GI 1
What instructions will the nurse provide to a client with a gastrointestinal problem who is scheduled for an abdominal x-ray?
"wear a hospital gown and remove any jewelry or belts"
Which interventions will the nurse include when care of a client with peritonitis is focused on restoring fluid volume balance? Select all that apply.
-administering IV isotonic fluids and broad spectrum antibiotics -assigning the AP to weigh the client daily and record intake and output -providing NGT care and keeping the stomach decompressed -maintaining the client on NPO status while the NGT is in place to low suction -assessing whether the client retains fluid used for irrigation by comparing and recording the amount of fluid returned with the amount of fluid instilled
What procedural teaching will the nurse provide for a client scheduled for an abdominal CT scan with contrast? Select all that apply.
-an IV line will be placed for injection of the contrast -the CT technician may ask you to hold your breath while images are taken -you may feel warm and flushed, and may experience a metallic taste with the injection -if you are claustrophobic, you can be given a mild sedative before the procedure
Which teaching points will the nurse include when instructing a client about preparation for a colonoscopy? Select all that apply.
-avoid taking aspirin, nsaids, or anticoagulants for several days before the test -do not eat or drink for 4 to 5 hrs before the test -drink only clear liquids the day before the colonoscopy -an IV will be placed to give medication to help you relax during the procedure
Which signs and symptoms will the nurse assess when a client is diagnosed with oral cancer? Select all that apply.
-bleeding from the mouth -difficulty chewing or swallowing -thick or absent saliva -thickening or lump in cheek
Which drugs will the nurse expect the health care provider to prescribe for a client after esophageal trauma? Select all that apply.
-broad spectrum antibiotics -corticosteroids -pain medications -viscous lidocaine
Which actions will the nurse include when providing care for a client after a colonoscopy procedure? Select all that apply.
-checking vital signs every 15 to 30 mins until the client is alert -keeping client in left lateral position to promote passing of flatus -assessing for signs and symptoms of bowel perforation, including severe abdominal pain and guarding -preventing the client from taking anything by mouth until sedation wears off -keeping the top side rails up until the client is alert
Which clients will the nurse carefully assess for high risk of oral cavity disorders? Select all that apply.
-clients who are homeless or live in institutions -clients who are developmentally disabled -clients who consume an unhealthy diet -clients who regularly use tobacco or alcohol
Which postoperative instructions will the nurse provide for a client after laparoscopic Nissen fundoplication (LNF)? Select all that apply.
-consume a soft diet for about a week; avoid carbonated beverages, tough foods, and raw vegetables that are difficult to swallow -you must not drive for a week after surgery; especially do not drive after taking an opioid pain medication -walk every day but do not do any heavy lifting -report a fever above 101 F, nausea, vomiting, or uncontrollable bloating or pain
In collaboration with the registered dietitian nutritionist, which nutrients and substances will the nurse instruct a client with ulcerative colitis (UC) to avoid to reduce symptoms? Select all that apply.
-corn -caffeine -dried fruits -dairy products -pepper based spices
Which gastrointestinal (GI) changes will the nurse expect in an older client with a GI problem? Select all that apply.
-decreased absorption of iron and vitamin b12 -decreased peristalsis with constipation -decreased lipase with decreased fat digestion -decreased drug metabolism with risk of toxicities
Which laboratory assessment findings will the nurse expect in a client who is diagnosed with ulcerative colitis?
-decreased hemoglobin -decreased potassium -elevated WBC count -elevated erythrocyte sedimentation rate
Which actions will the nurse teach a client with GERD to use to prevent harm? Select all that apply.
-do not consume caffeinated or carbonated beverages -avoid peppermint, chocolate, and fried foods -eat slowly and chew food thoroughly -consume four to six small meals each day -do not eat for 3 hours before going to bed
Which actions will the nurse teach a client with severe GERD that causes pain after each meal, lasts for at least 45 minutes, and worsens when he or she lies down? Select all that apply.
-drink fluids right away -take an antacid as prescribed by the healthcare provider -maintain an upright position for at least an hour after you eat
Which actions will the nurse teach a client to avoid to prevent harm after Nissen fundoplication surgery when gas bloat syndrome occurs? Select all that apply.
-drinking carbonated beverages -eating gas-producing foods -chewing gum -drinking through a straw
Which are the most common symptoms of gastroesophageal reflux disease (GERD) reported to the nurse by a client? Select all that apply.
-dyspepsia -regurgitation
Which important information will the nurse include when teaching clients how to maintain healthy oral cavities? Select all that apply.
-eat a well balanced diet and stay hydrated by drinking water -if you wear dentures, make sure that they are in good repair and fit properly -thoroughly brush and floss your teeth (or brush dentures) consistently twice daily -see the dentist regularly and have dental problems repaired as soon as possible
Which signs and symptoms will the nurse expect to assess when a client is diagnosed with a paraesophageal hernia? Select all that apply.
-feeling of fullness (after eating) -breathlessness (after eating) -chest pain that mimics angina
Which disease features will the nurse commonly associate with a client who has Crohn disease (CD) that are rare or absent in a client with ulcerative colitis (UC)? Select all that apply.
-fistulas commonly develop -clients have five to six soft, loose, nonbloody stools per day -the appearance of the affected intestine areas resemble cobblestone
For which abnormal laboratory findings will the nurse monitor when providing care for a client with acute pancreatitis? Select all that apply.
-increased serum lipase -increased serum amylase
Which actions will the nurse perform when caring for a client with acute appendicitis before surgical management? Select all that apply.
-maintaining the client on NPO status -administering IV fluids as prescribed -advising the client to maintain semi fowlers position -giving adequate medications to control the clients pain
Which findings will the nurse be sure to document after inspecting a client's abdomen during assessment? Select all that apply.
-overall asymmetry of the abdomen -discoloration or scarring -abdominal distention and skin folds -location and size of pressure injuries
Which important information will the nurse include when teaching a client about peritonitis? Select all that apply.
-peritonitis is caused by contamination of the peritoneal cavity by bacteria or chemicals -respiratory problems associated with peritonitis are related to increased abdominal pressure against the diaphragm -chemical peritonitis is caused by leakage of pancreatic enzymes or gastric acids -when the peritoneal cavity is contaminated by bacteria, the body begins an inflammatory reaction, walling off a localized area to fight the infection
Which important information will the nurse gather when a client reports a change in bowel habits? Select all that apply.
-presence of abdominal distention or gas -occurrence of diarrhea or constipation -color and consistency of feces -presence of bloody or tarry stools
About which pancreatic functions will the nurse teach a client with a gastrointestinal (GI) disorder? Select all that apply.
-producing glucagon from the endocrine part of the organ -secreting enzymes for digestion from the exocrine part of the organ -producing enzymes that digest carbohydrates, fats, and proteins -beta cells producing insulin
Which care actions does the nurse expect to perform when caring for a client who had an appendectomy with an abscess? Select all that apply.
-providing care for wound drains inserted during surgery -administering IV antibiotics as prescribed by the surgeon -assessing the NGT position and drainage -helping the patient out of bed on the evening of surgery
Which actions will the nurse assign to the assistive personnel (AP) who will be helping to care for a client with stomatitis? Select all that apply.
-providing oral care every hrs or more if stomatitis is not controlled -encouraging frequent rinsing of the mouth with warm saline, sodium bicarbonate (baking soda) solution, or a combination of these solutions -removing dentures if the client has severe stomatitis or oral pain
Which nonsurgical treatment options for cancer of the esophagus will the nurse discuss with the client? Select all that apply.
-swallowing therapy -nutritional therapy -chemoradiation -photodynamic therapy -esophageal dilation
Which assessment findings on a client with peritonitis indicate to the nurse the probability that the fluid shift into the peritoneal cavity is continuing? Select all that apply.
-tachycardia -decreasing urine output -skin tenting over the forehead and sternum
When the nurse is providing discharge instructions for a client recovering from peritonitis, which essential findings will the client and family be instructed to report immediately to the primary health care provider? Select all that apply.
-unusual or foul smelling drainage -signs of wound dehiscence or ileus -swelling, redness, warmth, or bleeding from the incision site -a temp higher than 101 -abdominal pain or board like stiffness in the abdomen
Which actions will the nurse teach a client to take to prevent the spread of gastroenteritis? Select all that apply.
-washing hands well for at least 30 secs -using easily accessible hand sanitizers -sanitizing all surfaces that may be contaminated
Which common signs and symptoms will the nurse expect to find on assessment of a 60-year-old client who has had gastroenteritis for the past 2 days? Select all that apply.
-weight loss -elevated temperature -dry mucous membranes -hypotension -oliguria -poor skin turgor
Which client with symptoms of chronic abdominal pain and frequent bowel movements will the nurse consider at highest risk for a diagnosis of ulcerative colitis (UC)?
26 yr old white woman of Jewish ancestry who has an identical twin sister with the disorder
Which client does the nurse assess as at highest risk for development of esophageal cancer?
55 yr old who smokes and is 25 lbs overweight
Which surgical client will the nurse recognize as having the highest risk for development of peritonitis?
72 yr old having a bowel resection for colon cancer
Which lunch food selection made by a client with diverticulosis indicates to the nurse the correct understanding of the necessary dietary modifications for management of the problem?
a turkey sandwich on whole wheat bread, steamed carrots, and a raw apple
Which cardinal signs will the nurse expect to assess in a client diagnosed with peritonitis?
abdominal pain with distention and tenderness
Which most accurate diagnostic test will the nurse expect to be ordered for a client to verify the diagnosis of GERD?
ambulatory esophageal pH monitoring
What does the nurse suspect when a client comes into the emergency department (ED) with right lower quadrant cramping pain, nausea, vomiting, and guarding with rigidity of the abdomen?
appendicitis
What is the most important assessment for the nurse to perform before administering the first dose of sulfasalazine to a client diagnosed with ulcerative colitis?
asking whether he or she has an allergy to sulfa drugs
Which diagnostic test will the nurse expect the client to undergo to best identify a hiatal hernia?
barium swallowing with fluoroscopy
What is the nurse's best response when a client asks which diagnostic test will determine if an oral tumor is cancerous?
biopsy is the definitive method for diagnosing oral cancer
For which finding does the nurse alert the health care provider immediately after assessing a client's abdomen?
bulging, pulsating mass
When the nurse collects a client's gastrointestinal (GI) history, which substances are most likely to be risk factors for peptic ulcer disease or GI bleeding? Select all that apply.
caffeine aspirin alcohol ibuprofen
Which oral disorder does the nurse suspect when assessment findings reveal white plaquelike lesions that when wiped away show an underlying red and sore surface?
candidiasis
Which cause does the nurse recognize as a potential intentional cause for a client's esophageal trauma?
chemical injury
Based on the nurse's knowledge of gastrointestinal (GI) changes that occur with age, for which disorder in an older client will the nurse vigilantly monitor related to decreased peristalsis?
constipation with possible impaction
For which client assessment finding will the nurse withhold the scheduled monthly dose of a prescribed parenteral biologic for management of ulcerative colitis (UC)?
cough and fever of 102
How does the nurse expect a client's nasogastric (NG) tube drainage to appear immediately after Nissen fundoplication surgery?
dark brown
What does the nurse expect when a client's parietal cells do not produce enough intrinsic factor?
development of pernicious anemia
What is the most common symptom the nurse expects clients with esophageal cancer to report?
difficulty with swallowing
Which drug will the nurse be sure to question to prevent harm when prescribed for an older adult with gastroenteritis?
diphenoxylate hydrochloride with atropine sulfate
Which question will the nurse be sure to ask a client suspected of having leukoplakia?
do you smoke, dip, or chew tobacco products?
What is the nurse's best action when assessment of a client 2 hours after abdominal surgery reveals hypoactive bowel sounds?
documenting the finding and continue to monitor
Which diagnostic procedure does the nurse expect will be ordered by the health care provider to view a client's liver, gallbladder, bile ducts, and pancreas for identification of the location of an obstruction?
endoscopic retrograde cholangiopancreatography
What does the nurse suspect when assessing a client's mouth and finding an oral cavity tumor that appears as a red, velvety lesion on the tongue, palate, floor of the mouth, or mandibular mucosa?
erythroplakia
Which nonsurgical treatment will the nurse expect the client with esophageal cancer to receive for immediate relief of dysphagia?
esophageal dilation
Which gastrointestinal condition does the nurse suspect a client is at increased risk for, when she reports emotional distress about her family situation and whether she will be able to return to work?
exacerbation of irritable bowel syndrome
Which drug does the nurse expect to administer to a client in order to decrease hydrochloric acid secretion in the stomach?
famotidine
The nurse reviews a client's laboratory values and discovers a serum potassium level of 3.1 mEq/L. Which gastrointestinal condition could cause this value?
gastric suctioning
What type of bowel sounds will the nurse expect to auscultate when a client reports having diarrhea for the past 2 days?
increased loud and gurgling sounds
Which laboratory finding will the nurse expect to see in a client who is suspected of having an acute, uncomplicated appendicitis?
increased white blood cell count
Which statement by a client with gastroenteritis due to infection with the norovirus indicates that the nurse's teaching about this illness has been successful?
it is most likely that I got this infectious illness from either contaminated food or water
What is the nurse's first priority when providing care for a client after an esophagogastroduodenoscopy (EGD)?
keeping the client NPO until the gag reflex returns
Which priority teaching will the nurse provide to prevent harm when a client with an oral problem is prescribed viscous lidocaine?
lidocaine causes an anesthetic effect so you may not feel burns from hot liquids
Which complication will the nurse suspect when a client with peritonitis reports increased pain in the upper left abdominal quadrant and in the left shoulder, especially during inhalation?
localized abscess
Which action is the priority for the nurse to take when caring for clients with oral cancers?
maintaining the airway
What is the nurse's priority assessment when a client is given IV midazolam hydrochloride before a colonoscopy?
monitoring the rate and depth of respirations
What is the nurse's best first action when the stoma of a client who had a permanent ileostomy placed 2 days ago now has a dark bluish-purple appearance?
notifying the surgeon immediately
What manifestation of esophageal cancer does the nurse recognize when a client describes experiencing a dull and steady substernal pain after drinking cold liquids?
odynophagia
For which reason will the nurse carefully examine the mouth of an older adult for candidiasis?
older adults immune systems decline with aging increasing their risk for candidiasis
Which priority teaching will the nurse provide to an older client with GERD who is prescribed omeprazole for symptom relief?
older adults taking this drug may be at increased risk for hip fracture because it interferes with calcium absorption
Which serum laboratory value is most important for the nurse to monitor when caring for an older client with gastroenteritis who has an irregular heart rate and reports "feeling weak?"
potassium
For which gastrointestinal diagnostic test does the nurse teach a client to expect mild gas pain, flatulence, and a small amount of bleeding after the procedure if a biopsy was obtained?
proctosigmoidoscopy
Which new-onset assessment finding in a client with Crohn disease (CD) indicates to the nurse the possibility of fistula development?
pyuria with fever
Which action will the nurse instruct a client with celiac disease to perform to reduce symptoms?
reading labels on prepared foods
After esophagectomy for esophageal cancer, what is the nurse's priority for client care?
respiratory care
In which position will the nurse place a client with peritonitis to promote comfort and prevent harm from potential complications?
semi-fowler
To prevent harm after a surgical procedure for peritonitis, which action will the nurse teach a client to avoid?
taking additipnal acetaminophen to prevent liver toxicity
Which action is appropriate for the nurse to take to prevent harm when caring for a client with ulcerative colitis who has undergone a total proctocolectomy with placement of a permanent ileostomy?
using a skin barrier to prevent excoriation
For what priority information will the nurse ask next after a client reports decreased appetite, decreased nutritional intake, and episodes of nausea over the past 2 months?
usual weight and weight loss
