Med surg GI

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

"Has your partner had recent forceful vomiting?"

A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment?

"I'll eat frequent, small, bland meals that are high in fiber."

The nurse is developing a care management plan with a client who has been diagnosed with gastroesophageal reflux disease. What should the nurse should instruct the client to do? Select all that apply.

Avoid beverages that contain caffeine. Avoid all alcoholic beverages. Avoid a diet high in fatty foods.

Which dietary instruction would be appropriate for the nurse to give a client who is recovering from acute pancreatitis?

Avoid crash dieting.

The nurse is caring for a client recently diagnosed with hepatitis C. In reviewing the client's history, what information will be most helpful as the nurse develops a teaching plan? The client:

Has history of STD/ STIs

Which statement indicates the client understands the lifestyle modifications required when managing ulcerative colitis?

Ill have to stop smoking

A client takes 30 ml of magnesium hydroxide and aluminum hydroxide with simethicone 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?

It has a short duration of action.

A client has just returned from surgery for a gastrectomy. The nurse should position the client in which position?

Low fowler's

The nurse is caring for a client that has undergone a colon resection. While turning the client, wound dehiscence with evisceration occurs. What is the nurse's first response?

Place saline-soaked sterile dressings on the wound.

The nurse should monitor the client with acute pancreatitis for which complication?

Pneumonia

A client newly diagnosed with ulcerative colitis who has been placed on steroids asks the nurse why steroids are prescribed. What should the nurse tell the client?

Steroids are used in severe flare-ups because they can decrease the incidence of bleeding

Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy?

Teach the client to use a folded blanket or pillow to splint the incision.

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

To keep gastric pH at 3.0 to 3.5

A client presents to the emergency department with reports of acute GI distress, bloody diarrhea, weight loss, and fever. A family history of what would be significant to this client's diagnosis?

Ulcertive colitis

A client underwent insertion of a nasogastric (NG) tube for partial bowel obstruction the previous evening. The nurse notes that the tube is not secured to the client's face. How will the nurse proceed?

Verify placement of the tube.

When caring for the client with hepatitis B, which situation would expose the nurse to the virus?

a blood splash into the nurse's eyes

The nurse is caring for a 70-year-old male client after a colectomy. The client has received chemotherapy prior to surgery and has hypertension and diabetes mellitus. Which factors put this client at risk for sepsis? Select all that apply.

age diabetes mellitus abdominal surgery

After the nurse teaches the parent of an infant with pyloric stenosis about the condition, which cause, if stated by the parent, indicates effective teaching?

an enlarged muscle below the stomach

During clindamycin therapy, a nurse monitors a client for pseudomembranous colitis. This serious adverse reaction to clindamycin results from superinfection with which organism?

c diff

When preparing a client for a scheduled colonoscopy, the nurse should tell the client that this procedure will involve:

cleansing the bowel with laxatives

TPN is prescribed for a client with Crohn's disease. What indicates to the nurse that the TPN has been effective?

has met nutritional needs.

Eight hours following bowel surgery, the nurse observes that the client's urine output has decreased from 50 to 20 mL/h. The nurse should assess the client further for which condition?

hemorrhage

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

inhibits contraction of the bile duct and gallbladder.

What medication is used for high ammonia levels

lactulose

The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube on low continuous suction. Which acid-base imbalance is most likely to occur?

metabolic alkalosis

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

metallic taste

The nurse assigns an unlicensed assistive personnel (UAP) to provide care for a client with peptic ulcer disease. Concerned about possible ulcer perforation, the nurse should instruct the UAP to report to the nurse immediately if the client has:

serve abd pain

Which position would be best for the client in the early postoperative period after a hemorrhoidectomy?

side lying

Fat in stools

stedorrhea- signs of cystic fibrosis

A client with appendicitis is experiencing excruciating abdominal pain. An abdominal X-ray film reveals intraperitoneal air. What should the nurse prepare the client for?

surgery

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 action to minimize the vomiting urge?

take long slow breaths

In the early postoperative period following abdominal surgery, the nurse notes a bright red, 3″ × 5″ (7.6 × 12.7 cm) area of drainage on the client's dressing. What should be the nurse's first action in response to this observation?

take vitals, check for changes that may indicate a post-op bleed