Life Span Chapter 33

The nurse is caring for a patient with a sliding hiatal hernia. In which position should the nurse expect the patient to report that the symptoms are more acute?

Lying down

The nurse is caring for a patient with bulimia. Which complication should the nurse recognize that this patient is at risk for developing?

Metabolic alkalosis

The nurse teaching a patient with gastroesophageal reflux about the influence of body position on the disease process. Which patient statement indicates that teaching has been effective?

"I elevate the head of the bed 4 to 6 inches."

The nurse is providing care to a patient 3 days after a Billroth I procedure. About which observation should the nurse be most concerned?

Reports of abdominal cramping shortly after eating

The nurse is checks the gastric pH and provides antacids as prescribed to a patient recovering from a motor vehicle crash. What is the nurse attempting to prevent by these interventions?

Stress ulcers

The nurse is collecting data for a patient who is taking Prevacid for peptic ulcer disease. Which data collection finding requires immediate intervention?

Tarry stools

A patient who is unconscious begins to vomit blood. What action should the nurse take first?

Turn patient onto side.

A patient with a nasogastric tube to low intermittent suction after surgery begins to vomit bright red blood. Which action should the nurse take first?

Turn the patient onto his or her side

The nurse is caring for a patient recovering from radical neck dissection for cancer and tracheostomy placement. What action by the nurse should take priority?

Ensuring airway patency

The nurse is reinforcing teaching provided to a patient being tested for type B gastritis. Which patient statement indicates a correct understanding of the test that is used to diagnose this condition?

Esophagogastroduodenoscopy.

The nurse is caring for a patient who complains of nausea related to gastric cancer. Which supplement should the nurse suggest?

Ginger

The nurse is preparing to calculate a patient's body mass index. What measurements does the nurse need to make this calculation?

Height and weight

The nurse is teaching a patient about gastric surgery and dumping syndrome. Which statement indicates that the patient understands dumping syndrome?

"I need to eat small frequent meals."

The nurse is caring for a patient with gastroesophageal reflux disease (GERD). Which patient statement indicates a need for nutritional instruction?

"I should drink milk, as it is the perfect food.

The nurse is reinforcing teaching provided to a patient with a peptic ulcer. Which patient statement indicates understanding of the medication ranitidine (Zantac)?

"It reduces production of gastric acid."

The nurse is caring for a patient on a gastrointestinal unit. Which patient statement should cause the nurse the most concern?

"Lately, I've had two or three loose, sticky black stools every day.

The nurse is reinforcing teaching provided to a patient scheduled for pyloroplasty. Which patient statement indicates a correct understanding of the procedure?

"The surgery will improve the movement of food from my stomach to my small intestine.

The nurse is reinforcing teaching provided to a patient with dumping syndrome. Which patient statement indicates a correct understanding of this condition?

"There is rapid entry of food into the jejunum."

A patient with a hiatal hernia is experiencing heartburn. Which should the nurse suggest to this patient

Avoid bedtime snacks

The nurse is contributing to a patient's teaching plan on how to avoid dumping syndrome after a gastrectomy. What should be included in the teaching?

Avoid fluids with meals.

The nurse is reinforcing teaching provided to a patient with a hiatal hernia. Which patient statement indicates a correct understanding of lifestyle modification to reduce symptoms?

Avoid nicotine and alcohol use.

The nurse is caring for a patient who has developed esophagitis from gastroesophageal reflux disease (GERD). For which additional complication should the nurse anticipate providing care to this patient?

Barrett's esophagus

The nursing assistant is delivering patient meals. Which meal should the nurse expect to be delivered to a patient who had gastric bypass surgery the day before?

Clear liquids

A patient with a duodenal peptic ulcer vomits old blood. What description should the nurse use to document the appearance of the vomitus?

Coffee-ground particles

The nurse is caring for a patient with a vented nasogastric tube ordered "to suction" after a gastrectomy. What type of suction should the nurse use to decrease the development of complications?

Intermittent low suction

The nurse is caring for a patient who has a nasogastric tube in place following gastric surgery. Why should the nurse use normal saline to irrigate the nasogastric tube?

It maintains electrolytes.

A patient is recovering from a Billroth I procedure and has a nasogastric Levin tube set to low intermittent suction. As the patient turns in bed, the Levin tube is partially pulled out. Which action should the nurse take?

Notify the registered nurse (RN)

The nurse is caring for a patient who suddenly begins having large amounts of bright red hematemesis. After the patient is turned onto the side, what should the nurse do?

Obtain the patient's vital signs.

The nurse is visiting the home of a patient recovering from a sleeve gastrectomy. Which observation indicates that this surgery has been successful for the patient?

Patient claims that she never feels hungry

The nurse is evaluating care provided to a patient with bulimia nervosa. Which observation indicates that addition care is required?

Patient states that looking in a mirror makes her nauseated

The nurse is reinforcing teaching with a patient who had a large portion of the stomach removed. Which patient statement indicates understanding of why the patient will need to receive vitamin B12 for life

Pernicious anemia

A patient with a nasogastric tube connected to suction is NPO (nothing by mouth) and reports a dry mouth and gagging feeling. What action should the nurse take?

Provide oral care

After collecting data the nurse suspects that an adolescent patient is at risk for developing anorexia nervosa. What data did the nurse use to come to this conclusion? (Select all that apply.)

a. Age 17 years b. Phobia about weight gain c. Fearful of mother present during the interview d. Asked the nurse repeatedly why certain information was needed

A patient with morbid obesity is admitted to the hospital for leg wounds. Which observations should the nurse expect when collecting data from this patient? (Select all that apply.)

a. BMI 41 d. Shortness of breath with walking e. Body weight 120 lbs over ideal weight

The nurse is caring for a patient recovering from a bleeding gastric ulcer. Which patient statements indicate correct understanding of beverages to avoid after treatment of a bleeding gastric ulcer? (Select all that apply.)

a. Beer c. Coffee d. Iced tea f. Diet soda pop

The nurse is caring for a patient who has a nursing diagnosis of acute postoperative pain after a gastrectomy. The patient has a nasogastric (NG) tube. What interventions should the nurse implement? (Select all that apply.)

a. Encourage total bedrest. b. Monitor NG tube functioning. d. Provide pain medication as ordered.

A patient is considering surgery to treat obesity. Which factors meet established criteria for the use of surgery in the treatment of obesity? (Select all that apply.)

a. Hypertension c. Gross obesity for 5 years d. Psychiatric and social stability f. Failure to reduce weight with other forms of therapy

The nurse is participating in planning care for a patient who is experiencing nausea. Which interventions should be included in this patient's plan of care? (Select all that apply.)

a. Provide antiemetics as prescribed b. Ensure the environment is odor-free d. Provide oral care every 2 hours as needed e. Instruct to avoid odors or foods that precipitate nausea

The nurse is providing care to a patient anticipating radiation therapy for head and neck cancer. What should the nurse include in pre-therapy education? (Select all that apply.

b. "Good oral hygiene habits are important to prevent decay." d. "It is important that you visit the dentist before radiation therapy begins." f. "Artificial saliva can be used if the radiation therapy causes drying of the mouth."

The nurse has instructed a patient prescribed omeprazole (Prilosec) for peptic ulcer disease on use of the medication. What patient statements indicate understanding of the instructions? (Select all that apply.)

c. "I will take the capsule before eating a meal in the morning." e. "I will report any abdominal pain, diarrhea, or bleeding that occurs." f. "I'll have to have regular blood counts and tests of my liver enzymes."

The nurse is caring for a patient who has aphthous stomatitis. What care should the nurse provide? (Select all that apply.)

c. Apply a topical anesthetic. d. Teach to avoid irritating foods. e. Suggest stress management techniques.