The Client with Cancer of the Stomach

The nurse should assess the client who is being admitted to the hospital with upper GI bleeding for which of the following? Select all that apply. a) Dry, flushed skin. b) Decreased urine output. c) Tachycardia. d) Widening pulse pressure. e) Rapid respirations. f) Thirst.

b, c, e, f

A client has a nasogastric (NG) tube following a subtotal gastrectomy. The nurse should: a) Irrigate the tube with 30 mL of sterile water every hour, if needed. b) Reposition the tube if it is not draining well. c) Monitor the client for nausea, vomiting, and abdominal distention. d) Turn the machine to high suction if the drainage is sluggish on low suction.

C

After a subtotal gastrectomy, the nurse is developing a plan with the client to assist the client to gain weight. To help the client meet nutritional goals at home, the nurse should: a) Instruct the client to increase the amount eaten at each meal. b) Encourage the client to eat smaller amounts more frequently. c) Explain that if vomiting occurs after a meal, nothing more should be eaten that day. d) Inform the client that bland foods are typically less nutritional and should be used minimally.

B

A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During preoperative teaching, the nurse is reinforcing information about the surgical procedure. Which of the following explanations is most accurate? a) The procedure will result in enlargement of the pyloric sphincter. b) The procedure will result in anastomosis of the gastric stump to the jejunum. c) The procedure will result in removal of the duodenum. d) The procedure will result in repositioning of the vagus nerve.

B

After a subtotal gastrectomy, the nasogastric tube drainage will be what color for about 12 to 24 hours after surgery? a) Dark brown. b) Bile green. c) Bright red. d) Cloudy white.

A

After surgery for gastric cancer, a client is scheduled to undergo radiation therapy. It will be most important for the nurse to include information about which of the following in the client's teaching plan? a) Nutritional intake. b) Management of alopecia. c) Exercise and activity levels. d) Access to community resources.

A

A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication? a) The client has a sore throat. b) The client displays signs of sedation. c) The client experiences a sudden increase in temperature. d) The client demonstrates a lack of appetite.

C

Following a gastrectomy, the nurse should position the client in which of the following positions? a) Prone. b) Supine. c) Low Fowler's. d) Right or left Sims.

C

Since the diagnosis of stomach cancer, the client has been having trouble sleeping and is frequently preoccupied with thoughts about how life will change. The client says, "I wish my life could stay the same." Based on this information, the nurse should understand that the client: a) Is having difficulty coping. b) Has a sleep disorder. c) Is grieving. d) Is anxious.

C

What should the nurse teach a client about how to avoid the dumping syndrome? Select all that apply. a) Consume three regularly spaced meals per day. b) Eat a diet with high-carbohydrate foods with each meal. c) Reduce fluids with meals but take them between meals. d) Obtain adequate amounts of protein and fat in each meal. e) Eat in a relaxing environment.

C, D, E

A client who is recovering from a subtotal gastrectomy experiences dumping syndrome. The client asks the nurse, "When will I be able to eat three meals a day again like I used to?" Which of the following responses by the nurse is most appropriate? a) "Eating six meals a day is time-consuming, isn't it?" b) "You will have to eat six small meals a day for the rest of your life." c) "You will be able to tolerate three meals a day before you are discharged." d) "Most clients can resume their normal meal patterns in about 6 to 12 months."

D

One month following a subtotal gastrectomy for cancer, the nurse is evaluating the nursing care goal related to nutrition. Which of the following indicates that the client has attained the goal? The client has: a) Regained weight loss. b) Resumed normal dietary intake of three meals a day. c) Controlled nausea and vomiting through regular use of antiemetics. d) Achieved optimal nutritional status through oral or parenteral feedings.

D

To reduce the risk of dumping syndrome, the nurse should teach the client to do which of the following? a) Sit upright for 30 minutes after meals. b) Drink liquids with meals, avoiding caffeine. c) Avoid milk and other dairy products. d) Decrease the carbohydrate content of meals.

D