GI and MS

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

"Avoid coffee and alcoholic beverages."

A male client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been "spitting up blood." A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client's wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is

"Has your husband recently fallen or injured his chest?"

A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response?

"You may have eaten contaminated restaurant food."

Classic signs of Liver Failure

1. Hyper ammonimia 2. Jaundice 3. Fluid Overload 4. Bleeding

Name factors that can damage the liver

1. Infection 2. Ischemia 3. Medications. 4. Toxins 5. Alcohol

Complications associated with paracentesis

1. Infection-peritonitis 2. Bleeding. 3. Bowel perforation.

Measures to lower ammonia levels?

1. Lactulose 2. Neomycin 3. Low Protein diet

Cause of ascites in a patient with liver failure.

1. portal hypertension 2. low plasma proteins

Treatment for osteomyelitis

2-3 months antibiotics wound care

Patient with liver cirrhosis is showing signs of neuro impairment which lab value will you check?

Ammonia levels

The physician orders a Bernstein test for a client who complains of chest pain. When teaching the client about this test, the nurse explains that it's done to:

Assess for acid perfusion of the esophageal mucosa.

When is the best time to give Sucralfate?

Before meals and at bedtime.

Definitive diagnostic procedure for osteoporosis

Bone density scan or DEXA

Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube?

Change the tube feeding solutions and tubing at least every 24 hours

A male 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?

Check the tube for kinks

Which conditions make enema contraindicated?

Diverticulitis and Appendicitis

Most common cause of Colon Cancer in the younger groups

Familial adenomatous polyposis

Mode of transmission for Hepatitis A?

Fecal-oral

Priority management for ANY acute GI distress.

GI Rest, Fluid and electrolyte replacement

Priority in the management for patients with cholecystitis/cholelithiasis

GI rest, Pain control, Antibiotics, Nutritional management Long term: Stone dissolution, Surgery

Priority post procedure care for endoscopy.

Gag reflex assessment

Organ meat

Gouty arthritis

Condition that leads to recurrent peptic ulcer formation?

H. Pylori infection

Patient is having acute GI bleeding, what is your priority?

Hemodynamic Stability(VS and H+H)

Electrolyte imbalance common in pancreatitis?

Hypocalcemia

Nursing responsibility after barium swallow.

Increase fluid intake. Laxatives as ordered

Intervention to prevent diverticulitis for a patient with diverticulosis.

Increased fluid and fiber in the diet to have healthy and regular bowel habits.

The nurse provides health teachings about Sucralfate. Which of the following best describes sucralfate?

It promotes healing by adhering to ulcer surface.

While palpating a female client's right upper quadrant (RUQ), the nurse would expect to find which of the following structures?

Liver

Which dietary modification will you recommend for a patient with Gouty Arthritis?

Low uric acid/purine diet. Increased fluid intake

Patient has fresh bloody stool where is the possible cause of bleeding?

Lower GIT

A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?

Lying on left side with knees bent

Sodium Bicarbonate was prescribed to a patient to relieve heartburn. The nurse knows that the medication is contraindicated to which of the following conditions?

Metabolic alkalosis

Patient with dilaudid PCA. Which drug should be readily available?

Narcan

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

Nothing by mouth

Type of arthritis common for obese patients

Osteoarthritis

Why is pain medication contraindicated for a patient suspected with appendicitis?

Pain meds may mask signs of rupture.

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

Pancreatitis

Diverticulitis ruptures what is the likely complication?

Peritonitis

The nurse caring for a client with small-bowel obstruction would plan to implement which nursing intervention first?

Preparing to insert a nasogastric (NG) tube

What differentiates Crohn's and Ulcerative Colitis

Presence of blood in the stool .

Priority in the management of liver cirrhosis

Preserve remaining liver function, End of life concerns

Fatal complication from a fractured long bone.

Pulmonary/fat embolismCompartment syndrome

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

Purpura and petechiae

Priority management for acute musculoskeletal injuries

Rest Immobilize Compress Elevate

Which type of heart failure can lead to liver failure?

Right sided heart failure.

Complication of arthroscopy

Septic Arthritis

Patient with unexplained anemia is suspected GI bleed but there are no obvious signs of bleeding, which test will be recommended?

Stool occult blood

Priority assessment for a patient after left femoral fracture repair

VS and Neurovascular assessment for affected extremity.

Patient with Chronic gastritis, which vitamin deficiency will be most evident?

Vitamin B 12 Deficiency, pernicious anemia

During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to hypoprothrombinemia?

Vitamin K

Which lab value will you review for a patient with Rheumatoid Arthritis?

WBC, ANA, ESR, CRP

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

alcohol abuse and smoking

A patient with gastroesophageal reflux disease asks which food will not aggravate his present condition. The nurse should instruct the patient to include which of the following?

baked chicken breast

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

decreased urine output

Which diagnostic test would be used first to evaluate a client with upper GI bleeding?

hgb and hct

When is the best time to give Calcium?

in the morning, Ca absorbed with activity.

Produced by the parietal cells to absorb Vitamin B12.

intrinsic factor

Weight bearing joints

osteoarthritis

A male client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse's first response is to:

place saline-soaked sterile dressings on the wound.

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

severe RUQ pain

Which lab value is the best indicator of liver function?

ALT and AST

A client is suspected to have appendicitis. He complains of severe RLQ pain, nausea and vomiting, temperature is at 102 F. Which of the following interventions will be most appropriate?

Administer NS at 100 ml/hr

What laboratory finding is the primary diagnostic indicator for pancreatitis?

Elevated serum lipase

The client who is on long-term NSAID therapy is also receiving Misoprostol. The medication exhibits its therapeutic effect if the client did not experience which of the following symptoms?

Epigastric pain

The electrolyte imbalance expected with patients having acute exacerbation of IBS and IBD?

Hypokalemia/Hyponatremia

Priority for a patient having diarrhea.

Identify and treat the cause Correct fluid and electrolyte imbalance.

A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of:

increasing fluid intake to prevent dehydration.