Patho Chp 42 Disorders of the Upper and Lower GI System
A participant in a community education program asks what causes colon cancer. Which modifiable risk factor should the nurse include when responding to this person? "Having chronic constipation." "Eating a diet high in fat and low in fiber." "Having chronic GI infections." "Being of Jewish ancestry."
"Eating a diet high in fat and low in fiber." A diet that that is heavy on red and processed meats and light on fruits and vegetables is a modifiable risk factor for the development of colon cancer. Infection is a risk factor for inflammatory bowel disease (Crohn and ulcerative colitis). Chronic constipation is a risk factor for intestinal obstruction. Jewish ancestry is a risk factor for Crohn disease.
After learning the diagnosis of irritable bowel syndrome, a patient is concerned about permanent damage. Which should be the nurse's response? "Your healthcare provider will prescribe steroids to decrease the risk of permanent damage to the colon." "Most people can avoid damage to the colon by eating high-fiber foods." "The symptoms are troublesome, but irritable bowel syndrome doesn't cause permanent damage to the colon." "Permanent damage from irritable bowel syndrome depends on how many years you've had it."
"The symptoms are troublesome, but irritable bowel syndrome doesn't cause permanent damage to the colon." Irritable bowel syndrome does not cause permanent damage to the colon. Damage to the colon is not influenced by the duration of disease, and damage does not depend on diet or steroid use.
Which is the least invasive treatment for esophageal perforation? A. Esophagectomy B. Debridement and repair C. Diversion and delayed repair D. Esophageal stent
C. Diversion and delayed repair Rationale: Esophageal stenting is the least invasive management of perforation and performed with endoscopy. Esophagectomy, debridement with repair, and diversion with delayed repair are all invasive surgeries.
A client has peptic ulcer disease (PUD). Which manifestation indicates a flare-up? A. Constipation B. Diarrhea C. Epigastric pain D. H. pylori infection
C. Epigastric pain Epigastric pain is the most common symptom of both gastric and duodenal ulcers. It is characterized by a gnawing or burning sensation and occurs after meals-classically shortly after meals with gastric ulcer and 2 to 3 hours afterward with duodenal ulcers. Constipation and diarrhea are not signs of PUD. H. pylori infection is a cause of PUD.
A patient reports epigastric pain that is relieved by eating. Which health problem is this patient most likely experiencing? Stomatitis Peptic ulcer disease (PUD) Gastroesophageal reflux disease (GERD) Hiatal hernia
Peptic ulcer disease (PUD) On the basis of clinical presentations, including dyspepsia, relation of pain relieved by food, a healthcare provider may suspect PUD. The other health problems do not have the same symptoms.
A patient reports epigastric pain and dyspepsia. Which condition should nurse suspect in the patient? Hernia Peptic ulcer disease (PUD) Constipation Acid reflux
Peptic ulcer disease (PUD) Patients with PUD present with epigastric pain and dyspepsia, although some patients may be asymptomatic. The other choices are not symptoms of PUD.
A patient is diagnosed with peptic ulcer disease (PUD). Which measure should the nurse suggest to prevent an exacerbation of the symptoms? Reduce nonsteroidal anti-inflammatory drug use Increase alcohol consumption Start smoking Eat spicy food
Reduce nonsteroidal anti-inflammatory drug use Agents that contribute to PUD are nonsteroidal anti-inflammatory drugs (NSAIDs). Tobacco use increases stomach acid. Excessive alcohol intake irritates the stomach lining. No specific food (or diet) has been identified as a risk factor. A person should avoid any foods that cause upset stomach.
Which manifestation should the nurse expect to assess in a client with a small-bowel obstruction (SBO)? (Select all that apply.) A. Pain B. Nausea C. Vomiting D. Increased appetite E. Abdominal distention
A. Pain B. Nausea C. Vomiting E. Abdominal distention Rationale: The classic signs and symptoms of SBO are abdominal pain, nausea, vomiting, and abdominal distention. Clients report the inability to satisfactorily pass gas or stool. On physical examination, clients with SBO demonstrate hyperactive, high-pitched bowel sounds ("rushes and tinkles"); an absence of bowel sounds is noted with an ileus.
The nurse is caring for a patient experiencing abdominal distention after surgery. Which additional clinical manifestation should the nurse expect with a possible small-bowel obstruction (SBO)? Abdominal pain and nausea Rectal itching Absence of bowel sounds Dysphagia
Abdominal pain and nausea The classic signs and symptoms of SBO are abdominal pain, nausea, vomiting, and abdominal distention. Patients report the inability to satisfactorily pass gas or stool. The absence of bowel sounds accompanies an ileus. SBO bowel sounds are hyperactive and high pitched. Rectal itching is a clinical manifestation of hemorrhoids. Dysphagia accompanies esophageal issues.
The nurse is caring for a patient with newly diagnosed diverticula. Which factor is a risk for this health problem? Develops most often in the ascending colon Occurs anywhere in the colon and rectum Affects those with advanced age Affects men more than women
Affects those with advanced age One risk factor for diverticular disease is advanced age. Diverticular disease affects men and women equally. Diverticula most often develop in the descending and not the ascending colon. Diverticula occur everywhere in the colon except the rectum.
Which type of drug lowers esophageal sphincter (LES) tone and causes the patient to experience esophageal reflux? Albuterol Antacid Histamine Cimetidine
Albuterol Albuterol decreases LES tone. Histamine increases LES tone. Cimetidine causes no change. Antacids increase LES tone by increasing gastric pH.
A patient is being evaluated for a lower GI disorder. Which symptom should indicate to the nurse that the patient has colorectal cancer (CRC)? Vomiting Gained weight Change in bowel habits Hyperemia
Change in bowel habits Early CRC typically does not have symptoms. However, when symptomatic, patients present with a complaint of hematochezia and change in bowel habits. Other complaints may include fatigue, weight loss, generalized or localized abdominal pain, and symptoms of anemia.
A patient is diagnosed with stomach cancer. Which should the nurse expect to assess in this patient? Hoarseness Heartburn Hyperactive bowel sounds Early satiety
Early satiety Early satiety is a manifestation of stomach cancer. The other symptoms are not associated with this disease. Manifestations of stomach cancer include the following: Weight loss Abdominal pain Dysphagia Nausea Occult GI bleeding Palpable abdominal mass in the RUQ
The nurse is caring for a patient with Barrett esophagus. For which type of cancer should the nurse assess this patient? Esophageal Stomach Oral Liver
Esophageal Adenocarcinoma of the esophagus is defined as a carcinoma displaying glandular differentiation that arises in the esophagus. Risk factors of adenocarcinoma include Barrett esophagus (BE). BE does not cause oral, stomach, or liver cancer.
A patient reports reflux and a sour taste in the mouth. Which health problem should the nurse suspect this patient is experiencing? Peptic ulcer disease Hiatal hernia Stomach cancer Gastrointestinal bleeding
Hiatal hernia Patients most frequently report symptoms of gastroesophageal reflux, such as heartburn, nocturnal epigastric distress, and a sour or acidic taste at the back of the throat. The patient's symptoms do not indicate any of the other disease processes.
The parents of an infant are concerned about a new onset of projectile vomiting and weight loss. Which health problem should the nurse suspect in this patient? Hypertrophic pyloric stenosis Hiatal hernia Adrenal crisis Gastroesophageal reflux disease
Hypertrophic pyloric stenosis The classic presentation of infantile hypertrophic pyloric stenosis (IHPS) includes gradual onset of worsening nonbilious projectile vomiting beginning at 4-6 weeks of age, dehydration or weight loss, and possibly visible peristalsis in the upper abdomen. The typical clinical feature is that the baby is hungry after vomiting and eager to feed. The other health problems would not cause projectile vomiting.
The nurse is preparing a patient with appendicitis for surgery. Which information should the nurse include in their teaching? No need of intravenous fluids or electrolyte replacements. Laparoscopic surgery is the preferred method of treatment. The use of antibiotics is not required. Open abdominal surgery is the gold standard for appendicitis.
Laparoscopic surgery is the preferred method of treatment. Treatment is aimed at medical stabilization with intravenous fluids, electrolyte replacements, and antibiotics. While some healthcare providers may advocate for purely medical management for some cases of simple appendicitis, surgery—most often laparoscopic surgery—remains the gold standard for treatment of simple and complicated appendicitis. Appendicitis is the most common nonobstetric surgical emergency during pregnancy. It occurs in approximately 1 in 800-1500 pregnancies. However, preoperative diagnosis is inaccurate up to 50% of the time, because of the physiological changes associated with pregnancy, such as displacement of the appendix by the gravid uterus, leukocytosis, and pregnancy-related nausea and vomiting. While maternal risk is nearly zero, the risk of fetal loss is increased in cases of perforated appendix and when an appendectomy is performed on a nondiseased appendix (negative appendectomy). Imaging is critical for assisting in an accurate diagnosis. The American College of Radiology Appropriateness Criteria identifies ultrasound as the initial imaging study of choice in this patient population.
A patient with Crohn disease asks the nurse why they must undergo stool sampling. Which reason should the nurse include in the response? Confirm laboratory findings Confirm diagnostic Rule out cancer Rule out infection
Rule out infection The diagnosis of ulcerative colitis and Crohn disease is based first on clinical symptoms. Patients with bloody or mucoid diarrhea, cramping, and abdominal pain should undergo stool sampling to rule out infectious causes of diarrhea (infectious enterocolitis) and to determine whether markers of intestinal inflammation are in the stool. Colonoscopy is used to rule out colon cancer. Diagnosis is confirmed with lower endoscopy studies to visualize and biopsy the bowel tissues. Serum assays such as C-reactive protein and erythrocyte sedimentation rate may provide evidence and degree of inflammation.
A patient with an esophageal rupture develops a fever. For which complication should the nurse plan care for this patient? Pneumothorax Myocardial infarction Sepsis Aortic dissection
Sepsis Patients with esophageal perforations can quickly develop septic shock; therefore, treatment needs to be initiated promptly. Myocardial infarction, aortic dissection, and pneumothorax are not complications of a ruptured esophagus. Approximately 25% of patients may be managed nonsurgically if they meet specific criteria such as having a recent, well-circumscribed perforation that does not leak into the abdominal cavity. Nonsurgical management includes NPO status (no food or fluids by mouth), decompressive therapies, and an endoscopically placed esophageal stent. Abdominal esophageal perforations should be managed surgically. Surgical interventions include drainage of the contaminated space, debridement and repair of the perforation, esophageal diversion and delayed repair, and esophagectomy.
A patient with appendicitis asks how it is treated. Which response from the nurse is the most accurate? Surgery Enemas or laxatives to relieve constipation Watch and wait Antibiotics only
Surgery Treatment is aimed at medical stabilization with intravenous fluids, electrolyte replacements, and antibiotics. While some practitioners may advocate for purely medical management for some cases of simple appendicitis, surgery—most often laparoscopic surgery—remains the gold standard for treatment of simple and complicated appendicitis. "Watch and wait," or watchful waiting treatment, is used for indolent (slow-growing) cancers. Enemas or laxatives are used to relieve constipation. These medicines increase the likelihood that an inflamed appendix will burst.
A patient recovering from surgery 3 days ago is experiencing abdominal pain and nausea. Which assessment finding indicates that the patient has an intestinal obstruction? Abdominal pain relieved by right hip flexion Abdominal pain with rectal bleeding and diarrhea Abdominal distention with high-pitched bowel sounds Constipation with anorexia and weight
The classic signs and symptoms of small-bowel obstruction (SBO) are abdominal pain, nausea, vomiting, and abdominal distention. Additionally, patients report the inability to satisfactorily pass gas or stool. On physical examination, patients with SBO demonstrate hyperactive, high-pitched bowel sounds ("rushes and tinkles"); an absence of bowel sounds is noted with an ileus. Constipation with anorexia and weight loss is a clinical manifestation of colon cancer. Abdominal pain relieved by right hip flexion is a symptom of appendicitis and possible perforation with peritonitis, not of intestinal obstruction. Rectal bleeding with diarrhea is a clinical manifestation of ulcerative colitis.
The nurse is preparing a booth for a health fair. Which modifiable risk factor should the nurse identify that decreases the risk of developing colon cancer? Drinking alcohol Daily aspirin Eating red meat Smoking
The use of NSAIDs, particularly aspirin, reduce the risk of developing colon cancer. Smoking, alcohol, and red meat are identified as factors that increase the risk for the disease. Daily aspirin
For which reason should the nurse assess a patient for a small-bowel obstruction (SBO)? Umbilical hernia Esophageal burning Excessive flatus Burping after eating
Umbilical hernia A hernia is one reason for the development of a SBO. The other choices are not identified as causing a SBO. Mechanical obstructions, which make up 90% of all obstructions, are the result of compression of the intestine by adhesion, tumors, fecal impaction, and hernias, in which the bowel becomes trapped in a weakened area of the abdominal wall.
A client is diagnosed with a duodenal ulcer. Which is the sequence of events in the pathophysiological process in the development of peptic ulcer disease? Mucosal erosion Mucosal ulceration Helicobacter pylori infection Imbalance of hydrochloric acid and pepsinogen
1. Helicobacter pylori infection 2. Imbalance of hydrochloric acid and pepsinogen 3.Mucosal erosion 4. Mucosal ulceration The most common cause of peptic ulcer disease is Helicobacter pylori. The infection leads to an imbalance of hydrochloric acid and pepsinogen. From that imbalance, erosion occurs. Ulceration follows erosion.
A client has a history of Crohn disease (CD). Which manifestation is most likely related to this condition? (Select all that apply.) A. Abdominal pain B. Increased appetite C. Diarrhea D. Intestinal strictures E. Weight loss
A. Abdominal pain C. Diarrhea D. Intestinal strictures E. Weight loss Rational: General symptoms associated with Crohn disease (CD) include fever, loss of appetite, weight loss, fatigue, and night sweats. Specific symptoms of CD include nausea, vomiting, and diarrhea with or without blood. Clients with CD also experience abdominal pain and pain with defecation due to anorectal fissures. Complications of CD include bowel strictures and obstructions. Clients may develop perforations in the bowel and intra-abdominal abscesses.
A client complaining of heartburn and dysphagia is diagnosed with eosinophilic esophagitis. Which response should the nurse make when asked the reason for the inflammation? A. "Your esophagus is inflamed from infection." B. "Your esophagus is inflamed from corrosive medication." C. "Your esophagus is inflamed by an allergic response." D. "Your esophagus is inflamed from radiation."
C. "Your esophagus is inflamed by an allergic response." Clients who are immunosuppressed are at risk for infectious esophagitis Eosinophilic esophagitis (EoE) - Cause unknown; many associated factors is an allergic reaction that results in inflammation of the esophagus. Radiation esophagitis - Radiation treatment of thoracic cancers; exacerbated by chemotherapeutic agents, cause iatrogenic injury leading to inflammation of the esophagus. Corrosive esophagitis - Ingestion of strong alkaline or acid substances Pill esophagitis - Swallowed pill lodges transversely in esophageal lumen and causes inflammation can injure and inflame the esophagus.
A patient reports blood in the stool and an unexpected weight loss. Which health problem should the nurse suspect in this patient? Stomach cancer Colorectal cancer Gastrointestinal bleeding Hemorrhoids
Colorectal cancer When symptomatic, patients with colorectal cancer (CRC) present with a complaint of hematochezia and change in bowel habits. Other complaints may include fatigue, weight loss, generalized or localized abdominal pain, and symptoms of anemia. The other disease processes do not include blood in the stool and weight loss as primary symptoms.
The nurse teaches lifestyle modifications to a client with gastroesophageal reflux disease (GERD). Which statement by the client indicates understanding? A. "I will gain weight." B. "I will eat large meals." C. "I will lie down after meals." D. "I will avoid acidic foods."
D. "I will avoid acidic foods." Rationale: The client with GERD will want to avoid acidic food in order to avoid symptoms. Other changes to minimize symptoms include losing weight if obese, eating smaller meals, and sitting up after meals
A patient is diagnosed with esophageal dysfunction. Which health problem most likely contributed to the development of this disorder? Paralytic ileus Crohn disease Ulcerative colitis Gastroesophageal reflux disease
Gastroesophageal reflux disease Eosinophilic esophagitis (EoE) is an allergic esophagitis, characterized by histologic evidence of eosinophil-induced inflammation and clinical symptoms of esophageal dysfunction. Risk factors for EoE include gastroesophageal reflux disease (GERD). The other choices are not associated with the development of EoE.
The nurse is caring for a patient with diverticulosis. Which aspect of the patient's diet places the patient at risk for diverticulosis? Low-cholesterol diet High intake of salt High intake of red meat Low fiber intake
Low fiber intake A diet low in fiber contributes to diverticulosis. A high intake of red meat increases the risk of colon cancer. A high intake of salt increases the risk of gastric cancer. A low-cholesterol diet does not impact diverticulitis or other gastrointestinal disease risk.
The nurse notes that a patient is prescribed morphine for pain control. On which teaching topic should the nurse prepare material for this patient? Activity status Sodium restriction Fluid restriction Gastric reflux
Morphine is a medication that decreases the tone of the lower esophageal sphincter. This increases the risk for gastric reflux. The other choices are not appropriate for this patient. Gastric reflux
Which clinical manifestation is associated with cancer of the top part of the stomach? (Select all that apply.) A. Feeling of fullness after a small meal B. Unintentional weight gain C. Dysphagia D. Abdominal pain E. Nausea
A. Feeling of fullness after a small meal C. Dysphagia D. Abdominal pain E. Nausea Rationale: Signs and symptoms of stomach cancer include nausea, dysphagia, abdominal pain, and early satiety with a small meal. Unintentional weight loss, not weight gain, is associated with this cancer.
The nurse is teaching a client about esophageal diverticular clinical manifestations. Which clinical manifestation should the nurse include when teaching a client about esophageal diverticula? (Select all that apply.) A. Heartburn B. Gurgling when swallowing C. Dysphagia D. Fever E. Abdominal pain
A. Heartburn B. Gurgling when swallowing C. Dysphagia Rationale: Esophageal diverticula can cause dysphagia, heartburn, and a gurgling sound when swallowing. Fever and abdominal pain accompany diverticular disease of the lower gastrointestinal tract.
The nurse is caring for a client with ulcerative colitis. Which treatment should the nurse anticipate for this client? A. Immunosuppressants B. Acid reduction therapy C. Chemotherapy D. Radiation
A. Immunosuppressants Rationale: Immunosuppressants are part of the medical management of the client with ulcerative colitis. Radiation and chemotherapy are used to treat cancers. Acid reduction therapy is used in gastroesophageal reflux disease.
A client is diagnosed with a hiatal hernia. Which should the nurse expect when assessing this client? (Select all that apply.) A. Normal stool B. Backflow of stomach acid into the esophagus (acid reflux) C. Bad breath D. Chest or abdominal pain E. Regurgitation of food or liquids into the mouth
A. Normal stool B. Backflow of stomach acid into the esophagus (acid reflux) D. Chest or abdominal pain Larger hiatal hernias can cause heartburn, regurgitation of food or liquids into the mouth, backflow of stomach acid into the esophagus (acid reflux), difficulty swallowing, chest or abdominal pain, shortness of breath, and vomiting of blood or passing of black stools (which may indicate gastrointestinal bleeding). Bad breath, or halitosis, accompanies upper esophageal diverticula.
The nurse is teaching a client with colon cancer about modifiable risks factors. Which statement by the client indicates that teaching has been effective? A. "I'll stop smoking." B. "I'll remove all fiber from my diet." C. "I'll eat a lot of fat and processed meats." D. "I'll keep drinking alcohol."
A. "I'll stop smoking." Rationale: Some of the cancer-causing substances associated with smoking may be swallowed, increasing the risk of colorectal cancer, so the client's statement about stopping smoking indicates that teaching has been effective. A diet that is high in red and processed meats (for example, beef, lamb, or hot dogs) increases colorectal cancer risk. A diet rich in fruits, vegetables, and high-fiber grains helps reduce the risk of colorectal cancer, so removing fiber would increase risk.
Which client should the nurse identify as being at risk for the development of esophageal diverticula? A. 56-year-old man B. 9-year-old child C. 8-month-old infant D. 18-year-old woman
A. 56-year-old man Esophageal diverticula is an acquired, nondashgender-specific condition that usually affects middle-aged and older adults
A patient is diagnosed with possible diverticulitis. For which complication should the nurse monitor this patient? Abscess and perforation Jaundice Pancreatitis Peptic ulcer
Abscess and perforation Complicated diverticulitis is inflammation associated with formation of an abscess, fistula, obstruction, bleeding, or a perforation. The other health problems are not associated with diverticulitis.
The nurse is caring for a client with gastroesophageal reflux disease (GERD). Which time of day should the nurse expect the client to have symptoms? A. In the morning B. After a meal C. At nighttime D. Midday
B. After a meal Rationale: Symptoms of GERD can occur at any time of day but are most likely to follow a meal.
A client experiencing gurgling with swallowing is prescribed continuous dynamic fluoroscopy. Which disorder is being investigated in this client? A. Hiatal hernia B. Esophageal diverticulum C. Esophageal perforation D. Esophageal rings
B. Esophageal diverticulum Rationale: Continuous dynamic fluoroscopy is the diagnostic test of choice to diagnose esophageal diverticula that has the symptom of gurgling when swallowing. Hiatal hernia, esophageal rings, and esophageal perforation are diagnosed with chest radiograph and swallow studies.
A 5-week-old infant is vomiting 30dash60 minutes after feedings and exhibiting persistent hunger. Which health problem should the nurse suspect this infant is experiencing? A. Duodenal ulcer B. Hypertrophic pyloric stenosis C. Gastric cancer D. Gastroenteritis
B. Hypertrophic pyloric stenosis The classic manifestations of infantile hypertrophic pyloric stenosis (IHPS) include gradual onset of worsening nonbilious projectile vomiting beginning at 4dash6 weeks of age, dehydration or weight loss, and possibly visible peristalsis in the upper abdomen. The baby is hungry after vomiting and eager to feed. Gastric cancer is found in older clients. Most duodenal ulcers are caused by chronic Helicobacter pylori infection. Anti-inflammatory medications such as aspirin and ibuprofen, which many people use for muscle pain relief and arthritis, also affect the lining of the duodenum and cause the production of excess stomach acid. Gastroenteritis is marked by diarrhea, abdominal pain, vomiting, headache, fever, and chills.
Which factor can cause a small-bowel obstruction (SBO)? A. Exercise B. Neoplasm C. Eating fiber D. Diet
B. Neoplasm Rationale: Seventy-five percent of SBOs are due to adhesions. Adhesions are fibrous bands (scar tissue) that form between tissues and organs and commonly occur after abdominal surgery. Other common causes are tumors, hernias, and intrinsic defects. The mnemonic HANG IV may be used to recall the causes of SBO: hernia, adhesions, neoplasm/tumor, gallstone ileus, intussusception, and volvulus. Diet, exercise, and eating fiber do not contribute to the development of a SBO.
The nurse is reviewing information about colon cancer with a new nurse. Which statement by the nurse indicates that further teaching is required? A. "Removal of colon polyps can help prevent colorectal cancer." B. "Most colorectal cancers do not develop from polyps." C. "Smoking is a modifiable risk factor." D. "Age is the main risk factor for colorectal cancer."
B. "Most colorectal cancers do not develop from polyps." Rationale: Most colorectal cancers develop from polyps. Removal of colon polyps can help prevent colorectal cancer. Colon polyps and early cancer may have no early signs or symptoms. Therefore, regular colorectal cancer screening is important. Smoking and age are risks factors for colon cancer.
The nurse is caring for a client with peptic ulcer disease. Which location should the nurse expect the client to report pain? A. Back pain B. Neck pain C. Epigastric D. Lower right quadrant
C. Epigastric Rationale: Peptic ulcers may cause epigastric pain. Back pain may follow a lower esophageal perforation, and neck pain may occur with an upper esophageal perforation. Lower right quadrant pain is associated with appendicitis.
The nurse reviews actions to prevent colorectal cancer to a client with no risk factors. Which client statement should indicate that teaching has been effective? A. "There are no genetic tests for colorectal cancer." B. "I will need to start my screening at age 40." C. "I have no risk so I do not need screening." D. "Screening may include testing for blood that cannot be seen."
D. "Screening may include testing for blood that cannot be seen." Rationale: Screening for colorectal cancer includes testing for occult blood, which is blood that is not visible to the naked eye. Men and women are both to begin screening at age 50 if there are no risk factors. Those with risk factors should begin screening before age 50. There are genetic tests available for colorectal cancer screening.
A patient reports hearing a gurgling sound when swallowing. Which health problem should the nurse suspect is occurring with this patient? Gastroesophageal reflux disease Stomach cancer Esophageal diverticula Stomatitis
Esophageal diverticula Most esophageal diverticula are asymptomatic. However, when large enough to hold undigested food and fluids, hypopharyngeal diverticula present with symptoms that affect the upper esophagus and airway. Patients may experience a gurgling sound during swallowing. This symptom is not associated with the other disease processes.
A patient is diagnosed with esophageal diverticula. Which symptom should the nurse expect to assess in this patient? Hyperactive bowel sounds Abdominal tenderness Hypoactive bowel sounds Gurgling when swallowing
Gurgling when swallowing Most esophageal diverticula are asymptomatic. However, when large enough to hold undigested food and fluids, hypopharyngeal diverticula present with symptoms that affect the upper esophagus and airway. Patients may experience a gurgling sound during swallowing. This health problem does not affect bowel sounds or causes abdominal tenderness.
A patient is being tested to confirm the diagnosis of gastritis. Which infection is most frequently the cause of chronic gastritis? Viral H. pylori Parasitic Fungal
H. pylori Chronic gastritis is often caused by infectious agents, primarily bacteria, specifically H. pylori. Less commonly, acute gastritis may be caused by other bacterial infections or viral, parasitic, or fungal infections.
Which is the most common symptom of a hiatal hernia? Nasopharyngeal reflux Dysphagia Heartburn Black stool
Heartburn Patients most frequently report symptoms of gastroesophageal reflux, such as heartburn, nocturnal epigastric distress, and a sour or acidic taste at the back of the throat. The patient's symptoms do not indicate any of the other disease processes.
Which factor can cause secondary constipation? Healthy diet Pharmacologic Exercise Low calcium
Pharmacologic Pharmacologic causes, such as from the use of opioids, calcium carbonate, and aluminum hydroxide antacids, can cause secondary constipation. Healthy diet and exercise promote normal bowel movements. A healthy diet and low calcium are not identified as causing secondary constipation.
The nurse prepares material on gastroesophageal reflux disease for a community health fair. Which risk factor should the nurse include? Hypertension Chronic obstructive pulmonary disease (COPD) Pregnancy Heart disease
Pregnancy Pregnancy is identified as a risk factor for GERD. The other choices are not considered risk factors for the disease process.
A patient with irritable bowel syndrome reports abdominal pain or discomfort at least 3 days a month. Which additional information is needed to use the Rome III classification? Symptoms occur in 3 consecutive months. Occurs with low energy and fatigue. Weight loss has occurred. Early satiety occurs daily.
Symptoms occur in 3 consecutive months. The Rome III criteria are used to help diagnose irritable bowel syndrome (IBS) and include the presence of abdominal pain or discomfort on at least 3 days a month. The Rome criteria also include two or more of the following: (1) improvement with defecation, (2) onset (of each episode of discomfort) associated with a change in frequency of defecation, and (3) change in consistency of stool. Weight loss, early satiety, low energy, and fatigue are not part of the Rome III classification.