Brunner 46- Gastritis & PUD

A client is newly diagnosed with a peptic ulcer. For which medications will the nurse prepare teaching for this client? Select all that apply.

=Metronidazole =Bismuth subsalicylate =Omeprazole

During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of gastritis would be the:

Immediacy of the occurrence. Acute gastritis usually develops quickly, whereas chronic gastritis results from prolonged inflammation of the stomach.

A client who had been prescribed nothing by mouth as treatment for acute gastritis is now reporting a decrease in symptoms and increase in hunger. Which action will the nurse take?

Provide ice chips.

The nurse is caring for a client who has just returned from the PACU after surgery for peptic ulcer disease. For what potential complications does the nurse know to monitor? Select all that apply.

Pyloric obstruction Perforation Hemorrhage Penetration

A client is recovering at home after surgical removal of a malignant gastric tumor. The client reports feeling weak and fatigued. Which recommendation will the nurse provide the client?

Suggest a home health aide to help with ADLs.

A client is newly diagnosed with stomach cancer. The nurse will plan to provide the client education on which treatment?

Surgery

TRUE/ FALSE Most peptic ulcers result from infection with the gram-negative bacteria H. pylori, which may be acquired through ingestion of food and water.

TRUE

TRUE/ FALSE The best time to teach a client to take proton pump inhibitors is 30 minutes before a meal

TRUE

TRUE/ FALSE The vast majority of gastric cancers are acquired and not inherited.

TRUE

A healthcare provider prescribes a combination of drugs to treat reoccurring peptic ulcer disease, and the client asks the nurse the reason for all the medications. What teaching should the nurse review with the client?

The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori.

Which is an accurate statement regarding gastric cancer?

The incidence of stomach cancer continues to decrease in the United States.

The nurse is preparing a teaching tool about delayed release proton pump inhibitors used to treat duodenal ulcer disease caused by H. pylori. Which statement will the nurse include that would apply to most types of proton pump inhibitor prescribed to treat this condition?

The medication is to be swallowed whole and taken before meals

A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate?

"Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery."

A client admitted for treatment of a gastric ulcer is being prepared for discharge. The client will follow a regimen of antacid therapy. Discharge teaching should include which instructions? Choose all that apply.

"Continue to take antacids even if your symptoms subside." "You may be prescribed H2-receptor antagonists for up to 1 year."

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement?

"I have learned some relaxation strategies that decrease my stress."

A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply.

-Burning sensation localized in the back or mid-epigastrium -Feeling of emptiness that precedes meals from 1 to 3 hours -Severe gnawing pain that increases in severity as the day progresses

A client diagnosed with a peptic ulcer says, "Now I have something else I have to worry about." Which actions will the nurse take to help reduce the client's anxiety? Select all that apply.

-Interact with the client in a relaxed manner. -Help identify the client's current stressors. -Discuss potential coping techniques with the client. -Offer information about relaxation methods.

A client with gastric cancer is scheduled to undergo a Billroth II procedure. The client's spouse asks how much of the client's stomach will be removed. What would be the most accurate response from the nurse?

Approximately 75%

In patients with gastric cancer a _______may be used to evaluate for the presence of anemia.

CBC

A client with peptic ulcer disease caused by H. pylori is prescribed clarithromycin. Which information will the nurse include when teaching the client about this medication?

Do not take this medication with grapefruit juice.

_____________________ may occur as a result of any surgical procedure that involves the removal of a significant portion of the stomach or includes resection or removal of the pylorus.

Dumping Syndrome

Which diagnostic test would be used first to evaluate a client with upper GI bleeding?

Hemoglobin and hematocrit

Gastritis and _____________ from peptic ulcer disease are the two most common causes of upper GI tract bleeding.

Hemorrhage

Which is a true statement regarding the nursing considerations in administration of metronidazole?

It leaves a metallic taste in the mouth.

Which of the following is considered an early symptom of gastric cancer?

Pain relieved by antacids

Currently, the most commonly used therapy for peptic ulcers is a combination of ____________, proton pump inhibitors, and bismuth salts that suppresses or eradicates H. pylori.

antibiotics

A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching?

"I will have to take vitamin B12 shots up to 1 year after surgery."

A client diagnosed with gastritis is asking the nurse why famotidine is being prescribed instead of cimetidine, which they have been prescribed in the past. Which statement by the nurse is appropriate for this client?

"It has fewer drug to drug interactions."

A client with gastric ulcers caused by H. pylori is prescribed metronidazole. Which client statement indicates to the nurse that teaching about this medication was effective?

"It might cause a metallic taste in my mouth."

A client with recurrent peptic ulcer disease asks, "How long do I have to take the medication?" Which response will the nurse make?

"Prophylactically for now."

A client with a peptic ulcer asks, "How does something that goes into my lungs, like smoking, affect my stomach?" Which response by the nurse is most appropriate?

"Smoking reduces the amount of bicarbonate needed to buffer stomach acid."

A client with peptic ulcer disease asks for pain medication. Which response will the nurse make?

"The medications for the ulcer will reduce the pain."

A client being treated for a peptic ulcer seeks medical attention for vomiting blood. Whic

"The pain stopped so I stopped taking the medications."

The nurse is preparing to visit the home of a client recovering from gastritis. Which information will the nurse prepare to instruct this client? Select all that apply.

-Methods to remember to take medication as prescribed -Adhering with the prescribed medication regimen -Findings that should be reported to the health care provider -Identification of foods and substances that cause the condition

Which of the following interventions are appropriate for clients with gastritis? Select all that apply.

-Use a calm approach to reduce anxiety. -Discourage cigarette smoking. -Notify the physician of indicators of hemorrhagic gastritis. -Provide general education about how to prevent recurrences.

The nurse is caring for a patient who has been diagnosed with gastritis. To promote fluid balance when treating gastritis, the nurse knows that what minimal daily intake of fluids is required?

1.5 L

A nursing student is preparing a teaching plan about peptic ulcer disease. The student knows to include teaching about the percentage of clients with peptic ulcers who experience bleeding. The percentage is

15%

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems?

Acute gastritis

A client has a family history of stomach cancer. Which factor would further increase the client's risk for developing gastric cancer? Select all that apply.

Age 55 years Previous infection with H. pylori

A client is admitted with a new onset of pyloric obstruction. What client symptoms should the nurse anticipate? Select all that apply.

Anorexia Nausea and vomiting Epigastric fullness

A young adult client is prescribed misoprostol to prevent gastric ulcers caused by frequent use of nonsteroidal anti-inflammatory agents for an autoimmune disorder. For which reason will the nurse question giving the client a dose of this medication?

Awaiting the results of a pregnancy test It is a pregnancy category X medication and should not be taken by a pregnant client as it can soften the cervix and result in miscarriage or premature labor.

The nurse is assessing a client with advanced gastric cancer. The nurse anticipates that the assessment will reveal which finding?

Bloating after meals

A client with active schizophrenia has developed acute gastritis after ingesting a strongly alkaline solution during a psychotic episode. Which emergency treatments should the nurse anticipate using with the client? Select all that apply.

Diluted lemon juice Diluted vinegar Emergency treatment consists of diluting and neutralizing the offending agent. To neutralize acids, common antacids (e.g., aluminum hydroxide) are used; to neutralize an alkali, diluted lemon juice or diluted vinegar is used. If corrosion is extensive or severe, emetics such as syrup of ipecac and lavage are avoided because of the danger of perforation and damage to the esophagus.

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist?

Endoscopy

TRUE/ FALSE Acute gastritis is a prolonged inflammation due to benign or malignant ulcers of the stomach.

FALSE

TRUE/ FALSE The most common site for a peptic ulcer formation is in the pylorus.

FALSE

Which medication is classified as a histamine-2 receptor antagonist?

Famotidine

The nurse is caring for a client experiencing unintentional weight loss and occasional abdominal pain. Which additional symptoms will the nurse expect to assess if the client has a tumor In the small intestine? Select all that apply.

Fatigue Nausea Vomiting Weakness

A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal?

Slows gastric emptying

A nurse is preparing to discharge a client newly diagnosed with peptic ulcer disease. The client's diagnostic test results were positive for H. pylori bacteria. The health care provider has ordered the "triple therapy" regimen. Which medications will the nurse educate the client on?

Proton-pump inhibitor and two antibiotics

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply.

Severe peptic ulcers Extreme gastric hyperacidity Gastrin-secreting tumors of the pancreas

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

Six small meals daily with 120 mL fluid between meals

A client recovering from a total gastrectomy has a low red blood cell count. Which medication will the nurse expect to be prescribed for this client?

Vitamin B12 injections

The nurse is creating a discharge plan of care for a client with a peptic ulcer. The nurse tells the client to avoid

decaffeinated coffee.

The nurse in the ED admits a client with suspected gastric outlet obstruction. The client's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order?

Nasogastric tube insertion

Tumors of the small intestine are uncommon, of these approximately 64% are __________________.

malignant

A client recovering from surgery for gastric cancer develops dumping syndrome. Which teachings will the nurse provide to reduce the symptoms of this condition? Select all that apply.

Ingest 6 small meals a day. Eat foods low in carbohydrates.

A client with a peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. Which statement by the client indicates the best understanding of the medication regimen?

"The medications will kill the bacteria and stop the acid production."

A nurse is monitoring a client with peptic ulcer disease. Which assessment findings would most likely indicate perforation of the ulcer? Select all that apply.

Tachycardia Hypotension A rigid, board-like abdomen

A client taking metronidazole for the treatment of H. pylori states that the medication is causing nausea. What teaching should the nurse provide to the client to alleviate the nausea?

Take the medication with meals to decrease the nausea.

The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following?

Duodenum

The nurse advises the patient who has just been diagnosed with acute gastritis to:

Refrain from food until the GI symptoms subside.

The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included in the care plan? Select all that apply.

-Frequently monitoring hemoglobin and hematocrit levels -Observing stools and vomitus for color, consistency, and volume -Checking the blood pressure and pulse rate every 15 to 20 minutes The nurse assesses the patient for faintness or dizziness and nausea, which may precede or accompany bleeding. The nurse must monitor vital signs frequently and evaluate the patient for tachycardia, hypotension, and tachypnea. Other nursing interventions include monitoring the hemoglobin and hematocrit, testing the stool for gross or occult blood, and recording hourly urinary output to detect anuria or oliguria (absence of or decreased urine production).

The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10% to 20% of clients is:

Hemorrhage

A client recovering from surgery to resect a gastric tumor reports abdominal cramping and diarrhea after eating. Which additional symptoms will the nurse use to determine if the client is experiencing dumping syndrome? Select all that apply.

Report of extreme hunger 3 hours after eating Sudden onset of extreme shakiness and fatigue

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

Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)