely to include which nursing diagnosis?

Evaluate the client's understanding of the procedure

As the nurse completes the admission assessment of a client admitted for gastric bypass surgery, the client states, "Finally! I'll be thin and able to eat without much concern." How should the nurse intervene?

decrease the intestinal bacteria count.

For a client who must undergo colon surgery, the physician orders preoperative cleansing enemas and neomycin sulfate (Mycifradin). The rationale for neomycin use in this client is to:

Hepatic encephalopathy, a major complication of advanced cirrhosis, occurs when the liver no longer can convert ammonia (a by-product of protein breakdown) into glutamine. This leads to an increased blood level of ammonia — a central nervous system toxin — which causes a decrease in the level of consciousness. Fatigue, muscle weakness, nausea, anorexia, and weight gain occur during the early stages of cirrhosis. Ans. difficulty in arousal.

For a client with cirrhosis, deterioration of hepatic function is best indicated by:

Diarrhea causes a bicarbonate deficit. With loss of the relative alkalinity of the lower GI tract, the relative acidity of the upper GI tract predominates leading to (Ans.metabolic acidosis).

In a client with enteritis and frequent diarrhea, the nurse should anticipate an acid-base imbalance of:

Atropine decreases salivation and gastric secretions

One hour before a client is to undergo abdominal surgery, the physician orders atropine, 0.6 mg I.M. The client asks the nurse why this drug must be administered. How should the nurse respond?

The client has the right to refuse any medical treatment, regardless of the consequences. The client is displaying hopelessness over the diagnosis; therefore, the nurse should encourage the client to discuss these feelings using therapeutic conversation.

The nurse is administering medications to a client diagnosed with hepatitis B. When the nurse hands the client his medications, the client says, "I would rather not take that pill or any others. I know there is no cure for hepatitis B." The nurse recognizes that the client is expressing feelings of hopelessness about his diagnosis. Which response by the nurse respects the client's rights concerning medication administration?

destroys the odor-proof seal.

The nurse is caring for a client with a colostomy. The client tells the nurse that he makes small pin holes in the drainage bag to help relieve gas. The nurse should teach him that this action:

Avoid coffee and alcoholic beverages."

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction?

Positioning the client on the side with the knees flexed

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

Irritability and drowsiness

When caring for a client with hepatitis B, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function?

Cyanosis, coughing, and choking occur when fluid from the blind pouch is aspirated into the trachea

Which findings are common in neonates born with esophageal atresia?

The client diagnosed with Clostridium difficile diarrhea requires contact isolation. Contact isolation precautions require the use of glove and a gown if soiling is likely.

Which infection control equipment is necessary for the client diagnosed with Clostridium difficile diarrhea?

docusate sodium (Colace)

Which medication should the nurse expect to administer to a client with constipation?

Withholding all oral intake, as ordered, to decrease pancreatic secretions

Which nursing action is most appropriate for a client hospitalized with acute pancreatitis?

Corticosteroid therapy and Antidiarrheal medications

A 28-year-old client is admitted with inflammatory bowel syndrome (Crohn's disease). Which therapies should the nurse expect to be part of the care plan?

A client who's dizzy and anemic is at risk for injury because of his weakened state. Assisting him with the bedpan would best meet his needs at this time without risking his safety. The client may fall if walking to the bathroom, left alone to urinate, or trying to stand up.

A 68-year-old male is being admitted to the hospital with abdominal pain, anemia, and bloody stools. He complains of feeling weak and dizzy. He has rectal pressure and needs to urinate and move his bowels. The nurse should help him:

Ulcerative colitis

A client comes to the emergency department complaining of acute GI distress. When obtaining the client's history, the nurse inquires about the family history. Which disorder has a familial basis?

If abdominal distention is accompanied by nausea, the nurse must first auscultate bowel sounds

A client had a nephrectomy 2 days ago and is now complaining of abdominal pressure and nausea. The first nursing action should be to:

The predominant clinical feature of acute pancreatitis is abdominal pain, which usually reaches peak intensity several hours after onset of the illness. Therefore, relieving abdominal pain is the nurse's primary goal

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

vitamin B12.

A client is admitted to the hospital with an exacerbation of his chronic gastritis. When assessing his nutritional status, the nurse should expect a deficiency in:

Atrophy of the gastric mucosa

A client, age 82, is admitted to an acute care facility for treatment of an acute flare-up of a chronic GI condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the GI tract. Which age-related change increases the risk of anemia?

Alterations in hepatic blood flow resulting from a drug interaction can affect metabolism and excretion

Alterations in hepatic blood flow resulting from a drug interaction also can affect:

A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to (Ans. 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.

The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

Nothing by mouth

The nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?

A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K to produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client for signs of bleeding, including purpura and petechiae.

The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease?

The hepatitis A virus is transmitted by the fecal-oral route, primarily through ingestion of contaminated food or liquids.

The nurse is developing a care plan for a client with hepatitis A. What is the main route of transmission of this hepatitis virus?

alcohol abuse and smoking.

The nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

The Hemovac drain isn't compressed; instead it's fully expanded.

The physician calls the nurse for an update on his client who underwent abdominal surgery five hours ago. The physician asks the nurse for the total amount of drainage collected in the Hemovac since surgery. The nurse reports that according to documentation, no drainage has been recorded. When the nurse finishes on the telephone, she goes to assess the client. Which assessment finding explains the absence of drainage?

collect the specimen in a sterile container.

The physician orders a stool culture to help diagnose a client with prolonged diarrhea. The nurse who obtains the stool specimen should:

Obstruction of the appendix

A client with severe abdominal pain is being evaluated for appendicitis. What is the most common cause of appendicitis?

This drug should be injected into a large muscle mass.

A client is scheduled to undergo a left hemicolectomy for colorectal cancer. The physician prescribes phenobarbital (Luminal), 100 mg I.M. 60 minutes before surgery, for sedation. Which statement accurately describes administration of phenobarbital?

metallic taste.

A client with amebiasis, an intestinal infection, is prescribed metronidazole (Flagyl). When teaching the client about adverse reactions to this drug, the nurse should mention:

Take long, slow breaths

A client with an esophageal stricture is about to undergo esophageal dilatation. As the bougies are passed down the esophagus, the nurse should instruct the client to do which of the following to minimize the vomiting urge?

assess for acid perfusion of the esophageal mucosa.

The physician orders a Bernstein test (which is performed by inserting a nasogastric [NG] tube and aspirating gastric contents) for a client who complains of chest pain. When teaching the client about this test, the nurse explains that it's done to:

Daily weight measurement is the most accurate indicator of fluid status; a loss of 2.2 lb (1 kg) indicates loss of 1 L of fluid. Because spironolactone is a diuretic,

The physician prescribes spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect?

Acute pancreatitis can cause decreased urine output, which results from the renal failure that sometimes accompanies this condition

When evaluating a client for complications of acute pancreatitis, the nurse would observe for:

maintaining fluid balance.

When planning care for a client with a small-bowel obstruction, the nurse should consider the primary goal to be:

Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis.

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