AN Upper GI Health Problems

The client is scheduled to have an upper gastrointestinal tract series of x - rays . Following the x - rays , what should the nurse instruct the client to do ? 1. Take a laxative . 2. Follow a clear liquid diet . 3. Administer an enema . 4. Take an antiemetic .

1. The client should take a laxative after an upper gastrointestinal series to stimulate a bowel movement .

0. The nurse is obtaining a nursing history from a client with a suspected gastric ulcer . Which sign ( s ) or symptom ( s ) should the nurse assess ? Select all that apply . 1. epigastric pain at night 2. relief of epigastric pain after eating 3. vomiting 4. weight loss 5. melena

10. 3 , 4 , 5. Vomiting and weight loss are common with gastric ulcers

The nurse is teaching a client with a peptic ulcer about the diet that should be followed after discharge . What types of food should the nurse suggest the client include in the diet ? 1. bland foods 2. high - protein foods 3. any foods that are tolerated 4. a glass of milk with each meal

16. 3. Diet therapy for ulcer disease is a controversial issue . There is no scientific evidence that diet therapy promotes healing .

The nurse is assessing a client who is being admitted to the hospital with upper gastrointestinal ( GI ) bleeding . Which finding ( s ) are significant ? Select all that apply . 1. dry , flushed skin 2. decreased urine output 3. tachycardia 4. widening pulse pressure 5. rapid respirations 6. thirst

2 , 3 , 5 , 6. The client who is experiencing upper GI bleeding is at risk for developing hypovolemic shock from blood loss . Therefore , the signs and symptoms the nurse should expect to find are those related to hypovolemia , including decreased urine output , tachycardia , rapid respirations , and thirst .

A client with peptic ulcer disease is taking omeprazole over the counter to relieve symptoms of stomach pain . The nurse should instruct the client that long - term use of this drug is a risk for which complication ? 1. gastric bleeding 2. hip fracture 3. anemia 4. dizziness

2. Long - term use of proton pump inhibitors such as omeprazole is a risk factor for fractures , particularly in the hip , spine , and wrist , and the nurse should instruct the client about this risk

The client has just returned to the nursing unit following a gastrectomy . The nurse should place the client in which position ? 1. prone 2. supine 3. low Fowler 4. lateral recumbent

3 . A client who has had abdominal surgery is best placed in a low Fowler position postoperatively .

Since receiving a diagnosis of stomach cancer , a client has been having trouble sleeping and is frequently preoccupied with thoughts about how life will change . The client says , " I wish my life could stay the same . " The nurse determines that the client is experiencing which problem ? 1. having difficulty coping 2. experiencing a sleep disorder 3. going through a grieving process 4. showing signs of anxiety disorder

3 . The client is going through the grieving process as they adjust to the diagnosis . There are no indications of inadequate coping as the client is able to verbalize concerns

Following a subtotal gastrectomy , a client has a nasogastric ( NG ) tube connected to low suction . What should the nurse do ? 1. Irrigate the tube with 30 mL of sterile water every hour , if needed . 2. Reposition the tube if it is not draining well . 3. Monitor the client for nausea , vomiting , and abdominal distention . 4. Change to high suction if the drainage is sluggish on low suction .

3. Nausea , vomiting , or abdominal distention indicates that gas and secretions are accumulating within the gastric pouch due to impaired peristalsis or edema at the operative site and may indicate that the drainage system is not working properly .

A client is to take one daily dose of ranitidine at home to treat a peptic ulcer . Which response from the client indicates that the client understands how to take the medication ? " I'll take the drug : 1. before meals . " 2. with meals . " 3. at bedtime . " 4. when pain occurs . "

3. Ranitidine blocks the secretion of hydrochloric acid . Clients who take only one daily dose of ranitidine are usually advised to take it at bedtime to inhibit the nocturnal secretion of acid

nurse notes the absence of saliva . The client During the assessment of a client's mouth , the reports having pain behind the ear . The client has been nothing - by - mouth ( NPO ) for several days but now can have liquids . What should the nurse do next ? 1. Request a prescription for an antifungal mouthwash . 2. Instruct the client to brush the gums as well as the teeth . 3. Encourage the client to suck on hard candy . 4. Give the client a hydrogen peroxide - based mouthwash .

3. The lack of saliva , pain near the area of the ear , and the prolonged NPO status of the client are indications that the client may be developing parotitis , or inflammation of the parotid gland .

A client with peptic ulcer disease is admitted to the hospital for a gastric resection . The client reports a sudden sharp pain in the midepigastric area that radiates to the shoulder . What should the nurse do first ? 1. Establish an intravenous ( IV ) line . 2. Administer pain medication . 3. Notify the surgeon . 4. Call for a stat electrocardiogram ( ECG ) .

3. The sharp , sudden midepigastric pain indicates the client may have a perforated ulcer

A client who has been diagnosed with gastroesophageal reflux disease ( GERD ) has heartburn . To decrease the heartburn , the nurse should instruct the client to eliminate which item from the diet ? 1. lean beef 2. air - popped popcorn 3. hot chocolate 4. raw vegetables

3. With GERD , eating substances that decrease lower esophageal sphincter pressure causes heartburn

Within 6 hours following a subtotal gastrectomy , the drainage from the client's nasogastric ( NG ) tube is bright red . What should the nurse do first 1. Clamp the NG tube . 2. Remove the existing NG tube . 3. Irrigate the NG tube with iced saline . 4. Chart the finding in the client's medical record .

4. NG drainage is expected to be bright red during the first 12 hours after surgery and then darken within 24 hours .

A nurse is caring for a client who has just returned from surgery to treat a fractured mandible . The jaws are wired . What should the nurse do if the client begins to vomit ? 1. Administer an antiemetic as prescribed . 2. Cut the wires , and assist the client to expectorate 3. Have the client sit up , bend over , and spit into an emesis basin 4. Insert a suction tube to clear the vomitus from the oral cavity.

mandible , 3. Following surgery for a fractured the client's jaws will be wired . The nurse should be prepared to intervene quickly in case the client develops respiratory distress or begins to choke or vomit .

A client with peptic ulcer disease is taking cimetidine . What is the expected outcome of this drug ? 1. Heal the ulcer . 2. Protect the ulcer surface from acids . 3. Reduce acid concentration . 4. Limit gastric acid secretion .

4 Histamine-2 (H2) receptor antagonists, such as cimetidine, reduce gastric acid secretion

Amoxicillin trihydrate 300 mg oral ( PO ) has been prescribed for a client with an oral infection . The medication is available in a liquid suspension that is available as 250 mg / 5 mL . How many milliliters should the nurse administer ? Record your answer using a whole number .

6 mL . To administer 300 mg PO , the nurse will need to administer 6 mL . The following formula is used to calculate the correct dosage : 300 mg / X mL = 250 mg / 5mL .

peptic ulcer A client with a reports epigastric pain that frequently causes the client to wake up during the night . The nurse should instruct the client to take which action ( s ) ? Select all that apply . 1. Obtain adequate rest to reduce stimulation . 2. Eat small , frequent meals throughout the day . 3. Take all medications on time as prescribed . 4. Sit up for 1 hour when awakened at night . 5. Stay away from crowded areas .

1 2 3 4. The nurse should encourage the client to reduce stimulation that may enhance gastric secretion .

After a gastric resection for a malignant tumor , a client is scheduled to undergo radiation therapy . What is the most important information the nurse should include in the discharge teaching plan ? 1. how to maintain adequate nutrition 2. what do for alopecia 3. how to exercise to attain activity goals 4. where to access community resources

1 Clients who have had gastric surgery are prone to postoperative complications such as dumping syndrome and postprandial hypoglycemia which can affect nutritional intake

Following surgery to set a fractured mandible , the client has swelling at the surgery site . What is the priority goal of nursing care ? 1. Prevent nausea and vomiting . 2. Maintain a patent airway . 3. Provide frequent oral hygiene . 4. Establish a way for the client to communicate .

2 . The priority of care in the immediate postoperative phase is to maintain a patent airway . The nurse should observe the client carefully for signs of respiratory distress .

The nurse is caring for a client who has had a the gastroscopy . Which finding ( s ) indicate that client is developing a complication related to the procedure ? Select all that apply . The client : 1. has a sore throat . 2. has a temperature of 100 ° F ( 37.8 ° C ) . 3. appears drowsy following the procedure . 4. has epigastric pain . 5. experiences hematemesis .

2 4 5. Following a gastroscopy the nurse should monitor the client for complications , which include perforation and the potential for aspiration . An elevated temperature , epigastric pain , or the vomiting of blood ( hematemesis ) are all indications of a possible perforation and should be reported promptly .

A client is experiencing gastroesophageal reflux . managing reflux ? What should the nurse teach the client about 1. Limit caffeine intake to two cups of coffee per day . 2. Do not lie down for 2 hours after eating . 3. Follow a low - protein diet . 4. Take medications with milk to decrease irritation .

2. The nurse should instruct the client to not lie down for about 2 hours after eating to prevent reflux .

The nurse is teaching a client with stomatitis about managing oral discomfort . Which instruction is most appropriate ? 1. Drink hot tea at frequent intervals 2. Gargle with an antiseptic mouthwash 3. Use an electric toothbrush . 4. Eat a soft , bland diet .

2.4 . Clients with stomatitis ( inflammation of the mouth ) have significant discomfort , which impacts their ability to eat and drink .

A client has been taking aluminum hydroxide 30 mL six times per day at home to treat a peptic ulcer . The client has been unable to have a bowel movement for 3 days . What should the nurse etermine is the most likely cause of the client's constipation ? 1. The client has not been including enough fiber in the diet . 2. The client needs to increase daily exercise . 3. The client is experiencing an adverse effect of aluminum hydroxide . 4. The client has developed a gastrointestinal obstruction .

20. 3. It is most likely that the client is experiencing an adverse effect of the antacid . Antacids with aluminum salt products , such as aluminum hydroxide , form insoluble salts in the body

A client with cancer of the stomach had a total gastrectomy 2 days earlier . Which finding indicates the client is ready to try a liquid diet ? The client : 1. is hungry . 2. took pain medication 2 hours ago . 3. has frequent bowel sounds . 4. has had a bowel movement .

22. 3. The client can begin eating with a liquid diet when bowel sounds return , usually in 2 to 3 days .

A client who is recovering from gastric surgery is receiving intravenous ( IV ) fluids to be infused at 100 mL per hour . The IV tubing delivers 15 gtt / mL . The nurse should infuse the solution at a flow rate of how many drops per minute to ensure that the client receives 100 mL per hour ? Record your answer using a whole number . - gtt / min .

25 gtt / min . To administer IV fluids at 100 mL per hour using tubing that has a drip factor of 15 gtt / mL , the nurse should use the following formula : 100 mL / 60 minutes × 15 gtt / 1 mL = 25 gtt / min .

2 A client admitted to the hospital with peptic ulcer disease tells the nurse about having black tarry stools . What should the nurse do ? 1. Encourage the client to increase fluid intake . 2. Advise the client to avoid iron - rich foods . 3. Place the client on contact precautions . 4. Report the finding to the health care provider ( HCP ) .

4 . Black tarry stools are an important sign of bleeding in peptic ulcer disease .

The nurse is teaching a client who had a gastrectomy how to reduce the risk for dumping syndrome . What should the nurse teach the client to do ? 1. Sit upright for 30 minutes after meals . 2. Drink liquids with meals , avoiding caffeine . 3. Avoid milk and other dairy products . 4. Decrease the carbohydrate content of meals .

4 . Carbohydrates are restricted , but protein , including meat and dairy products , is recommended because it is digested more slowly

A client who has a history of bacterial endocarditis is scheduled to have oral surgery to remove a tooth . What should the nurse instruct the client to do ? 1. Gargle with a saline solution before the appointment . 2. Rinse the mouth with mouthwash the night before and the day of the surgery . 3. Contact the health care provider ( HCP ) to request a sedative . 4. Be sure the dentist prescribes a prophylactic antibiotic before the oral surgery .

4 . Clients who are at risk for developing infective endocarditis due to cardiac conditions such as a history of bacterial endocarditis must take prophylactic antibiotics before any dental procedure that may cause bleeding .

9. A client is admitted to the hospital bright red blood and is diagnosed with a bleeding after vomiting duodenal ulcer . The client develops a sudden , sharp pain in the midepigastric region along with a rigid , boardlike abdomen . After obtaining the client's vital signs , what should the nurse do next ? 1. Administer pain medication as prescribed . 2. Raise the head of the bed . 3. Prepare to insert a nasogastric tube . 4. Notify the health care provider ( HCP ) .

4 . The client is experiencing a perforation of the ulcer , and the nurse should notify the HCP immediately

A client who is recovering from a subtotal gastrectomy experiences dumping syndrome and is to eat six small meals a day . The client asks the nurse , " When will I be able to eat three meals a day again like I used to ? " Which response by the nurse is most appropriate ? 1. " Eating six meals a day is time - consuming , isn't it ? " 2. " You will have to eat six small meals a day for the rest of your life . " 3. " You will be able to tolerate three meals a day before you are discharged . " 4. " Most clients can resume their normal meal patterns in about 6 to 12 months . "

4 . The symptoms related to dumping syndrome that occur after a gastrectomy usually disappear by 6 to 12 months after surgery

One month following a subtotal gastrectomy for cancer , the nurse is evaluating the nursing care goal related to improved nutrition . What indicates that the client has attained the goal ? The client : 1. has regained weight loss . 2. has resumed their normal dietary intake of three meals a day . 3. has controlled nausea and vomiting through regular use of antiemetics . 4. has achieved adequate nutritional status through oral or parenteral feedings .

4. An appropriate expected outcome is for the client to achieve optimal nutritional status through the use of oral feedings or total parenteral nutrition ( TPN ) .

A client is diagnosed with peptic ulcer disease caused by Helicobacter pylori infection . The client is following a 2 - week drug regimen that includes clarithromycin along with omeprazole and amoxicillin . How should the nurse instruct the client to take these medications ? 1. Alternate the use of the drugs . 2. Take the drugs at different times during the day . 3. Discontinue all drugs if nausea occurs . 4. Take the drugs for the entire 2 - week period .

4. The use of the triple - therapy approach to the H. pylori infection has proved effective ; therefore , the nurse advises the client to take the drugs as prescribed for the duration of the prescription .

The nurse is preparing a community presentation on oral cancer . Which is a primary risk factor for oral cancer that the nurse should emphasize in the presentation ? 1. use of alcohol 2. frequent use of mouthwash 3. lack of vitamin B₁2 4. lack of regular teeth cleaning by a dentist

6.1 . Chronic and excessive use of alcohol can lead to oral cancer . Smoking and the use of smokeless tobacco are other significant risk factors .

A client has early signs of oral cancer . What should the nurse include in a focused assessment ? Select all that apply . 1. an infection or inflammation in the mouth 2. lost the sense of taste 3. difficulty swallowing 4. significant weight loss 5. changes in the frequency of urination 6. numbness of the tongue

7./+1 , 3 , 4 , 6. The nurse is conducting a focused assessment of the client's mouth and ability to obtain nutrition . Therefore , the nurse focuses on inspecting the mouth for infection or inflammation , determining if the client has difficulty swallowing , and assuring nutrition by noting weight loss . A sign of oral cancer is numbness of the tongue ; losing a sense of taste is not an early sign of oral cancer . Urinary output , while important , is not a part of a focused assessment for this health problem .

A client has had a subtotal gastrectomy and has a nasogastric tube with intermittent suction . Twenty four hours after the surgery , the drainage in the client's nasogastric tube is dark brown . What should the nurse do ? 1. Reassure the client that this is normal drainage . 2. Irrigate the nasogastric tube . 3. Notify the health care provider ( HCP ) . 4. Discontinue the suction .

Apply 1. About 12 to 24 hours after a subtotal gastrectomy , gastric drainage is normally brown , which indicates digested blood ; the nurse can reassure the client that this is a normal color