PANCREATIC/HEPATIC

A patient comes to the ED with severe abdominal pain, nausea, and vomiting. The physician plans to rule out possible acute pancreatitis. The nurse would expect the diagnosis to be confirmed with which of the following elevated laboratory tests? Serum calcium Serum bilirubin Serum amylase Serum potassium

amylase

Which of the following is clinical manifestation of cholelithiasis? Epigastric distress prior to a meal Clay-colored stools Upper left quadrant abdominal pain Nonpalpable abdominal mass

clay stooles

Which of the following conditions in a patient with pancreatitis makes it necessary for the nurse to check fluid intake and output, hourly urine output, and monitor electrolyte levels? Frequent vomiting leading to loss of fluid volume Dry mouth, which makes the patient thirsty Acetone in the urine High glucose levels in the blood

frequent vomitting leading to loss of fluids

Which condition is most likely to have a nursing diagnosis of fluid volume deficit? Appendicitis Pancreatitis Cholecystitis Gastric ulcer

pancretis

When caring for a client with acute pancreatitis, the nurse should use which comfort measure? Administering an analgesic once per shift, as ordered, to prevent drug addiction Positioning the client on the side with the knees flexed Encouraging frequent visits from family and friends Administering frequent oral feedings

position the client on the side with knees flexed

A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client? Relieving abdominal pain Preventing fluid volume overload Maintaining adequate nutritional status Teaching about the disease and its treatment

relieve ab pain

This example of cholesterol gallstones (left side of picture) is the result of decreased bile acid synthesis and increased cholesterol synthesis in the liver, which in turn, form stones. Cholesterol stones account for what percentage of cases of gallbladder disease in the United States? 15% 25% 60% 75%

75

Ursodeoxycholic acid (UDCA) has been used to dissolve small, radiolucent gallstones. Which duration of therapy is required to dissolve the stones? 1 month 4 months 7 months Over 1 year

7

Management of a patient with ascites includes nutritional modifications and diuretic therapy. Which of the following interventions would a nurse expect to be part of patient care? Select all that apply. Aldactone, an aldosterone-blocking agent would be used. Zaroxolyn would be the thiazide diuretic of choice. A daily weight change of 0.5 pounds would require health care provider notification. Daily salt intake would be restricted to 2 grams or less. The diuretic will be held if the serum sodium level decreases to <134 m Eq/L.

Aldactone, an aldosterone-blocking agent would be used. Daily salt intake would be restricted to 2 grams or less. The diuretic will be held if the serum sodium level decreases to <134 m Eq/L.

A nursing student has learned about many collaborative interventions to achieve pain relief for clients with acute pancreatitis. Which of the following are appropriate? Choose all that apply. Encourage bed rest to decrease the client's metabolic rate. Teach the client about the correlation between alcohol intake and pain. Allow the client to have sips of clear liquids. Withhold oral feedings to limit the release of secretin.

Encourage bed rest to decrease the client's metabolic rate. Withhold oral feedings to limit the release of secretin. Teach the client about the correlation between alcohol intake and pain.

The nurse should assess for an important early indicator of acute pancreatitis. What prolonged and elevated level would the nurse determine is an early indicator? Serum calcium Serum lipase Serum bilirubin Serum amylase

lipase

The nurse knows that the client with cholelithiasis can have a nutritional deficiency. The obstruction of bile flow due to cholelitiasis can interfere with the absorption of Vitamin A Vitamin B6 Vitamin B12 Vitamin C

Obstruction of bile flow interferes with absorption of the fat-soluble vitamins A, D, E, and K. Clients may exhibit deficiencies of these vitamins if biliary obstruction has been prolonged. Vitamins B6, B12, and C are not fat soluable.

A client diagnosed with acute pancreatitis is being transferred to another facility. The nurse caring for the client completes the transfer summary, which includes information about the client's drinking history and other assessment findings. Which assessment findings confirm his diagnosis? Recent weight loss and temperature elevation Presence of blood in the client's stool and recent hypertension Presence of easy bruising and bradycardia Adventitious breath sounds and hypertension

Recent weight loss and temperature elevation

The patient admitted with acute pancreatitis has passed the acute stage and is now able to tolerate solid foods. What type of diet will increase caloric intake without stimulating pancreatic enzymes beyond the ability of the pancreas to respond? Low-sodium, high-potassium, low-fat diet High-carbohydrate, high-protein, low-fat diet Low-carbohydrate, high-potassium diet High-carbohydrate, low-protein, low-fat diet

The nurse should provide a high-carbohydrate, low-protein, low-fat diet when tolerated. These foods increase caloric intake without stimulating pancreatic secretions beyond the ability of the pancreas to respond.

Which foods should be avoided following acute gallbladder inflammation? Cooked fruits Cheese Coffee Mashed potatoes

cheese

Sixty to eighty percent of pancreatic tumors occur in the head of the pancreas. Tumors in this region obstruct the common bile duct. Which of the following clinical manifestations would indicate a common bile duct obstruction associated with a tumor in the head of the pancreas? Choose all that apply. Clay-colored stools Dark urine Jaundice Pruritis Weight gain

clay dark jaundice pruitis

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder? Edema and inflammation Pleural effusion Sepsis Disseminated intravascular coagulopathy

edema and inflammation

A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find? Increased serum calcium levels Elevated urine amylase levels Decreased liver enzyme levels Decreased white blood cell count

elevated urinary amylases

The nurse admits a woman who is 8 weeks postpartum. The client presents with reports of severe right upper quadrant pain that radiates to her back. She states she just finished eating Thanksgiving dinner earlier that evening. The nurse suspects gallbladder disease. Statistics show that incidence of gallbladder disease is greater for women who are which of the following? Select all that apply. Multiparous Obese Older than 60 years Thin Wealthy

multiparious and obese

Which of the following conditions is most likely to involve a nursing diagnosis of fluid volume deficit? Appendicitis Pancreatitis Cholecystitis Peptic ulcer

pancreatitis

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery? Potassium Vitamin K Vitamin B Oral bile acids

vit k

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: yellow sclerae. light amber urine. circumoral pallor. black, tarry stools.

yellow sclerae

A patient discharged following a laparoscopic cholecystectomy calls the surgeon's office complaining of severe right shoulder pain 24 hours after surgery. Which of the following statements is the correct information for the nurse to provide to this patient? This pain is caused from the gas used to inflate your abdominal area during surgery. Sitting upright in a chair, walking, or using a heating pad may ease the discomfort. This pain is caused from your incision. Take analgesics as needed and as prescribed and report to surgeon if pain is unrelieved even with analgesic use. This may be the beginning symptoms of an infection. You need to come to see the surgeon today for an evaluation. This pain may be caused by a bile duct injury. You will need to go to the hospital immediately to have this evaluated.

a

A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority? Acute pain related to biliary spasms Deficient knowledge related to prevention of disease recurrence Anxiety related to unknown outcome of hospitalization Imbalanced nutrition: Less than body requirements related to biliary inflammation

acute pain