MEDSURG FINAL - GI CONTENT

A nurse cares for a client with obesity who is scheduled to undergo vagal blocking therapy. When teaching the client about the procedure or device, which statements will the nurse include? Select all that apply.

-"It is a pacemaker-type device that is implanted under your skin." -"A pre-programed pulsating signal is delivered." -"Recharge the device two times per week."

The health care provider prescribes a combination of three drugs to treat peptic ulcer disease. The nurse, preparing to review the drug actions and side effects with the patient, understands that the triple combination should be in which order? -Antibiotics, prostaglandin E1 analogs, and bismuth salts -Proton pump inhibitors, prostaglandin E1 analogs, and bismuth salts -Bismuth salts, antibiotics, and proton pump inhibitors -Prostaglandin E1 analogs, antibiotics, and proton pump inhibitors

-Bismuth salts, antibiotics, and proton pump inhibitors Refer to Table 23-1 in the text to review the recommended triple combination.

What are the contraindications of Metronidazole?

-anorexia -metallic taste -avoid alcohol -increases warfarin's blood thinning effects

What are abnormal drainage types associated with Jackson-Pratt?

-excessive drainage -bright, red -thick enough to block tube -has foul odor

List complications of parenteral nutrition.

-pneumothorax -air embolism -clotted catheter -displaced catheter -sepsis -hyperglycemia -fluid overload -rebound hyperglycemia

A person with a sigmoid colostomy will have what kind of stool?

A more formed stool.

A nurse assesses a client after an open whipple procedure. Which action should the nurse perform first?

Assess the client's endotracheal tube with 40% FiO2

A client has a new order for metoclorpramide (Reglan). The nurse identifies that this medication can be safely administered for which condition?

Gastroesophageal reflux disease (GERD)

A nurse is initiating parenteral nutrition (PN) to a postoperative patient who has developed complications. The nurse should initiate therapy by performing which of the following actions?

Initiating the infusion slowly and monitoring the patient's fluid and glucose tolerance

A nurse is caring for a patient who has a diagnosis of GI bleed. During shift assessment, the nurse finds the patient to betachycardic and hypotensive, and the patient has an episode of hematemesis while the nurse is in the room.

Notify the physician stat! Examine stools, monitor VS, skin, LOC, HCT/HGB. Avoid activities leading to intra-abdominal pressure.

Prophylactic therapy for NSAID ulcers?

PPIs and misprostol

The nurse cares for clients with obesity and understands that causes are multifactorial. What factors contribute to the development of obesity? Select all that apply.

Physiology Behavioral Environment Genetics

A nurse cares for a client recovering from an open Whipple procedure. Which action should the nurse take?

Place the client in semi-fowler's position

A patient's sigmoidoscopy has been successfully completed and the patient is preparing to return home. Which of the following teaching points should the nurse include in the patient's discharge education?

The patient can resume a normal routine immediately.

What is the rationale behind vagal nerve blocking?

Vagal blocking results in diminished gastric contraction and emptying, limited ghrelin secretion, and diminished pancreatic enzyme secretion-all of which cause increased satiety, less cravings, and diminished absorption of calories leading to weight loss.

Assessment of advanced cirrhosis?

bilirubin test - prolonged prothrombin time ultrasound - density of tissue and cells CT/MRI/Radioisotope/elastography studies - liver size, blood flow, function ABG - perfusion imbalance Dx confirmed by liver biopsy

Diet guidelines regarding biliopancreatic diversion with duodenal switch

consume fat as tolerated low carb intake eat two protein snacks - animal protein is poorly tolerated ensure low-fowler position during mealtimes do not drink fluids during meals receive monthly injections of vitamin B12 and iron as prescribed

What labs are monitored for liver function?

serum bilirubin - conjugation ability albumin and globulin - proteins affected by liver impairments prothrombin time ALP *AST/ALT - enzyme release *GGT/GGTP - elevated with alcohol LDH Ammonia Cholesterol

Octreotide (Sandostatin)

somatostatin analog - decreases variceal bleeding when treating for immediate control

When is naltrexone/bupropion contraindicated in those with BMI >30 ?

Clients with: -hypertension -epilepsy -eating disorders -alcohol abuse -suicidal patients

Biliopancreatic diversion with duodenal switch

Half of the stomach is removed, holding only 60 mL. Jejunum is excluded, duodenum is disconnected and sealed, ileum is divided above the ileocal junction.

Which medication classification represents a proton (gastric acid) pump inhibitor? -Omeprazole -Sucralfate -Famotidine -Metronidazole

Omeprazole

H2 receptor antagonists

decrease stomach acid secretion

A patient with a cholelithiasis has been scheduled for a laparoscopic cholecystectomy. Why islaparoscopic cholecystectomy preferred by surgeons over an open procedure? A) Laparoscopic cholecystectomy poses fewer surgical risks than an open procedure. B) Laparoscopic cholecystectomy can be performed in a clinic setting, while an open procedurerequires an OR. C) A laparoscopic approach allows for the removal of the entire gallbladder. D) A laparoscopic approach can be performed under conscious sedation.

A

A patient with pancreatic cancer has been scheduled for a pancreaticoduodenectomy (Whipple procedure). During health education, the patient should be informed that this procedure will involve the removal of which of the following? Select all that apply. A) Gallbladder B) Part of the stomach C) Duodenum D) Part of the common bile duct E) Part of the rectum

A, B , C, D

Vasopressin (Pitressin)

emergency therapy for variceal bleeding - decreases and constricts pressure; contraindicated by CAD

Methods for de-clogging and NG tube of crushed meds

-warm water irrigation -milking the tube -infusing digestive enzymes -employing a mechanical de-clogging device

A nurse is creating a care plan for a patient who is receiving parenteral nutrition. The patient's care plan should include nursing actions relevant to what potential complications? Select all that apply.

Clotted or displaced catheter Pneumothorax Hyperglycemia Line sepsis

A nurse is preparing to discharge a patient home on parenteral nutrition. What should an effective home care teaching program address?

Preparing the patient to troubleshoot for problems Teaching the patient and family strict aseptic technique Teaching the patient and family how to set up the infusion

What is a concern with abruptly stopping nutrition?

Rebound hypoglycemia

Antacids

neutralize the acids in the stomach

surface agents

preserve mucosal barrier - give on an empty stomach, 1 h before meals or 2 h post-meals - separate antacid doses by 30 minutes

A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation? A. The client's hepatic function is decreasing. B. The client didn't take his morning dose of lactulose (Cephulac). C. The client is relaxed and not in pain D. The client is avoiding the nurse.

A The decreased level of consciousness caused by an increased serum ammonia level indicates hepatic disfunction. If the client didn't take his morning dose of lactulose, he wouldn't have elevated ammonia levels and decreased level of consciousness this soon. These assessment findings don't indicate that the client is relaxed or avoiding the nurse.

A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize? A) Insertion of a nasogastric tube B) Insertion of a central venous catheter C) Administration of a mineral oil enema D) Administration of a glycerin suppository and an oral laxative

ANS: A Feedback:Decompression of the bowel through a nasogastric tube is necessary for all patients with small bowel obstruction. Peripheral IV access is normally sufficient. Enemas, suppositories, and laxatives are not indicated if an obstruction is present.

A patient has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurses care should prioritize which of the following outcomes? A) Preventing infection B) Maintaining skin and tissue integrity C) Preventing nausea and vomiting D) Maintaining fluid and electrolyte balance

ANS: D Feedback:All of the listed focuses of care are important for the patient with a small bowel obstruction. However, the patients risk of fluid and electrolyte imbalances is an immediate threat to safety, and is a priority in nursing assessment and interventions.

Prokinetic Agents

Accelerate gastric emptying

A nurse is caring for a patient who has an order to discontinue the administration of parenteral nutrition. What should the nurse do to prevent the occurrence of rebound hypoglycemia in the patient?

After administration of the PN solution is gradually discontinued, an isotonic dextrose solution is administered for 1 to 2 hours to protect against rebound hypoglycemia.

A patient with gastroesophageal reflux disease (GERD) has a diagnosis of Barretts esophagus with minor cell changes. Which of the following principles should be integrated into the patients subsequent care? • The patient will require an upper endoscopy every 6 months to detect malignant changes. • Liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage. • Small amounts of blood are likely to be present in the stools and are not cause for concern. • Antacids may be discontinued when symptoms of heartburn subside.

Ans: A Feedback:In the patient with Barretts esophagus, the cells lining the lower esophagus have undergone change and are no longer squamous cells. The altered cells are considered precancerous and are a precursor to esophageal cancer. In order to facilitate early detection of malignant cells, an upper endoscopy is recommended every 6 months. H2 receptor antagonists are commonly prescribed for patients withGERD; however, monitoring of liver enzymes is not routine. Stools that contain evidence of frank bleeding or that are tarry are not expected and should be reported immediately. When antacids are prescribed for patients with GERD, they should be taken as ordered whether or not the patient is symptomatic.

A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole should the nurse best describe this medications therapeutic action? A) This medication will reduce the amount of acid secreted in your stomach. B) This medication will make the lining of your stomach more resistant to damage. C) This medication will specifically address the pain that accompanies peptic ulcer disease. D) This medication will help your stomach lining to repair itself.

Ans: A Feedback: Proton pump inhibitors like Prilosec inhibit the synthesis of stomach acid. PPIs do not increadurability of the stomach lining, relieve pain, or stimulate tissue repair.

The school nurse is planning a health fair for a group of fifth graders and dental health is one topic that the nurse plans to address. What would be most likely to increase the risk of tooth decay? • Organic fruit juice • Roasted nuts • Red meat that is high in fat • Cheddar cheese

Ans: A Feedback:Dental caries may be prevented by decreasing the amount of sugar and starch in the diet. Patients who snack should be encouraged to choose less cariogenic alternatives, such as fruits, vegetables, nuts, cheeses, or plain yogurt. Fruit juice is high in sugar, regardless of whether it is organic.

A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measures should the educator promote? Select all that apply. A) Immunization B) Use of standard precautions C) Consumption of a vitamin-rich diet D) Annual vitamin K injections E) Annual vitamin B12 injections

Ans: A, B Feedback:People who are at high risk, including nurses and other health care personnel exposed to blood or blood products, should receive active immunization. The consistent use of standard precautions is also highly beneficial. Vitamin supplementation is unrelated to an individual's risk of HBV.

A nurse is caring for a patient who has been admitted to the hospital with diverticulitis. Which of the following would be appropriate nursing diagnoses for this patient?Select all that apply. A. Acute Pain Related to Increased Peristalsis and GI Inflammation B. Activity Intolerance Related to Generalized Weakness C. Bowel Incontinence Related to Increased Intestinal Peristalsis D. Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea E. Impaired Urinary Elimination Related to GI Pressure on the Bladder

Ans: A, B, D Feedback: Patients with diverticulitis are likely to experience pain and decreased activity levels, and are at risk of fluid volume deficit. The patient is unlikely to experience fecal incontinence and urinary function is not directly influenced.

A patient's physician has ordered a "liver panel" in response to the patient's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select all that apply. A) Alanine aminotransferase (ALT) B) C-reactive protein (CRP) C) Gamma-glutamyl transferase (GGT) D) Aspartate aminotransferase (AST) E) B-type natriuretic peptide (BNP)

Ans: A, C, D Feedback:Liver function testing includes GGT, ALT, and AST. CRP addresses the presence of generalized inflammation and BNP is relevant to heart failure; neither is included in a liver panel.

A patient with end-stage liver disease has developed hypervolemia. What nursing interventions would be most appropriate when addressing the patient's fluid volume excess? Select all that apply. A) Administering diuretics B) Administering calcium channel blockers C) Implementing fluid restrictions D) Implementing a 1500 kcal/day restriction E) Enhancing patient positioning

Ans: A, C, E Feedback:Administering diuretics, implementing fluid restrictions, and enhancing patient positioning can optimize the management of fluid volume excess. Calcium channel blockers and calorie restriction do not address this problem.

39. A nurse is caring for a patient in the late stages of esophageal cancer. The nurse should plan to prevent or address what characteristics of this stage of the disease? Select all that apply. A) Perforation into the mediastinum B) Development of an esophageal lesion C) Erosion into the great vessels D) Painful swallowing E) Obstruction of the esophagus

Ans: A, C, E Feedback:In the later stages of esophageal cancer, obstruction of the esophagus is noted, with possible perforation into the mediastinum and erosion into the great vessels. Painful swallowing and the emergence of a lesion are early signs of esophageal cancer.

An adult patient is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the patient has completed the test? A) Stool will be yellow for the first 24 hours postprocedure. B) The barium may cause diarrhea for the next 24 hours. C) Fluids must be increased to facilitate the evacuation of the stool. D) Slight anal bleeding may be noted as the barium is passed.

Ans: C - Postprocedural patient education includes information about increasing fluid intake; evaluating bowel movements for evacuation of barium; and noting increased number of bowel movements, because barium, due to its high osmolarity, may draw fluid into the bowel, thus increasing the intraluminal contents and resulting in greater output. Yellow stool, diarrhea, and anal bleeding are not expected.

A nurse is performing health education with a patient who has a history of frequent, serious dental caries. When planning educational interventions, the nurse should identify a risk for what nursing diagnosis? a. Ineffective Tissue Perfusion b. Impaired Skin Integrity c. Aspiration d. Imbalanced Nutrition: Less Than Body Requirements

Ans: D Feedback:Because digestion normally begins in the mouth, adequate nutrition is related to good dental health and the general condition of the mouth. Any discomfort or adverse condition in the oral cavity can affect a persons nutritional status. Dental caries do not typically affect the patients tissue perfusion or skin integrity. Aspiration is not a likely consequence of dental caries.

A patient with esophageal varices is being cared for in the ICU. The varices have begun to bleed and the patient is at risk for hypovolemia. The patient has Ringer's lactate at 150 cc/hr infusing. What else might the nurse expect to have ordered to maintain volume for this patient? A) Arterial line B) Diuretics C) Foley catheter D) Volume expanders

Ans: D Feedback:Because patients with bleeding esophageal varices have intravascular volume depletion and are subject to electrolyte imbalance, IV fluids with electrolytes and volume expanders are provided to restore fluid volume and replace electrolytes. Diuretics would reduce vascular volume. An arterial line and Foley catheter are likely to be ordered, but neither actively maintains the patient's volume.

A patient has been diagnosed with peptic ulcer disease and the nurse is reviewing his medication regimen with him. What is currently the most commonly used drug regimen for peptic ulcers?

Antibiotics, PPI, BISMUTH SALTS - eradicate H.pylori

A physician has written an order for ranitidine (Zantac), 300 mg once daily. The nurse schedules the medication for which time? -At bedtime -After lunch -With supper -Before breakfast

At bedtime Currently, the most commonly used therapy for peptic ulcers is a combination of antibiotics, proton-pump inhibitors, and bismuth salts that suppress or eradicate H. pylori. Recommended therapy for 10 to 14 days includes triple therapy with two antibiotics (eg, metronidazole [Flagyl] or amoxicillin [Amoxil] and clarithromycin [Biaxin]) plus a proton-pump inhibitor (eg, lansoprazole [Prevacid], omeprazole [Prilosec], or rabeprazole [Aciphex]), or quadruple therapy with two antibiotics (metronidazole and tetracycline) plus a proton-pump inhibitor and bismuth salts (Pepto-Bismol). Research is being conducted to develop a vaccine against H. pylori.

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction?

Avoid coffee and alcoholic beverages." To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods and beverages that increase stomach acid, such as coffee and alcohol. The nurse also should teach the client to avoid lying down after meals, which can aggravate reflux, and to take antacids after eating. The client need not limit fluid intake with meals as long as the fluids aren't gastric irritants.

A client with acute liver failure exhibits confusion, a declining level of consciousness, and slowed respirations. The nurse finds him very difficult to arouse. The diagnostic information which best explains the client's behavior is: A. elevated liver enzymes and low serum protein level. B. subnormal serum glucose and elevated serum ammonia levels. C. subnormal clotting factors and platelet count. D. elevated blood urea nitrogen and creatinine levels and hyperglycemia.

B In acute liver failure, serum ammonia levels increase because the liver can't adequately detoxify the ammonia produced in the GI tract. In addition, serum glucose levels decline because the liver isn't capable of releasing stored glucose. Elevated serum ammonia and subnormal serum glucose levels depress the level of a client's consciousness. Elevated liver enzymes, low serum protein level, subnormal clotting factors and platelet count, elevated blood urea nitrogen and creatine levels, and hyperglycemia aren't as directly related to the client's level of consciousness.

When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately? A. Weight loss of 2 pounds in 3 days B. Change in the client's handwriting and/or cognitive performance C. Anorexia for more than 3 days D. Constipation for more than 2 days

B The earliest symptoms of hepatic encephalopathy include mental status changes and motor disturbances. The client will appear confused and unkempt and have altered mood and sleep patterns. Neurologic status should be assessed frequently. Mental status is monitored by the nurse keeping the client's daily record of handwriting and arithmetic performance. The nurse should report any change in mental status immediately. Chronic fatigue, anorexia, dyspepsia, nausea, vomiting, and diarrhea or constipation with accompanying weight loss are regular symptoms of cirrhosis.

A patient who suffered a stroke had an NG tube inserted to facilitate feeding shortly after admission. The patient has since become comatose and the patient's family asks the nurse why the physician is recommending the removal of the patient's NG tube and the insertion of a gastrostomy tube. What is the nurse's best response? A)It eliminates the risk for infection. B)Feeds can be infused at a faster rate. C)Regurgitation and aspiration are less likely. D)It allows caregivers to provide personal hygiene more easily.

C Feedback: Gastrostomy is preferred over NG feedings in the patient who is comatose because the gastroesophageal sphincter remains intact, making regurgitation and aspiration less likely than with NG feedings. Both tubes carry a risk for infection; this change in care is not motivated by the possibility of faster infusion or easier personal care.

A nurse is participating in a patient's care conference and the team is deciding between parenteral nutrition (PN) and a total nutritional admixture (TNA). What advantages are associated with providing TNA rather than PN? A)TNA can be mixed by a certified registered nurse. B)TNA can be administered over 8 hours, while PN requires 24-hour administration. C)TNA is less costly than PN. D)TNA does not require the use of a micron filter.

C Feedback:TNA is mixed in one container and administered to the patient over a 24-hour period. A 1.5-micron filter is used with the TNA solution. Advantages of the TNA over PN include cost savings. Pharmacy staff must prepare both solutions.

A patient with pancreatic cancer is admitted to the hospital for evaluation of possible treatment options. The patient asks the nurse to explain the Whipple procedure the the surgeon has described. The explanation includes the information that a Whipple procedure involves... a) creating a bypass around the obstruction caused by the tumor by joining the gallbladder to the jejunum b) resection of the entire pancreas and the distal portion of the stomach, with anastomosis of the common bile duct and the stomach into the duodenum c) removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum d) radical removal of the pancreas, the duodenum, and the spleen, and attachment of the stomach to the jejunum, which requires oral supplementation of pancreatic digestive enzymes and insulin replacement therapy

C) removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum

A patient has been discharged home on parenteral nutrition (PN). Much of the nurse's discharge education focused on coping. What must a patient on PN likely learn to cope with?

Changes in life style loss of eating as a social behavior sleep disturbances

The nurse is administering total parenteral nutrition (TPN) to a client who underwent surgery for gastric cancer. Which of the nurse's assessments most directly addresses a major complication of TPN?

Checking the patient's capillary blood glucose levels regularly The solution, used as a base for most TPN, consists of a high dextrose concentration and may raise blood glucose levels significantly, resulting in hyperglycemia.

A local public health nurse is informed that a cook in a local restaurant has been diagnosed with hepatitis A. What should the nurse advise individuals to obtain who ate at this restaurant and have never received the hepatitis A vaccine? A) The hepatitis A vaccine B) Albumin infusion C) The hepatitis A and B vaccines D) An immune globulin injection

D Feedback:For people who have not been previously vaccinated, hepatitis A can be prevented by the intramuscular administration of immune globulin during the incubation period, if given within 2 weeks of exposure. Administration of the hepatitis A vaccine will not protect the patient exposed to hepatitis A, as protection will take a few weeks to develop after the first dose of the vaccine. The hepatitis B vaccine provides protection again the hepatitis B virus, but plays no role in protection for the patient exposed to hepatitis A. Albumin confers no therapeutic benefit.

Benefits of lap-cholecystectomy vs. open procedure?

Decreased surgical risk decreased hospital stay decreased recovery NO paralytic ileus decreased post-op abdominal pain Discharge within same-day or 1-2 days Return to normal life within 1 week

What are nursing diagnoses related to obesity?

Deficient knowledge anxiety acute pain risk for deficient fluid volume risk for infection imbalanced nutrition disturbed body image risk for constipation and/or diarrhea

What information should the nurse include in the teaching plan for a client being treated for diverticulosis?

Drink at least 8 to 10 large glasses of fluid every day. The nurse should instruct a client with diverticulosis to drink at least 8 to 10 large glasses of fluid every day. The client should include unprocessed bran in the diet because it adds bulk, and should avoid the use of laxatives or enemas except when recommended by the physician. In addition, regular exercise should be encouraged if the client's current lifestyle is somewhat inactive.

A patients assessment and diagnostic testing are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment questions address likely etiologic factors? Select all that apply.

How many alcoholic drinks do you typically consume in a week? Have you ever been diagnosed with gallstones?

The nurse is admitting a client with traumatic injuries who also has class III obesity. When planning this client's care, the nurse should address the client's heightened risk of what nursing diagnoses related to obesity? Select all that apply. Unilateral neglect Impaired skin integrity Deficient fluid volume Impaired gas exchange Bowel incontinence

Impaired skin integrity Impaired gas exchange Obesity creates risks for ineffective respiration and consequent impaired gas exchange due to changes in the structure and function of the respiratory system. As well, obesity is associated with risks to skin integrity due to the possibility of pressure injuries. There is no accompanying risk of bowel incontinence or fluid volume deficit that is accounted for by obesity. If neglect exists, it is likely to be bilateral, not unilateral.

The nurse is asking the client with acute pancreatitis to describe the pain. What pain symptoms does the client describe related to acute pancreatitis?

Severe mid-abdominal to upper abdominal pain radiating to both sides and to the back

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.

Splenic vein, Inferior mesenteric vein, Gastric vein Feedback:This portal venous system is composed of five large veins: the superior mesenteric, inferior mesenteric, gastric, splenic, and cystic veins, which eventually form the vena portae that enters the liver. The inferior vena cava is not part of the portal system. The saphenous vein is located in the leg.

The output from a transverse colostomy will have what kind of stool?

Stool that's a more thick liquid to soft consistency.

Proton Pump Inhibitors

decrease gastric acid production - antiulcer drugs

What are possible postoperative gastric surgery complications?

hemorrhage dumping syndrome bile reflux gastric outlet obstruction shock

What anatomic area is affected by reduced pressure in GERD?

incompetent lower esophageal sphincter

Age-related changes in the gastrointestinal system include all of the following except: A. decreased gastric acid production. B. decreased gastric motility. C. increased GI surface area. D. decreased gastric emptying.

increased GI surface area

Ulcer healing medications?

must take at bedtime H2-recepter antagonists or PPIs daily

Self-care regarding biliopancreatic diversion with duodenal switch

nutrition nutritional supplements pain management importance of physical activity recognize symptoms of dumping syndrome empty, measure, and record Jackson-Pratt drainage avoid taking NSAIDs

How to educate client on whipple procedure care and discharge

pain/discomfort relief strategies drain management - when present diet modification (Tx: post-surgery hyperglycemia and malabsorption) pancreatic enzyme replacement vitamin supplementation low-fat diet be aware of complications r/t to the procedure

beta-blocking agents

prophylactic use of variceal bleeding to prevent re-bleeding, used in combination with nitrates

Reflux Inhibitors

stimulate parasympathetic - urinary retention

A nurse is participating in the emergency care of a patient who has just developed variceal bleeding. What intervention should the nurse anticipate?

vasopressin (pitression)