GI System Assessment ch 44

"It indicates if a cancer is present."

A client asks the nurse why the health care provider ordered the blood test carcinoembryonic antigen (CEA). The nurse answers:

"Your appendix doesn't play a major role, so you won't notice any difference after you recovery from surgery."

A client diagnosed with appendicitis is scheduled for an appendectomy. How should the nurse best respond when questioned about the postoperative effects of living without an appendix?

Digestion of proteins

A client diagnosed with cystic fibrosis takes pancreatic enzyme replacements on a regular basis. The client's intake of trypsin facilitates what aspect of gastrointestinal (GI) function?

Apply local anesthetic to the back of the client's throat. Provide moderate sedation as prescribed

A client experiencing recurrent hematemesis is scheduled for upper gastrointestinal fibroscopy (UGF). Which action(s) will the nurse implement to prepare the client? Select all that apply.

Colonoscopy

A client has come to the outpatient radiology department for diagnostic testing that will allow the care team to evaluate and remove polyps. The nurse should prepare the client for what procedure?

"Abdominal ultrasound poses no known safety risks of any kind."

A client has presented to the emergency department with right upper quadrant pain; the health care provider has ordered abdominal ultrasound to rule out cholecystitis. The client expresses concern to the nurse about the safety of this diagnostic procedure. How should the nurse best respond?

Streaks of blood present in the stool

A client has returned to the medical unit after a barium enema. When assessing the client's subsequent bowel patterns and stools, what finding would warrant reporting to the health care provider?

"Do not take any NSAIDs within 72 hours of the test."

A client has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should give what instructions to the client?

Persistently low hemoglobin An abnormally low hematocrit

A client is assessed for a suspected deficit in intrinsic factor synthesis. Which diagnostic or assessment finding(s) is/are the most likely rationale(s) for this examination?

Provide cleansing enemas until clear Maintain nothing by mouth until after the test

A client is scheduled for a barium enema later in the day. Which actions will the nurse take to prepare the client on the morning of the test? Select all that apply.

Cancer

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

common bile duct, pancreatic duct, and biliary tree

A client is scheduled to have an endoscopic retrograde cholangiopancreatography. Which structures are visualized during this procedure?

low-residue diet for 2 to 3 days prior; NPO for 8 to 12 hours before

A client is scheduled to have an upper gastrointestinal series. Which preparations will the client be asked to follow prior to the procedure?

Do not give any food and fluids until the gag reflex returns.

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. Which nursing intervention is advised for this client?

lower esophageal sphincter

A client reports frequent episodes of reflux, and describes regurgitating small amounts of stomach contents into the esophagus. What sphincter is most likely not performing its normal physiologic function?

recent foods ingested.

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for

Increase fluid intake to evacuate the barium.

A client who has been experiencing changes in their bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery?

Avoid taking cimetidine 24 hours before the test

A client will be undergoing a urea breath test for the detection of Helicobacter pylori. Which instruction should the nurse give to the client to prepare for this test?

Remove all jewelry and metal from the body. Take nothing by mouth for 6 to 8 hours before the test. Expect the test to take 60 to 90 minutes to complete.

A client with a gastrointestinal disorder is scheduled for abdominal magnetic resonance imaging (MRI). Which teaching will the nurse provide to prepare the client for this test? Select all that apply.

The test is noninvasive.

A client with a recent history of intermittent bleeding is undergoing capsule endoscopy to determine the source of the bleeding. When explaining this diagnostic test to the client, what advantage should the nurse describe?

The pancreas secretes digestive enzymes.

A client with diabetes begins to have digestive problems and is told by the health care provider that they are a complication of the diabetes. Which of the following explanations from the nurse is most accurate?

Hemorrhoids

A clinic client has described recent dark-colored stools, and the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the client's current health status would contraindicate FOBT?

Left upper

A focused GI assessment begins with a complete history and physical examination. Identify the quadrant of the abdomen to be palpated or percussed for a client with pancreatitis.

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test?

The client may have cancer, but other GI disease must be ruled out.

A medical client's CA 19-9 levels have become available and they are significantly elevated. How should the nurse best interpret this diagnostic finding?

Upper GI tract

A nurse caring for a newly admitted client with a suspected gastrointestinal (GI) bleed assesses the client's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive of bleeding from what location?

GI diseases often produce skin changes.

A nurse is assessing the abdomen of a client just admitted to the unit with a suspected gastrointestinal (GI) disease. Inspection reveals several diverse lesions on the client's abdomen. How should the nurse best interpret this assessment finding?

lower right quadrant

A nurse is assisting with preoperative care for a client who requires an appendectomy. The nurse is aware that the surgery will involve which abdominal quadrant? Mark the correct area.

Stomach emptying takes place more slowly.

A nurse is caring for an 83-year-old client who is being assessed for recurrent and intractable nausea. What age-related change to the gastrointestinal (GI) system may be a contributor to the client's reporting?

Pepsin

A nurse promoting increased protein intake to enhance a client's wound healing knows that what enzyme is essential in the initiation of the digestion of protein?

Fluids must be increased to facilitate the evacuation of the stool.

An adult client is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include about what the client should expect after the test is completed?

duodenum

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?

Bowel perforation

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

Work history for exposure to environmental toxic wastes or radioactive materials

For a client with a disorder of the gastrointestinal (GI) system, which of the following histories would the nurse assess?

"Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food."

How would the nurse explain the formation and role of acid in the stomach?

10 inches

It is suspected that a client might have a problem in the duodenum and the client is scheduled to have GI studies done in the morning. In client education, the nurse describes the procedure and includes basic information about anatomy and the function of the organs involved. The client asks how long the duodenum is. What is the nurse's best response?

Prepare to meet the client's psychosocial needs.

Results of a client's preliminary assessment prompted an examination of the client's carcinoembryonic antigen (CEA) levels, which have come back positive. What is the nurse's most appropriate response to this finding?

upper GI enteroclysis

The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented?

Hyperactive

The nurse auscultates the abdomen to assess bowel sounds and documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds?

They usually have less control of the rectal sphincter.

The nurse determines which is a true statement regarding older clients, considering the age-related effects on the gastrointestinal (GI) system?

Splenic vein Inferior mesenteric vein Gastric vein

The nurse educator is reviewing the blood supply of the GI tract with a group of medical nurses. The nurse is explaining the fact that the veins that return blood from the digestive organs and the spleen form the portal venous system. What large veins will the nurse list when describing this system? Select all that apply.

red plaque on undersurface of tongue

The nurse inspects a client's tongue. Which finding would the nurse evaluate as an indication of potential oral cancer?

Sigmoid colon

The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass. The nurse is most correct to state at which location?

Hamburger and French fries

The nurse is assessing a client who is stating gastrointestinal upset and a feeling of bloating. Which type of meal would the nurse anticipate causing these types of symptoms?

Inspection Auscultation Percussion Palpation

The nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment? Use all options.

To relax colonic musculature and reduce spasm.

The nurse is assisting the health care provider with a colonoscopy for a client with rectal bleeding. The health care provider requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure?

Pentagastrin

The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions?

Abdominal cramps

The nurse is caring for a client recovering from a colonoscopy. Which assessment finding will the nurse expect in the client after the procedure?

"Let me have the primary health care provider explain this again to you."

The nurse is caring for a client scheduled for a diagnostic laparoscopy. The client has questions regarding the use of anesthetic during the procedure. Which response will the nurse provide the client?

Avoid bismuth subsalicylate before the test. Do not take proton pump inhibitors before the test.

The nurse is caring for a client who is scheduled for a urea breath test to detect for Helicobacter pylori as a reason for gastric distress. Which instruction(s) will the nurse provide to the client to prepare for this test? Select all that apply.

Secretion of mucus Absorption of nutrients Movement of nutrients into the bloodstream

The nurse is caring for a client with a duodenal ulcer and is relating the client's symptoms to the physiologic functions of the small intestine. What do these functions include? Select all that apply.

Frank blood in stool

The nurse is caring for a client with a gastrointestinal condition. For which reason will the nurse question the client being scheduled for a barium enema?

Slowed peristalsis

The nurse is caring for a client with gastrointestinal symptoms who reports being under a significant amount of stress at home and at work. Which gastrointestinal effect of stress should the nurse anticipate is affecting this client?

Liver function studies

The nurse is caring for a geriatric client and notices polypharmacy. Which diagnostic studies are anticipated?

Epigastric area and consider possible radiation of pain to the right subscapular region

The nurse is investigating a client's report of pain in the duodenal area. Where should the nurse perform the assessment?

Dyspepsia

The nurse is performing an assessment of a client. During the assessment the client informs the nurse of some recent "stomach trouble." What does the nurse know is the most common symptom of clients with GI dysfunction?

Position supine. Flex the knees. Inspect the skin. Auscultate bowel sounds. Percuss abdominal organs. Palpate for tenderness and masses.

The nurse is preparing to assess the abdomen of a client experiencing a gastrointestinal condition. Place in order the actions the nurse will take to complete this assessment. Use all options.

Dyspepsia

The nurse is preparing to educate a group of students on a gastrointestinal assessment. Which common condition will the nurse assess for in the client with gastrointestinal disorder?

Mouth

The nurse is providing client education about which parts of the body are involved in the digestion of food. What part of the GI tract begins the digestion of food?

The client must fast for 8 hours before the examination. The throat will be sprayed with a local anesthetic. After gastroscopy, the client cannot eat or drink until the gag reflex returns (1 to 2 hours).

The nurse is providing instructions to a client scheduled for a gastroscopy. What should the nurse be sure to include in the instructions? Select all that apply.

The client will need to be repositioned frequently throughout the procedure in order to prevent injury.

The nurse is teaching the client about the upcoming endoscopic retrograde cholangiopancreatography (ERCP). Although the nurse instructs on several pertinent points of care, which is emphasized?

Increase in the amount of fluids

The nurse is working on a general medical unit. A client is scheduled for an upper gastrointestinal series. Upon returning to the nursing unit, what does the nurse identify as the client goal?

weakened gag reflex

The nurse recognizes which change of the GI system is an age-related change?

Lipase Amylase Trypsin

What digestive enzymes does the pancreas secrete? Select all that apply.

duodenal ulcer

When gastric analysis testing reveals excess secretion of gastric acid, the nurse recognizes which medical diagnoses is supported?

Lying on the left side with legs drawn toward the chest

When providing health education to a client scheduled for a colonoscopy the nurse should explain that they will be placed in what position during this diagnostic test?

trypsin

Which enzyme aids in the digestion of protein?

Amylase

Which of the following digestive enzymes aids in the digesting of starch?

Absorption

Which of the following is the primary function of the small intestine?

small bowel enteroscopy

Which procedure is performed to examine and visualize the lumen of the small bowel?

increased peristalsis

Which response is a parasympathetic response in the GI tract?

Intrinsic Factor

Which term describes a gastric secretion that combines with vitamin B12 so that it can be absorbed?