NU 126 Exam 6 GI Part 2

Diet modifications for those diagnosed with IBD.

Low residue high protein High calorie with supplemental vitamins

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?

Atrophy of the gastric mucosa

Which of the following is the diagnostic of choice if the suspected diagnosis is diverticulitis ?

Computed Tomography Scan

The Billroth II is a wide resection that involves removing approximately _______ of the stomach and decreases the possibility of lymph node spread or metastatic recurrence.

75%

The nurse provides instructions to a client about measures to treat IBS. Which statement by the client indicates the need for further teaching? A. "I need to limit my dietary intake of fiber" B. " I need to drink plenty, at least 8 to 10 cups daily" C. " I need to eat regular meals and chew my food well" D. " I will take the prescribed meds because they will help regulate my bowel patterns"

A. * Dietary fiber and bulk help to produce bulky, soft stools and establish regular bowel elimination habits

When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include? A. Avoid smoking for at least 12 to 24 hours before the procedure. B. Take vitamin K before the procedure. C. Take three cleansing enemas before the procedure. D. Avoid the intake of red meat before the procedure.

A. Avoid smoking because this will increase GI motility

The nurse is investigating a patient's complaint of pain in the duodenal area. Where should the nurse perform the assessment? A. Epigastric area and consider possible radiation of pain to the right subscapular region B. Hypogastrium in the right or left lower quadrant C. Left lower quadrant D. Periumbilical area, followed by the right lower quadrant

A. epigastric

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? A. "Lie down after meals to promote digestion." B. "Avoid coffee and alcoholic beverages." C. "Take antacids with meals." D. "Limit fluid intake with meals."

B. Avoid coffee and alcoholic beverages. I initially put down D. but its not necessary to limit fluid intake with meals. To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods and beverages that increase stomach acid, such as coffee and alcohol

A client is scheduled for bowel resection with anastomosis involving the large intestine. Because of the surgical site, the nurse formulates the nursing diagnosis of Risk for infection. To complete the nursing diagnosis statement, the nurse should add which "related-to" phrase? A. Related to major surgery required by bowel resection B. Related to the presence of bacteria at the surgical site C. Related to malnutrition secondary to bowel resection with anastomosis D. Related to the presence of a nasogastric (NG) tube postoperatively

B. Related to the presence of bacteria at the surgical site An NG tube is placed through a natural opening not a wound, and therefore does not increase the risk of infection

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client states: A. "I should stop all my medications if I develop any side effects." B. "I should continue my treatment regimen as long as I have pain." C. "I have learned some relaxation strategies that decrease my stress." D. "I can buy whatever antacids are on sale because they all have the same effect."

C.

the nurse auscultates 5-6 bowel sounds heard in less than 30 secs. How does the nurse document the bowel sounds?

Hyperactive

Dyspepsia

condition that usually involves a combination of symptoms: abdominal pain, bloating, distention, nausea, and belching.

The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for:

hypokalemia and dehydration -

Crohn's disease is a condition of malabsorption caused by which pathophysiological process?

inflammation of all layers of intestinal mucosa

The nurse is assisting the physician with a colonoscopy for a patient with rectal bleeding. The physician requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure?

to relax colonic musculature and reduce spasm

hematemesis

vomiting of blood

For best results, when should antacids be taken?

1 or 2 hours before meals, they should be continued even when symptoms subside

The nurse is planning to teach a client with GERD about substances to avoid. Which items should the nurse include on the list? Select all that apply 1- Coffee 2- Chocolate 3- Peppermint 4- Nonfat Milk 5- Fried Chicken 6- Scrambled eggs

1, 2, 3, 5

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

Six small meals daily with 120 mL fluid between meals

A client is recently diagnosed with Crohn's disease and is beginning treatment. What first-line treatment does the nurse expect that the client will be placed on to decrease the inflammatory response?

Sulfasalazine

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

Type O

A client with diabetes begins to have digestive problems and is told by the physician that they are a complication of the diabetes. Which of the following explanations from the nurse is most accurate? A. The nerve fibers of the intestinal lining are experiencing neuropathy. B. The pancreas secretes digestive enzymes. C. Elevated glucose levels cause bacteria overgrowth in the large intestine. D. Insulin has an adverse effect of constipation.

B. The pancreas secretes digestive enzymes

The nurse is caring for a client following a gastrojejunostomy (Billroth II). Which postop prescription should the nurse question and verify? A. Leg exercises B. Early ambulation C. Irrigating the nasogastric tube D. Coughing and Deep breathing exercises

C. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery.

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 A. Notify the health care provider. B. Irrigate the client's NG tube. C.Place the client in the high-Fowler's position. D. Assess the client's abdomen and vital signs.

D. Assess the clients abdomen and vital signs. Its not C. S/S of perforation include sudden, severe upper abdominal pain . pain may be referred to the shoulder

During a nursing assessment, the nurse knows that the most common symptom of GI dysfunction is?

Dyspepsia

Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances?

Positron Emission Tomography (PET)

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol (Cytotec). What information from the nurse would be most accurate about misoprostol?

Prevents ulceration in clients taking NSAIDs