SG for GI ch 44-48

a client with a colostomy is asking the nurse about what he should and shouldn't eat and drink. which of the following responses would be appropriate?

"Be sure to drink at least 8 to 10 cups of fluid per day."

the nurse is preparing to interview a client with Laennec's cirrhosis. Based on an understanding of this disorder, which question would be most important to include?

"How often to you drink alcohol."

the nurse is talking with a client who is scheduled for a computed tomography (CT) colonography. which client statement would indicate to the nurse that the client needs additional teaching about this procedure?

"My doctor will be able to remove any polyps he finds."

A central venous catheter is inserted for a client being treated for acute pancreatitis. What would the nurse need to monitor closely?

- the nurse monitors pressure measurements -cardiac monitoring is continuous because electrolytes imbalances can produce dysrhythmias. the nurse continues to perform other assessments, including VS, lung sounds, serum electrolyte values, and observe for bleeding. if the client develops respiratory problems, he or she may require intubation and mechanical ventilation.

In addition to teaching a client with constipation to increase dietary fiber intake to 25 g/day what else would the nurse include as important?

-Bran cereals, fresh fruits and vegetables,and beans are excellent sources of insoluble fiber, which promote normal bowel function. Remind client to add these foods gradually -Review usual patterns of elimination -review current medications. -instruct client to increase fluids to 6to 8 glasses per day. -Encourage client to be out of bed, increase activity, or develop a regular exercise program -administer laxatives, suppositories, and enemas as ordered.

What would you expect a client with internal hemorrhoids to report to the nurse?

-cause bleeding but are less likely to cause pain, unless they protrude through the anus. -the amt of bleeding varies from an occasional drop or two of blood on tissue or underwear -usually protrude each time the client defecates but retracts after defecation. as the masses enlarge, they remain outside the sphincter.

A client is receiving tube feedings. What should the nurse include on the care plan to reduce client's risk for aspiration?

-check tube placement and gastric residual before feeding. -place client in semi-Fowler's position during and 30-60 minutes after an intermittent feeding and at all times for a continuous feeding -stop feeding if client vomits or aspiration is suspected.

What is the primary characteristic of colon cancer?

-is a change in bowel habits, such as alternating constipation and diarrhea. -occult or frank blood may be present in the stool.

a client undergoes surgery for a Kock pouch and returns to the nursing unit. The nurse anticipates that the ileal catheter will be removed in about

10-14 days

the nurse is checking the residual content for a client who is receiving intermittent feedings. which residual content, if obtained, would lead the nurse to delay the feeding

120m

a client weighs 215 lbs and is 5'8" tall. the nurse would calculate the client's body mass index BMI as which of the following ?

32.7

a client with peptic ulcer disease, who is receiving histamine-2 antagonist therapy, has a nasogastric tube in place. The nurse tests the pH of aspirated gastric fluid. which pH finding would the nurse interpret as indicating effectiveness of the client's medication?

5.0

A client with cirrhosis is at risk for developing esophageal varices. Which of the following instructions should a nurse provide the client to minimize such risk?

Abstain from drinking alcohol

A client with anorexia complains of constipation. which of the following nursing measures would be most effective in helping the client reduce constipation?

Assist client to increase dietary fiber

which of the following would a nurse expect to assess in a client with peritonitis?

Board-like abdomen

a client with a colostomy asks the nurse for suggestions for foods to help decrease the odor. which of the following foods would the nurse suggest

Buttermilk

A client ingests a carbohydrate solution as part of hydrogen breath testing. The nurse would need to monitor this client for which of the following?

Cramping and abdominal distention

a group of students is reviewing information about oral cancers in preparation for an examination. the students demonstrate a need for additional review when they identify which of the following as a risk factor?

History of GERD

When reviewing the history of a client with pancreatic cancer, the nurse would identify which of the following as a possible risk factor?

History of pancreatitis

When describing abdominal hernias to a group of nursing students, the instructor would identify which type as most common?

Inguinal

the physician orders the insertion of a simple lumen nasogastric tube. when gathering the equipment for the insertion, the nurse would select which of the following?

Levin tube

A client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. which test would the nurse expect to be used to provide definitive confirmation of the disorder?

Liver Biopsy

after teaching a group of students about irritable bowel syndrome and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-related antidiarrheal agent?

Loperamide (Imodium)

A client with N/V is to receive an antiemetic that inhibits the vomiting center in the brain. which of the following would the nurse expect the physician to order most likely?

Prochlorperazine (Compazine)

A client comes to the emergency dept because he noticed a bulging in his groin area when he coughs. He states that he noticed this ever since he lifted a heavy bag of gardening mulch last week. The physician determines that the client has an inguinal hernia and applies manual pressure to replace the protruding structure back into the abdominal cavity . the nurse understands that this procedure indicates that the hernia is which type?

Reducible

A client is admitted with a diagnosis of acute appendicitis. when assessing the abdomen, the nurse would expect the find rebound tenderness at which location?

Right Lower Quadrant

which of the following medications would the nurse expect the physician to order for a client with cirrhosis who develops portal hypertension?

Spironolactone (Aldactone)

A client with Crohn's disease is prescribed medication therapy. Which of the following would the nurse expect to administer as a first line agent?

Sulfasalazine

A client with GERD develops espophagitis. Which diagnostic test would the nurse expect the physician to order to confirm the diagnosis?

Upper endoscopy with biopsy

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?

Vitamin K

a client with a history of constipation is instructed to consume a high fiber diet. which of the following if statement by the client as an appropriate food choice indicates the need for additional teaching?

White bread

which of the following activities is contraindicated for a client undergoing ultrasonography

a client who chews gum during the test.

A client is being prepped to undergo lab and diagnostic testing to confirm the diagnosis of cirrhosis. Which test would the nurse expect to be used to provide definitive confirmation?

a liver biopsy, which reveals hepatic fibrosis, is the most conclusive diagnostic procedure

a client with a gastrojejunostomy is beginning to take solid foods. which finding would lead to nurse to suspect that the client is experiencing dumping syndrome ?

abdominal cramps

After teaching a group of students about intestinal obstruction, the instructor determines that the teaching was effective when the students identify which of the following as a cause of a functional obstruction?

abdominal surgery

After assessing client with peritonitis, the nurse would most likely document bowel sounds as:

absent

a nurse is caring for a client with diarrhea. which of the following interventions would help to ensure that the client's perianal remains intact?

applying ointment with vitamin A and D to the perianal area

when assisting with preparing a client scheduled for a barium swallow , which of the following would be appropriate to include?

avoid smoking for a least a day before the procedure

Client realizes that regular use of laxatives has improved his bowel pattern. The nurse cautions the client against prolonged use of laxatives for what reason.

because such use can cause a loss of normal colonic motility and intestinal tone. Also dull the gastrocolic reflex.

Dilated veins over the abdomen of a client with cirrhosis is called

caput medusae

Client with pilonidal sinus undergoes surgery. Which of the following will be in the post-op care plan?

caring for intact suture line

a client with a feeding tube is to receive medications. the medications supplied is an enteric-coated tablet. which of the following would be most appropriate?

check with the pharmacist to see of a liquid form is available

which of the following instructions should the nurse include in the teaching plan of a client who has undergone colostomy?

chew food well

A client is scheduled for an esophagoogastrodusdenoscopy (EGD) to detect lesions in the GI tract. the nurse would observe for which of the following while assessing the client during the procedure?

client's tolerance for pain and discomfort

Dr. orders Questran for client with cirrhosis. The nurse determines drug is effective when client exhibits which of the following

decreased c/o pruritis.

A patient has received three cleansing enemas in prep for a barium enema. Which would indicate to the nurse the patient is experiencing dehydration?

dizziness and confusion

What dietary recommendations should the nurse give a client after ostomy surgery to prevent irritation and slow transit time?

fiber is restricted.

which of the following laboratory test results would the nurse associate with obstructive jaundice?

increased direct bilirubin.

A client has undergone a total gastrectomy for refractory ulcers. What lifelong treatment will they need?

is a removal of the stomach is performed, the client receives vitamin B 12 injections or intranasal vitamin B12 for life because without the stomach, the intrinsic factors necessary for absorption is no longer produced.

A client is prescribed magnesium and aluminum hydroxide antacid to treat GERD. What should the nurse caution the client about?

may tend to cause diarrhea in some clients. In such cases, switching to an aluminum-only antacid or a calcium-containing antacid such as tums may be helpful

when performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. which of the following intervention should the nurse consider?

measure abdominal girth according to a set routine.

A client with esophageal varices is going to have injection sclerotherapy. Which statement by the client indicates successful teaching?

might need to have this procedure done again." Explanation: Persistent portal hypertension allows varices to form again, making it necessary to repeat injection sclerotherapy or variceal banding regularly. Injection sclerotherapy involves passing an endoscope orally to locate the varix.

a client has had surgery to create an ileoanal reservoir surgery. Which instructions would the nurse give to reduce the risk for bowel incontinence?

perform perineal exercises.

A client undergoing a diagnostic examination of gastrointestinal disorder was given polyethylene glycol/electrolytes solution as a part of the test preparation. which of the following measures should the nurse take once the solution is administered?

permit the client to drink any clear liquids

Which of the following interventions would the nurse need to keep in mind when a loop colostomy of a client is to be opened?

prepare client for pungent odor before the procedure,

the nurse is assisting a client with a colostomy to change his appliance and faceplate are removed, which of the following would the nurse assist the client to do next?

protect the periostomal area from drainage

an older client expresses anxiety before undergoing a barium enema . which of the following measures should the nurse take to relieve him of his next anxiety before the test?

provide printed directions about the steps to be taken

A group of students are studying for an examination on the GI system and are reviewing the structures of the esophagus and stomach. The students demonstrates understanding of the material when they identify which of the following as the opening between the stomach and duodenum?

pyloric sphincter

785-the nurse is caring for a client with hepatitis. Which of the following would lead to nurse to suspect that the client is in the prodromal phase?

rash

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 2 hours

the nurse is inspecting a client's stoma. which finding would the nurse need to report tpo the physician?

retraction beneath the skin

The nurse is providing care to a client who has had a percutaneous liver biopsy. The nurse would monitor the client for which of the following?

s/s of bleeding

What type of stool would you expect to find in an ascending colostomy?

semiliquid

the nurse is preparing to examine the abdomen of a client complaining of a change in his bowel pattern. the nurse would place the client in which position?

supine with knees flexed

the nurse is monitoring a client who has had colostomy surgery . which of the following findings would the nurse need to report to the physician?

temperature of 102.6 F. 39.2C

a client has undergone ileostomy surgery. the nurse suggests the use of a temporary appliance in the immediate postoperative phase based on which rationale

the size of the stoma changes in the postoperative phase

a client with an ileostomy is receiving medications in a slow-release capsule form. The nurse would be alert for which of the following?

undissolved capsules