Care GI

A nurse is providing care for a client who has a diagnosis of irritable bowel syndrome (IBS). When planning this client's care, the nurse should collaborate with the client and prioritize what goal?

Patient will accurately identify foods that trigger symptoms

During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase X in abdominal girth from distension. What complication of this procedure is the nurse aware may be occurring?

Perforation

The nurse is preparing to check for tube placement in the client's stomach as well as measure the residual volume. What is the main purpose of these nursing actións?

Prevent Aspiration

A client has an open traditional hiatal hernia repair this morning. What is the nurse's priority for client care at this time?

Preventing Respiratory Complications

The management of the client's gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the client is managing the tube correctly?

"I flush my tube with water before and after each of my medications."

A client has experienced symptoms of dumping syndrome following gastric surgery. To what physiologic phenomenon does the nurse attribute this syndrome?

A sudden release of peptides....

What health teaching will the nurse include to promote gastric health for an adult client? (Select all that apply.)

A. "Stop smoking or using tobacco of any form." B. "Do not drink excessive amounts of alcohol." D. "Avoid excessive amounts of pickled or smoked food." E. "Avoid taking large amounts of NSAIDs."

Immediately following a colonoscopy, which client behavior will the nurse report to the health care provider? (Select all That apply.)

Abdominal guarding Change in mental status

A patient's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather than ulcerative colitis, as the cause of the patient's signs and symptoms?

Absence of blood in the stool

When the nurse is listening to a patient's abdomen, which finding indicates a need for a focused abdominal assessment?

Absent Bowel Sounds

The nurse is planning client teaching for a client who is scheduled for an open colectomy. The nurse intends to address the topics of incision splinting and leg exercises during this teaching session. When is the best time for the nurse to provide teaching?

As soon an possible before the procedure

A nurse is providing care for a client with a diagnosis of late-stage Alzheimer disease. The client has just returned to the medical unit to begin supplemental feedings through an X NG tube. Which of the nurse's assessments addresses this client's most significant potential complication of feeding?

Aspiration Pneumonia

A nurse is having difficulty arousing a client following an esophagogastroduodenoscopy (EGD). Which of the following is the priority action by the nurse?

Assess respiratory status

A nurse is assessing a client's bowel sounds. At which of the following points in the assessment should the nurse auscultate the client's abdomen?

Auscultate before percussion

A nurse is caring for a client who has a prescription for a stool test for guaiac. The nurse understands the purpose of the test is to check the stool for which of the following substances?

Blood

A nurse assesses a patient who is recovering from an ileostomy placement. Which clinical manifestation would alert the nurse to urgently contact the health care provider?

Bluish purple stoma

A patient is scheduled for a fiberoptic colonoscopy. What does the nurse know that the fiberoptic colonoscopy is most frequently used to diagnose?

Cancer

The client with Crohn's disease is prescribed total parenteral nutrition (TPN). Which intervention should the nurse implement?

Check client glucose level

A client's new onset of dysphagia has required insertion of an NG tube for feeding; the nurse has modified the client's care plan accordingly. What intervention should the nurse include in the client's plan of care?

Confirm Placement of the tube

A nurse teaches a patient who has viral gastroenteritis. Which dietary instruction would the nurse include in this patient's teaching?

Drink plenty of fluids to prevent dehydration

The client has been seen by the health-care provider and the suspected diagnosis is peptic ulcer disease. Which diagnostic test would confirm this diagnosis?

EGD

A nurse is providing care for a client whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention best addresses this diagnosis?

Encourage the patient in the care of the ostomy to the extent that the patient is willing

The nurse plans teaching for a patient with a colostomy, but the patient refuses to look at the nurse or the stoma, stating"I just can't see myself with this thing". An appropriate nursing diagnosis for the patient is

Encourage the patient to share concerns and ask questions

A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which Most Frequent complication of this type of

Fluid and electrolyte imbalance

A nursing instructor asks the student to identify the bowel disorder which occurs when a portion of the bowel protrudes into weak or abnormal openings. The student identifies this as

Hernia

The client diagnosed with Crohn's disease is crying and tells the nurse, "I can't take it anymore. I never know when I will get sick and end up here in the hospital." Which statement would be the nurse's best response"

I can see you are very upset. Let me sit down and we can talk.

The nurse is admitting a client with traumatic injuries who also has obesity. When planning this client's care, the nurse should address the client's heightened risk of what nursing diagnoses related to obesity? Select all that apply.

Impaired skin integrity Impaired gas exchange

A client had an exploratory laparotomy to treat the cause of peritonitis and has a large incision that is closed with staples and two abdominal drains. Which finding(s) would the X nurse report immediately to the surgeon? (Select all that apply.)

Increased abdominal distension Fever and Chills

A client has been admitted to the hospital after diagnostic imaging revealed the presence of a gastric pyloric obstruction. What is the nurse's priority intervention?

Insert an NG tube for decompression

A nurse is preparing to place a client's prescribed nasogastric tube. What anticipatory guidance should the nurse provide to the client?

Insertion is likely to cause some gagging

The nurse is preparing to perform a client's abdominal assessment. What examination sequence should the nurse follow?

Inspect, Auscultate, Percuss, Palpate

A nurse is caring for a client with a nasogastric tube for feeding. During shift assessment, the nurse auscultates a new onset of bilateral lung crackles and notes a respiratory rate of 30 breaths per minute. The client's oxygen saturation is 89% by pulse oximetry. After ensuring the client's immediate safety, what is the nurse's most appropriate action?

Notify Provider - Aspiration Pneumonia

The nurse is caring for a patient with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the patient's abdomen is tense and rigid. What action takes priority?

Notify the health care provider

The client diagnosed with acute diverticulitis is complaining of severe abdominal pain. On assessment, the nurse finds a hard, rigid abdomen and temperature of 102°F. Which intervention should the nurse implement?

Notify the provider, Peritonitis

The nurse is caring for a client with a complete large bowel obstruction. What assessment findings would the nurse expect? (Select all that apply.)

Obstipation Abdominal Distension Abdominal Pain

A nurse cares for a client who is recovering from a colonoscopy. Which actions would the nurse take? (Select all that apply.)

Obtain vital signs every 15 to 30 minutes until alert. Assess the client for rectal bleeding and severe pain Make sure client has a ride home arranged

A nurse is caring for a client who is receiving a Total Parenteral Nutrition (TPN) solution. The current bag of solution was hung 24 hours ago, and 400 mL remains to infuse. Which of the following is the appropriate action for the nurse to take?

Remove the old bag and hang the new one

A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client's care plan?

Return of the gag reflex

Which assessment data would indicate to the nurse that the client's gastric ulcer has perforated?

Rigid, boardlike abdomen with rebound tenderness

A 16-year-old presents at the emergency department reporting right lower quadrant pain and is subsequently diagnosed with appendicitis. When planning this client's nursing • care, the nurse should prioritize what nursing diagnosis?

Risk for infection related to possible ruptured appendix

A nurse is caring for a patient hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize?

Strategies to avoid irritating foods and beverages

A client experiencing right lower abdominal pain has just returned from a colonoscopy. The nurse would report which of the following symptoms to the physician?

Streaks of blood on the toilet paper

The nurse is collecting a stool specimen from a patient. What characteristic of the stool indicates to the nurse that the patient may have an upper GI bleed?

Tarry Dark, Melena

A nurse in a clinic is instructing a client about a fecal occult blood test, which requires mailing three specimens. Which of the following statements by the client indicates understanding?

This is an easy way to screen for colon cancer

A client is admitted with severe abdominal pain. Radiographic studies revealed a bowel twisted upon itself. The nurse continues the education of the patient of the doctor's description of a

Volvulus

A nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics?

Watery with blood and mucus