Chapter 46: Management of Patients with Gastric and Duodenal Disorders

A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client?

"Be sure to wear sunscreen while taking this medicine."

A client with an H. pylori infection asks why bismuth subsalicylate is prescribed. Which response will the nurse make?

"It aids in the healing of the stomach lining."

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.)

"It can be caused by ingestion of strong acids.", "You may have ingested some irritating foods." "Is it possible that you are overusing aspirin."

A client being treated for a peptic ulcer seeks medical attention for vomiting blood. Which statement indicates to the nurse the reason for the client developing hematemesis?

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

The nurse is caring for a client with hypovolemia related to prolonged vomiting and decreased intake of oral fluids. What activity(ies) should the nurse include in the client's plan of care? Select all that apply

-Monitor weight daily, -Assess skin turgor and mucous membranes

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply

-Nizatidine - Famotidine - Cimetidine

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

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?

A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum

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 with chronic peptic ulcers is considering a vagotomy. Which information will the nurse provide to the client about this surgical procedure?

Adverse effects such as dumping syndrome and gastritis can occur

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse?

Assess the client's abdomen and vital signs

A client with peptic ulcer disease has a blood pressure of 88/40 mm Hg, dizziness, and nausea. Which complication will the nurse suspect is occurring with this client?

Bleeding from the ulcer

A client sustained second- and third-degree burns over 30% of the body surface area approximately 72 hours ago. What type of ulcer should the nurse be alert for while caring for this client?

Curling's Ulcer

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

Which of the following appears to be a significant factor in the development of gastric cancer?

Diet

Clients with Type O blood are at higher risk for which of the following GI disorders?

Duodenal ulcers

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

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

Famotidine

The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage?

Hematemesis

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During the assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed?

Hemorrhage

Which of the following is the most common complication associated with peptic ulcer?

Hemorrhage

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 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 is newly diagnosed with a gastric outlet obstruction. Which topic will the nurse include in client education?

Management of Constipation

The nurse visits the home of a client recovering from acute gastritis. Which observation indicates that teaching about the disorder was effective?

Medications placed in a pillbox

Which is a true statement regarding gastric cancer?

Most clients are asymptomatic during the early stage of the disease

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

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer.

Omeprazole

Which medication classification represents a proton (gastric acid) pump inhibitor?

Omeprazole

Which of the following medications is classified as a proton pump inhibitor (PPI)?

Omeprazole

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition?

Peptic ulcers

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate?

Perforation of the peptic ulcer

Which of the following is the most successful treatment for gastric cancer?

Removal of the tumor

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 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

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 group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

alcohol abuse and smoking

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description?

black and tarry

Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following?

mental confusion

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience

pain 2 to 3 hours after a meal