Gastrointestinal

A health care provider is about to perform a paracentesis on a client with abdominal ascites. The nurse should assist the client to assume which position?

Upright

A health care provider asks the licensed practical nurse (LPN) to reinforce preprocedure instructions to a client who will undergo a barium swallow (esophagography) in a few days. The LPN should include which instruction in this discussion?

Remove all metal and jewelry before the test.

The nurse analyzes the results of laboratory studies performed on a client with peptic ulcer disease (PUD). Which laboratory value would indicate a complication associated with the disease?

Hemoglobin 10.2 g/dL

The nurse is assisting with the insertion of a nasogastric tube into a client. The nurse should place the client in which position for insertion?

High-Fowler's position

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. Which data would further support this diagnosis?

History of chronic obstructive pulmonary disease with weight loss

A client presents to the urgent care center with complaints of abdominal pain. Suddenly the client vomits bright red blood. The nurse takes which immediate action?

Takes the client's vital signs.

The nurse is teaching a client who is newly diagnosed with a hiatal hernia about measures to prevent recurrence of symptoms. The nurse should make which accurate statement to the client?

"Be sure to sleep with your head elevated in bed."

A generally healthy 63-year-old man is seen in the health care provider's office for a routine examination. Which statement made by the client is important for the nurse to follow up on?

"Everyone in my immediate family has died from gastrointestinal cancer."

A sexually active 20-year-old client has developed viral hepatitis. Which statement made by the client would indicate a need for teaching?

"I can never drink alcohol again."

A client is seen in the ambulatory care office for a routine examination. Which statement by the client would be important for the nurse to follow up?

"I just lost a family member to gastrointestinal cancer."

The nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement made by the client supports the diagnosis of gastric ulcer?

"My pain comes shortly after I eat, maybe a half hour or so later."

The nurse is checking a client for the correct placement of a nasogastric (NG) tube. The nurse aspirates the client's stomach contents and checks its pH level. Which pH value indicates the correct placement of the tube?

3.5

A licensed practical nurse (LPN) is assisting in the insertion of a nasogastric (NG) tube for an adult client. The LPN helps determine the correct length to insert the tube by performing which measurement?

From the tip of the client's nose to the earlobe and then down to the xiphoid process

The nurse has been caring for a client with a Sengstaken-Blakemore tube. The health care provider arrives on the nursing unit and deflates the esophageal balloon. Following deflation of the balloon, the nurse should monitor the client closely for which?

Hematemesis

The nurse has been reinforcing dietary teaching for a client with gastroesophageal reflux disease (GERD) who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client?

A decrease in sour eructation

A client arrives at the emergency department and complains of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the health care provider's prescriptions. Which prescription should the nurse question if written on the health care provider's prescription form?

Administration of an opioid analgesic

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The nurse plans care, knowing that which problem occurs with this disorder?

Alteration in comfort related to abdominal pain

The nurse gathers data from a client admitted to the hospital with gastroesophageal reflux disease (GERD) who is scheduled for a Nissen fundoplication. Based on an understanding of this disease, the nurse determines that the client may be at risk for which complication?

Aspiration

The nurse is getting a client who underwent umbilical hernia repair ready for discharge. The nurse tells the client that it is important to continue to do which action after discharge?

Avoid coughing.

The nurse is reinforcing instructions to a client and his family about alcohol abuse and chronic cirrhosis. The nurse knows to include which essential elements in the discharge teaching guide? Select all that apply.

Avoid potentially hepatotoxic over-the-counter drugs Teach symptoms of complications and when to seek prompt medical attention Explain that cirrhosis of the liver is a chronic illness and the importance of continuous health care. Avoid spicy and rough foods and activities that increase portal pressure such as straining at stool, coughing, sneezing and vomiting.

A client has undergone esophagogastroduodenoscopy (EGD). The nurse places highest priority on which action as part of the client's care plan?

Checking for return of a gag reflex

The nurse is reinforcing medication instructions to a client with peptic ulcer disease. Which represents correct information given by the nurse?

Cimetidine (Tagamet) results in decreased secretion of stomach acid

The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to see documented in the record?

Diarrhea

The nurse is collecting data about how well a client with a gastrointestinal (GI) disorder is able to absorb food. While carrying out this function, the nurse recalls that absorption is defined as which?

The transfer of digested food molecules from the GI tract into the bloodstream

The nurse is evaluating the effect of dietary counseling on the client with cholecystitis. The nurse determines that the client understands the instructions given if the client states that which food item is acceptable to include in the diet?

Turkey and lettuce sandwich

The nurse is caring for a client with pneumonia with a history of bleeding esophageal varices. Based on this information, the nurse plans care, knowing that which could result in a potential complication?

Vigorous coughing

The nurse is caring for a client with a diagnosis of chronic gastritis. The nurse anticipates that the client is at risk for which vitamin deficiency?

Vitamin B12

The nurse is reinforcing discharge instructions to a client who has had a total gastrectomy. The nurse tells the client about the importance of returning to the health care clinic as scheduled for which priority assessment?

Vitamin B12 and folic acid studies

A client has undergone subtotal gastrectomy and the nurse is preparing the client for discharge. Which item should be included when reinforcing instructions to the client about ongoing self-management?

Smaller, more frequent meals should be eaten

A health care provider places a Miller-Abbott tube in a client who has a bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next?

Document the finding in the client's record.

A client is resuming a diet after partial gastrectomy. To minimize complications, the nurse should tell the client to avoid which practice?

Drinking liquids with meals

The nurse is reinforcing dietary instructions for a client with peptic ulcer disease. Which action does the nurse encourage the client to do?

Eat anything as long as it does not aggravate or cause pain

A client with acute pancreatitis is experiencing severe pain. After noting an absence of an analgesic prescription on the health care provider prescription sheet, the nurse should suggest contacting the health care provider to request a prescription for which medication?

Hydromorphone (Dilaudid)

The nurse is reinforcing dietary instructions for a client with peptic ulcer disease. Which statement made by the client indicates a need for further teaching?

I will eat a bland diet only.

The nurse is caring for a client with acute pancreatitis and a history of alcoholism and is monitoring the client for complications. Which data should be indicative of paralytic ileus?

Inability to pass flatus

A client is admitted to the hospital with viral hepatitis and is complaining of a loss of appetite. In order to provide adequate nutrition, which action does the nurse encourage the client to take?

Increase intake of fluids.

An acutely ill looking client arrives at the emergency department. The client complains of "the worst pain I ever felt in my belly. I can't get comfortable." The client is quiet but with each movement the client cries out in pain. The nurse suspects the client has peritonitis. Which data should the nurse collect to assist in validating this suspicion? Select all that apply.

Inspect the abdomen for rigidity. Check for the presence of hiccups. Inspect the client's mucous membranes.

The nurse should include which information when reinforcing home care instructions for a client who has peptic ulcer disease?

Learn to use stress reduction techniques

The nurse should include which instruction in a teaching plan for a client who has peptic ulcer disease?

Learn to use stress reduction techniques.

A client with hiatal hernia chronically experiences heartburn after meals. Which should the nurse teach the client to avoid?

Lying recumbent after meals

The nurse is caring for a client within the first 24 hours following a total gastrectomy for gastric cancer. During this time frame, on which intervention should the nurse focus?

Maintaining a patent nasogastric (NG) tube

A client arrives at the emergency department complaining of severe abdominal pain and is placed on NPO status. During a quick assessment the nurse observes that the client has both Cullen's sign and Grey Turner's sign and pancreatitis is suspected. The nurse should perform the following actions/prescriptions in which priority order? Arrange the actions in the order they should be performed. All options must be used.

Obtain vital signs and draw blood for laboratory analysis. Ensure the client receives intravenous pain medication. Hydrate the client with intravenous fluids. Place a nasogastric tube. Client is NPO (nothing by mouth). Inquire about when pain occurs and previous history including medications and alcohol.

The nurse is performing an abdominal assessment on a client. The nurse interprets that which finding is abnormal and should be reported to the registered nurse (RN) or health care provider?

Pulsation between the umbilicus and pubis

A client is admitted to the hospital with a bowel obstruction secondary to a recurrent malignancy, and the health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, which is the nurse's best action?

Remain with the client and be silent

The nurse is admitting a client to the hospital for the treatment of dehydration. The client reports nausea, vomiting, diarrhea, and cramping for the past week. The nurse asks the client about medications he is taking. The client denies taking prescription medications but states he has been taking some herbs given to him by his cousin. The nurse alerts the health care provider when the client states he has been taking which herb?

Senna

The nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The nurse notes that the pH is 5. Which information does this indicate?

Placement of the NG tube is accurate.

A client with viral hepatitis has no appetite, and food makes the client nauseated. Which nursing intervention should be appropriate?

Offer small, frequent meals.

A morbidly obese client, 3 days postoperative gastric bypass surgery, comes to the clinic complaining of pain. The nurse suspects that the client has an anastomotic leak requiring hospitalization. Which findings validate this suspicion? Select all that apply.

Oliguria Restlessness Abdominal pain Unexplained tachycardia

A client is admitted to the hospital with severe jaundice and is having diagnostic testing. Because the client has no complaints of fatigue, the client is encouraged to ambulate in the hall to maintain muscle strength. The client paces around the room but will not enter the hall. Which problem most likely is the reason for the client's reluctance to walk in the hall?

Feeling self-conscious about appearance

A client has been diagnosed with chronic gastritis and has been told that there is too little intrinsic factor being produced. The nurse tells the client that which therapy will be prescribed to treat the problem?

Vitamin B12 injections