GI III

The nursing student is caring for a patient with chronic pancreatitis who is receiving pancreatic enzyme replacement therapy, which statement by the student indicates the need for further study concerning this therapy?

If the patient has difficulty swallowing the enzyme preparation, I will mix it with foods containing protein

Which patient is at low risk for the development of gallbladder disorder?

Patient who is 20 years old and male

The nurse is evaluation electrolyte values for a patient with acute pancreatitis and notes that the serum calcium is 6.8 mEq/L, how does the nurse interpret this finding?

The result of the body not being able to use bound calcium

An 18-year-old is admitted with an acute onset of right lower quadrant pain at McBurney's point, appendicitis is suspected, for which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis?

Rebound tenderness

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism, the client asks what does my drinking have to do with my diagnosis, what effect of alcohol should the nurse include when responding?

Increases in enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

Which condition is most likely to be treated with antibiotics?

Acute necrotizing pancreatitis

Which statement about the care of a patient with T tube after a cholecystectomy is true?

Avoid raising the drainage system above the level of the gallbladder

A client who had surgery for a ruptured appendix develops Peritonitis . Which clinical findings related to peritonitis should the nurse expect the client to exhibit? Select all that apply

Fever, abdominal muscle rigidity

Which factor renders a patient the least likely to benefit from ESWL for the treatment of gallstones?

Height 5 feet 10 inches, 250 lbs

The daughter of a patient with cholelithiasis has heard that there is a genetic disposition for cholelithiasis. The daughter asks the nurse about the risk factors, how does the nurse respond?

Hormone replacement therapy has been associated with increased risk for cholecystitis

The nurse has instructed the patient in the recovery phase of acute pancreatitis about diet therapy, which statement by the patient indicates that teaching has been successful?

I will avoid eating chocolate

A client is returned to the surgical unit after an abdominal cholecystectomy, what is the main reason why the nurse should assess for clinical indicators of respiratory complications?

Incision is in close proximity to the clients diaphragm

Which statements are true regarding laparoscopic cholecystectomy?

Laaroscopic cholecystectomy is considered the gold standard and is performed far more often than the traditional open approach, Removing the gallbladder with the laparoscopic technique reduces the risk of wound complications, patients who have their gallbladder removed by the laparoscopic technique should be taught the importance of early ambulation to promote absorption of carbon dioxide, use of open surgical approach has greatly declined during the past 15 years

Which diagnostic test is the most accurate in verifying a diagnosis of acute pancreatitis?

Lipase

The nurse on a medical surgical unit is caring for several patients with acute cholecystitis, which task is best to delegate to the nursing assistant?

Obtain the patients vital signs

Which type of drug is used to treat acute biliary pain?

Opioids (morphine)

Before a cholecystectomy, vitamin K is prescribed, which element, should the nurse determine is the purpose of administering this medication?

Prothrombin

A patient is admitted to the unit with obstructive jaundice, which signs/symptom does the nurse expect to find upon assessment of the patient?

Pruritus

A client had surgery for perforated appendix with localized peritonitis, in which positions of should the nurse place this client?

Semi fowlers

You are providing postop care for a client who underwent laparoscopic cholecystectomy, what should be reported immediately to the physician?

The client reports right upper quadrant pain and tenderness

A patient is scheduled for tests to verify the medical diagnosis of cholecystitis, for which diagnostic test does the nurse provide patient teaching?

Ultrasonography of the right upper quadrant

A client underwent an exploratory laparotomy 2 days ago, the physician should be called immediately for which physical assessment finding?

Abdominal distention and rigidity

A client is admitted with tentative diagnosis of pancreatitis, the medical and nursing measures for this client are aimed towards maintaining nutrition, promoting rest, maintaining fluid and electrolyte balance and decreasing anxiety. Which intervention should the nurse implement? select all

Administer analgesics, teach relaxation exercises, monitor cardiac rate and rhythm

A patient with acute pancreatitis is at risk for the development of paralytic ileus, which action provides the nurse with the beset indication of bowel function?

Asking the patient if he or she has passed flatus or had a stool

A nurse is preparing a teaching plan for a client with a history of cholelithiasis, which information about why the ingestion of fatty foods will cause discomfort should the nurse include in the teaching plan?

Bile flow into the intestine is obstructed

Which clinical indicator should the nurse identify before scheduling a client for an endoscopic retrograde cholangiopancreatography (ERCP)?

Bilirubin level

For which clinical indicator should the nurse monitor when caring for a client with cholelithiasis and obstructive jaundice ?

Dark urine, yellow skin, clay colored stool

A client with a history of pancreatitis is scheduled for surgery to excise a pseudocyst of the pancreas. The client asks what a pseudocyst is, what information should the nurse include in a response to this question?

Dilated space of necrotic tissue and blood

A nurse is caring for a client with cholelithiasis and obstructive jaundice, when assessing this client, the nurse should be alert for which common clinical indicators associated with these conditions?

Ecchymosis, yellow sclera, pain in right upper quadrant

The nurse is caring for an older adult patient with acute biliary pain, which drug order does the nurse question?

Erlotinib (Tarceva)

The nurse is administering meperidine to a 78 year old patient for pain management, which assessment finding indicates the patient is experiencing a side effect of this drug?

seizure