prep u 140 infection and inflammation
A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client the nurse expects to note:
yellow sclerae
A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should the nurse administer to the client before surgery?
vitamin K
A client with chronic pancreatitis is treated for uncontrolled pain. Which complication does the nurse recognize is most common in the client with chronic pancreatitis
weight loss
A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct?
"Maintain a high carbohydrate, low fat diet."
A client has a nasogastric tube for suction and is NPO after a pancreaticoduodenectomy. Which is the explanation made by the nurse the major purpose of this treatment?
"The tube allows the gastrointestinal tract to rest"
A nurse should monitor blood glucose levels for a patient diagnosed with hyperinsulinism. What blood value does the nurse recognize as inadequate to sustain normal brain function?
30 mg/dl
A client who is 24 hours post op from laparoscopic cholecystectomy calls the nurse and reports pain in the right shoulder. How should the nurse respond to the clients report of symptoms?
Apply a heating pad to your shoulder 15 minutes hourly as needed
The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client?
Assisting the client to turn, cough, and deep breathe every 2 hours
Which of the following would be most appropriate for a client who is experiencing biliary colic?
Ensure that the client rests
A client is admitted to the health care facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find?
Elevated urine amylase levels
A critical care nurse is caring for a client with acute pancreatitis. One potentially severe complication involves the respiratory system. Which of the following would be an appropriate intervention to prevent complications associated with the respiratory system?
Maintain the client is semi-fowlers position
a client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of TPN?
Measure blood glucose concentration every 4 to 6 hours
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
a patient with acute pancreatitis puts the call bell on to tell the nurses about an increase in pain. The nurse observes the patient guarding; the abdomen is board-like and no bowel sounds are detected. What is the major concern for this patient?
The patient has developed peritonitis
The physician has written the following orders for a new client admitted with pancreatitis :bed rest, nothing by mouth, and administration of TPN. Which does the nurse attribute as the reason for NPO status?
To avoid inflammation of the pancreas
A client is admitted to the health care center with severe abdominal pain rated 10 on a 1-10 scale, tachycardia, hypertension, and muscle spasms. The nurse immediately administers morphine sulfate 4 mg slow intravenous pyelogram(IVP) as ordered. The nurse plans for which goal after administration of this medication?
To increase the clients pain threshold
The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason?
To reduce gastric and pancreatic secretions
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? a) Imbalanced nutrition: Less than body requirements related to biliary inflammation b) Anxiety related to unknown outcome of hospitalization c) Deficient knowledge related to prevention of disease recurrence d) Acute pain related to biliary spasms
acute pain related to biliary spasms
when caring for a patient with acute pancreatitis, the nurse must consider pain relief measures. What nursing interventions could the nurse provide? select all that apply
administering parental opioid analgesics as ordered encouraging bed rest to decrease the metabolic rate withholding oral feedings to limit the release of secretion
A client with calculi in the gallbladder is said to have
cholelithiasis
a client with calculi in the gallbladder is said to have
cholelithiasis
Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes melitus. Which of the following explains the cause of this secondary diabetes? a) Inability for the liver to reabsorb serum glucose b) Ingestion of foods high in sugar c) Dysfunction of the pancreatic islet cells d) Renal failure
dysfunction of the pancreatic islet cells
A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder?
edema and inflammation
When the nurse is caring for a patient with acute pancreatitis, what intervention can be provided in order to prevent atelectasis and prevent pooling of respiratory secretions?
frequent changes of positions
A nurse is preparing a client for surgery. During preoperative teaching, the client asks where is bile stored. The nurse knows that bile is stored in the:
gallbladder
A student nurse is preparing a plan of care for a client with chronic pancreatitis. What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority?
impaired nutrition:less than body requirements
A client is scheduled for a cholecystogram for later in the day. What is the nurses understanding on the diagnostic use of this exam?
it visualizes the gallbladder and bile duct
A patient is admitted to the hospital with a possible common bile obstruction. What clinical manifestations does the nurse understand are indicators of the problem? select all that apply
jaundice pruritus clay-colored feces
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
pancreatitis
When caring for a client with acute pancreatitis, the nurse should use which comfort measure?
positioning the client on the side with the knees flexed
a client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk?
reposition the client every two hours