Med Surg. Chapter 47 Management of Patients With Gastric and Duodenal Disorders

Symptoms associated with pyloric obstruction include all of the following except:

Diarrhea

Which of the following appears to be a significant factor in the development of gastric cancer?

Diet

A physician suspects that a client has peptic ulcer disease. With which of the following diagnostic procedures would the nurse most likely prepare to assist?

Endoscopy

A client is prescribed tetracycline to treat peptic ulcer disease. Which of the following instructions would the nurse give the client?

"Be sure to wear sunscreen while taking this medicine."

A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which of the following explanations from the nurse would be most accurate?

"Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery."

The nurse practitioner prescribes an antibiotic for chronic gastritis caused by H. pylori for a patient taking Coumadin. For this patient, which antibiotic should be avoided?

Flagyl

Which of the following is the most successful treatment for gastric cancer?

Removal of the tumor

A nurse is teaching a client who has experienced an episode of acute gastritis and knows further education is necessary when the client makes the following statement:

"My appetite should come back tomorrow."

The nurse is educating a patient about the discharge medication. When should the nurse instruct the patient to take the antacid medication?

1 to 3 hours after the meal

To promote fluid balance when treating gastritis, the nurse knows that the minimal daily intake of fluids should be:

1.5 L

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen?

10 to 14 days

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 to his right shoulder. The intial appropriate action by the nurse is to

Assess the client's abdomen and vital signs.

A patient is scheduled for removal of the lower portion of the antrum of the stomach and a small portion of the duodenum and pylorus. What is the name of this surgical procedure for peptic ulcer disease?

Billroth I

Which of the following is the first portion of the small intestine?

Duodenum

The nurse in the ED is admitting a patient with bloody stools. The nurse documents this finding as being which of the following?

Hematochezia

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

Hemoglobin and hematocrit

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. DurWhich of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake?

Hemorrhage

A nurse is caring for a client who had gastric bypass surgery 2 days ago. Which assessment finding requires immediate intervention?

The client's right lower leg is red and swollen.

Why are antacids administered regularly, rather than as needed, in peptic ulcer disease?

To keep gastric pH at 3.0 to 3.5

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. The nurse suspects:

Vasomotor symptoms associated with dumping syndrome

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."

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.

• Irritating foods • Ingestion of strong acids • Overuse of aspirin

A 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?

Nothing by mouth

The nurse is conducting a community health education program on obesity. The nurse includes which of the following diseases/disorders in the program?

Obstructive sleep apnea

Which of the following medications is classified as a proton pump inhibitor (PPI)?

Omeprazole

A patient is in the hospital for the treatment of peptic ulcer disease. The nurse finds the patient vomiting and complaining of a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate?

Perforation of the peptic ulcer

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?

Six small meals daily with 120 mL fluid between meals

The nurse recognizes that the patient diagnosed with a duodenal ulcer will likely experience

pain 2 to 3 hours after a meal.

A nurse is caring for a client who is undergoing a diagnostic workup for a suspected GI problem. The client reports gnawing epigastric pain following meals and heartburn. The nurse suspects the client has:

peptic ulcer disease.

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 client weighs 215 lbs and is 5' 8" tall. The nurse would calculate this client's body mass index (BMI) as which of the following?

32.7

Clients with Type O blood are at higher risk for which of the following GI disorders?

Duodenal ulcers

Which of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake?

Gastric banding

The nurse is conducting a community education program on peptic ulcer disease prevention. The nurse concludes that the most common cause of peptic ulcers is which of the following?

Gram-negative bacteria

Peptic ulcer disease occurs more frequently in people with which blood type?

O

Which of the following is included as a dietary guideline for a patient who has had bariatric surgery?

Restrict total meal size to less than 1 cup.

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be:

black and tarry.

Which of the following represents the medication classification of a proton (gastric acid) pump inhibitor?

Omeprazole (Prilosec)

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which of the following diseases/conditions?

Peptic ulcers

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:

vitamin B12.

Which of the following clients is at highest risk for peptic ulcer disease?

Client with blood type O

A client reports to the clinic, stating that she rapidly developed headache, abdominal pain, nausea, hiccuping, and fatigue about 2 hours ago. For dinner, she ate buffalo chicken wings and beer. Which of the following medical conditions is most consistent with the client's presenting problems?

Acute gastritis

A patient has a BMI ranger greater than 40 kg/m2. What would this patient's obesity classification be?

Class III

Review the following four examples of ideal body weight (IBW), actual weight, and body mass index (BMI). Using three criteria for each example, select the body weight that indicates morbid obesity.

IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2

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

drink liquids only between meals.

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. The nurse suspects the client has:

dumping syndrome.

A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? (Select all that apply.)

• Burning sensation localized in the back or mid-epigastrium • Feeling of emptiness that precedes meals from 1 to 3 hours • Severe gnawing pain that increases in severity as the day progresses

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply.

• Severe peptic ulcers • Extreme gastric hyperacidity • Gastrin-secreting tumors of the pancreas