Prep U: GI disorders

At 0800, the nurse reviews the amount of t-tube drainage for a client who underwent an open cholecystectomy yesterday. After reviewing the output record (see chart), the nurse should: evaluate the tube for patency. clamp the t-tube. irrigate the t-tube. report the 24-hour drainage amount at 12 noon. An enterostomy nurse is providing an in-service session on caring for colostomies. Which statement by a nurse indicates the need for further teaching? "I can remove the bag momentarily to allow gas to escape." "I can unclamp the bag momentarily to allow gas to escape." "I can place an odor-relieving tablet in the bag when changing the appliance to reduce odors." (x) "I can make a small pin hole in the bag to let the gas out, so I don't have to change the appliance frequently." A client's abdominal incision eviscerates. The nurse should first: lower the client's head and elevate the feet. take the client's vital signs and call the health care provider (HCP). (x) cover the incision with a dressing moistened with sterile normal saline solution. start an emergency infusion of IV fluids. A client is admitted with a diagnosis of ulcerative colitis. The nurse should assess the client for: steatorrhea. alternating periods of constipation and diarrhea. constipation. (x) bloody, diarrheal stools. A nurse asks a client who had abdominal surgery 3 days ago if he has moved his bowels since surgery. The client states, "I haven't moved my bowels, but I am passing gas." How should the nurse intervene? Administer a tap water enema. Notify the physician. Apply moist heat to the client's abdomen. (x) Encourage the client to ambulate at least three times per day. A nurse teaches a client infected with hepatitis A (HAV) about the disease process. Which of the following statements, if made by the client, would cause the nurse to further reinforce the teaching? (x) "I should have been more careful with my sexual practices." "With good hand hygiene I should not pass this to my family." "I may have eaten contaminated restaurant food." "Although this is infectious, I should have a full recovery."

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When planning the care for a client diagnosed with hepatitis A, the nurse should include which interventions? Select all that apply. Implement an exercise program. (x) Provide relief from nausea and vomiting. Administer pain medication. (x) Encourage multiple small meals daily. (x)Plan frequent rest periods. The nurse notes that a client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse interpret the significance of these symptoms? (x) The client may be developing hypocalcemia. The client is experiencing a reaction to meperidine. The client has a nutritional imbalance. The client needs a muscle relaxant to promote rest. When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as: (x) a canker sore of the oral soft tissues. an acute stomach infection. acid indigestion. an early sign of peptic ulcer disease. When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as: a canker sore of the oral soft tissues. an acute stomach infection. acid indigestion. an early sign of peptic ulcer disease. A client has vomited several times over the past 12 hours. The nurse should recognize the risk of what complication? (x) Metabolic alkalosis Metabolic acidosis Respiratory acidosis Respiratory alkalosis When the nurse is assessing the client's abdomen, which finding best indicates that a client's peristaltic activity is returning to normal after surgery? Peristalsis can be felt on abdominal palpation. The client passes flatus. The client says that she is hungry. Bowel sounds are hypoactive on auscultation. A client who had a cholecystectomy with a biliary drainage tube in place. What color of the drainage is expected? clear dark yellow-orange pinkish red green In caring for the client with hepatitis B, which situation would expose the nurse to the virus? touching the client's arm with ungloved hands while taking a blood pressure a blood splash into the nurse's eyes contact with fecal material disposing of syringes and needles without recapping Which is an appropriate nursing goal for the client who has ulcerative colitis? The client: maintains a daily record of intake and output. uses a heating pad to decrease abdominal cramping. accepts that a colostomy is inevitable at some time in his life. verbalizes the importance of small, frequent feedings.

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