Medical-surgical: gastrointestinal

A nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first?

Place the client in semi Fowler's position. A client who is receiving a PEG tube feedings should be positioned with the head of the bed elevated at least 30° during and after feedings to decrease the risk of aspiration.

A nurse is reinforcing teaching with a group of community residents about hepatitis B. Which of the following statements should the nurse include in the teaching?

A hepatitis B immunization is given to infants and children. Hepatitis B immune globulin is giving as part of the standard childhood immunizations. it can be administered as early as birth, especially in infants born to hepatitis B surface antigen (HBsAg) negative mothers. These infants should receive the second dose between 1 and 4 months age.

a nurse is completing a history and physical assessment for a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the clients condition?

Alcohol use Alcohol consumption is one of the major causes of chronic pancreatitis in the US.

A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should the nurse anticipate returning to the expected reference range within 72 hours after treatment begins?

Amylase Pancreatitis is the most common diagnosis for marked elevations in serum amylase.

A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect?

Anorexia Anorexia is an early manifestation of hepatitis A and is often severe. It is thought to result from the release of toxin by the damaged liver or by the failure of the damage liver cells to detoxify an abnormal product.

A nurse is collecting data from a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect?

Board like abdomen The nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit manifestations of a board like abdomen and severe pain in the abdomen or back that radiates to the right shoulder. Vomiting of blood and shark can occur if the perforation also causes hemorrhaging.

A community health nurse is planning an educational program about hepatitis A. When preparing the materials, the nurse should identify that which of the following groups is most at risk for developing hepatitis A?

Children and young adults Rationale: the hepatitis A virus can be contracted from the feces, bile, and blood of infected clients. The usual motor trans mission is the fecal oral route. Children and young adults are the two groups most often affected by the hepatitis A virus. Typically, a child or young adult acquires the infection at school, through poor hygiene, hand to mouth contact, or another form of close contact.

A nurse is caring for a client who is two days postoperative following a gastric bypass. The nurse notes that bowel sounds are present. Which of the following foods should the nurse provide at the initial meeting?

Clear liquids

A nurse is assisting with the care of a client who is receiving total parenteral nutrition therapy and has just returned to the room following physical therapy. The nurse notes that the infusion pump for the clients TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings?

Diaphoresis The nurse should recognize that the client has the potential for the development of hypoglycemia due to the sudden withdrawal of the TPN solution. In addition to diaphoresis, other potential manifestations of hypoglycemia can include weakness, anxiety, confusion, and hunger.

A nurse is reinforcing teaching with a client who has diverticulitis about preventing acute attacks. Which of the following foods should the nurse recommend?

Foods high in fiber

A nurse is assisting with the care of a client who has a history of cirrhosis and is admitted with manifestations of hepatic encephalopathy. The nurse should anticipate a prescription for which of the following laboratory test to determine the possibility of recent excessive alcohol use?

Gamma-glutamyl transferase (GGT) the GGt laboratory test is specific to the hepatobiliary system in which levels can be raised by alcohol and hepatotoxic drugs. Therefore, it is useful for monitoring drug toxicity and excessive alcohol use.

A nurse is assisting with the admission of a client who has fulminate hepatic failure. Which of the following procedures should the nurse expect for this client?

Liver transplant fulminant hepatic failure, most often caused by a viral hepatitis, is characterized by the development of hepatic encephalopathy within weeks of the onset of disease in a client without prior evidence of hepatic dysfunction. mortality remains high, even with treatment modalities such as blood or plasma exchanges, charcoal hemoperfusion, and corticosteroids, consequently, liver transplantation has become the treatment of choice for these clients.

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure?

Prothrombin time A major complication following a liver biopsy is hemorrhage. Many clients who have liver disease have clotting defects and are at risk for bleeding. Along with the PT, the activated partial thromboplastin time and a platelet count should be monitored.

A nurse is caring for a client who is four hours postoperative following a laparoscopic cholecystectomy. Which of the following findings should the nurse expect?

Right shoulder pain The client can experience pain in the right upper shoulder due to gas injected into the abdominal cavity during the laparoscopic procedure, which can irritate the diaphragm and cause referred pain into the shoulder area. The pain disappears in 1 to 2 days. Mild analgesics and a recumbent position can help relieve the pain.

The nurse is checking a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings should indicate to the nurse that a possible bowel perforation has occurred?

Rigid abdomen Abdominal tenderness in rigidity occur with a bowel perforation. As fluid escapes into the peritoneal cavity, there is a reduction in circulating blood volume and a lowered blood pressure, or hypotension, results.

A nurse is caring for a client who is dehydrated and receiving continuous tube feeding through a pump at 75 ML/hr. When the nurse checks the client at 0800, which of the following findings requires intervention by the nurse?

The head of the bed is elevated 20° The head of the bed should be elevated at least 30° while the tube feeding is administered. This position uses gravity to help the feeding progressed down through the digestive system and lessens the possibility of regurgitation.

A nurse is reinforcing teaching with a client who has Barrett's esophagus and is scheduled to undergo an esophagogastroduodenoscopy(EGD). Which of the following statements should the nurse include in the teaching?

This procedure can determine how well the lower part of your esophagus works An EGD is useful in determining the function of the esophageal lining and the extent of inflammation, potential scarring, and strictures.

A nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy(EGD). The nurse should identify that the purpose of this procedure is which of the following?

To detect an ulceration in the stomach An EGD is used to visualize the esophagus, stomach, and duodenum with a lighted tube to detect tumors, ulcerations, or obstructions.

A nurse is assisting with the admission of a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications?

Vasopressin Vasopressin constricts the splanchnic bed and decreases portal pressure. Vasopressin also constricts the distal esophageal and proximal gastric vein, which reduces inflow into the portal system and is used to treat bleeding varices.

A nurse is caring for a client who has celiac disease. Which of the following foods should the nurse remove from the clients meal tray?

Wheat toast Celiac disease is an autoimmune disorder characterized by a permanent intolerance to wheat, barley, and rye. wheat toast contains gluten and should be removed from the client's tray.