Ch. 5 Care of the Patient with a Gastrointestinal Disorder

A nurse is caring for a patient with diarrhea caused by a Clostridium difficile infection, and the patient demands medication to stop diarrhea. Which response would the nurse give the patient?

"Antidiarrheal medications increase the risk of additional complications."

Which instructions does the nurse give to a patient being treated fir oral candidiasis? (select all that apply)

"Avoid hot, cold, spicy, and fried foods." "Perform meticulous hand hygiene." "Use anesthetic an hour before meals."

Which statement by a patient demonstrates an understanding of the role of normal bacteria in the colon?

"Bacteria in the colon produce vitamin K to help with clotting."

Which instruction is important to give a patient after an upper gastrointestinal (GI) study?

"Increase your fluid intake."

Which dietary instruction doe the nurse give to a patient scheduled for a colonoscopy?

"Maintain a clear liquid diet for 1-3 days before the procedure."

A patient is prescribed lansoprazole (Prevacid) and sucralfate (Carafate) for stomach ulcers caused by gastroesophageal reflux disease (GERD). Which instruction is most important to this patient?

"Take lansoprazole 30 minutes before sucralfate

A patient who recently had an appendectomy asks the nurse, "Are there and undesirable effects of removing the appendix?" which response by the nurse is appropriate?

"The appendix has no known digestive function."

Which statement by the student nurse indicates effective learning about the function of the hypothalamus?

"The hypothalamus influences eating habits."

A patient with carcinoma of the esophagus is about to undergo surgery, an esophagogasterectomy, and is very anxious about what to expect immediately after surgery. Which statement would be appropriate to help alleviate the patient's anxiety?

"When you wake up, we will be monitoring you very closely and keep you as comfortable as possible."

Which patient has greater chance of developing Barrett's esophagus (esophageal metaplasia)?

A patient with untreated gastroesophageal reflux disease (GERD)

Which condition is associated with dumping syndrome?

After gastric resection or peptic ulcer surgery

Which of the following medications would be most effective in treating duodenal ulceration caused by Helicobacter pylori?

Amoxicillin

A patient complains of soreness in the mouth and difficulty swallowing food. Which objective sign in this patient will indicate oral candidiasis?

Angular cheilitis

Which classes of drug are used to reduce symptoms of peptic ulcers? (select all that apply)

Antacids Mucosal healing agents Proton pump inhibitors (PPIs) Histamine 2 receptor blockers

A nurse is teaching an obese patient with gastroesophageal reflux disease (GERD) measure that should be taken to prevent complications. Which instructions would the nurse give? (select all that apply)

Avoid tea and coffee Maintain a low-fat diet Avoid smoking cigarettes

A patient with a posotive breath test result has been diagnosed with Helicobacter pylori (H. pylori) peptic ulcer disease. The nurse anticipates administering which drugs? (select all that apply)

Bismuth Tetracycline (Tetra- ABC) Metronidazole (Flagyl)

A patient has been diagnosed with diverticulosis as a result of muscle thickening and increased intracolonic pressure. Which recommendation would the nurse give the patient with regard to food choices?

Bran, fruits, and vegetables

The nurse anticipates a patient with achalasia will undergo which surgical procedure?

Cardiomyotomy

A patient come to the clinic reporting intestinal cramping, diarrhea, and bloating after ingesting foods, such as pasta and pizza. However, meals consisting of meat, vegetables, and a potato do not cause these symptoms. The nurse anticipates the patient may be diagnosed with which disease?

Celiac Disease

Which disorder does the nurse suspect in an elderly patient with a history of diverticulosis who reports rectal bleeding?

Colon cancer

The health care provider prescribes diphenoxylate hydrochloride with atropine (Lomotil) for a patient. Which condition is the patient most likely suffering from?

Diarrhea

A nurse is caring for a patient who will undergo a tube gastric analysis in 20 hours. Which medication, if prescribed, would prompt the nurse to hold the medication and speak to the provider?

Dicyclomine (Bentyl)

A nurse is caring for patient with cancer of the small intestine that required the removal of the duodenum and the jejunum. The nurse knows the patient will have difficulties with which physiologic process?

Digestion

Which condition indicates a need for esophageal manometry?

Dysphagia

A patient is undergoing diagnostic tests to rule out carcinoma of the oral cavity. Which symptoms have been associated with the disease? (select all that apply)

Dysphagia Toothache Mouth edema Constant earache Difficulty in chewing, swallowing, or speaking Numbness or loss of sensation in part of the mouth

A nurse is providing education to patient taking tetracycline for chlamydia. Which instruction would be best for promoting the growth of healthy bacteria?

Eat plain yogurt for breakfast

Which nursing intervention is important to prevent complications after an upper gastrointestinal study with barium?

Ensure increase in fluid intake

Which diagnostic test involves visualization of the esophagus, stomach, and duodenum via a flexible endoscope?

Esophagogastroduodenoscopy

A nurse caring for a patient who recently had gallbladder removed knows the patient will have difficulties digesting large amounts of which type if nutrients?

Fats

When the nurse is interviewing a patient about his health history, which conditions should the nurse include as relevant to gastrointestinal (GI) system? (select all that apply)

Hemorrhoids Lactose intolerance Nausea and vomiting Abdominal distention

A nurse caring for a patient with peptic ulcer disease (PUD) knows to be vigilant for which sign of a life-threatening complication?

Hypotension

Which advice would the nurse give to a patient experiencing heartburn after meals?

Identify and avoid causative foods.

Which advice would the nurse give to a patient reporting constipation?

Increase your fluid intake

A patient comes to the clinic complaining of heartburn after meals and is diagnosed with gastroesophageal reflux disease. Which dietary instructions should the nurse include in teaching?

Limit caffeinated foods and drinks

Which body part is the largest glandular organ in the body that functions as an accessory organ of digestion?

Liver

A patient who has been diagnosed with gastroesophageal reflux disease (GERD) asks the nurse why symptoms are persisting even after diet modifications and medications. The nurse bases the reply on which pathophysiologic change?

Lower esophageal sphincter relaxation

Which nursing action is important after a patient has a partial gastrectomy to prevent further complications?

Measure the patient's blood serum vitamin B12 level

A patient arrives at the clinic complaining of white patches on the tongue and inner cheeks. The patient has a history of diabetes mellitus and current diagnosis of chlamydial infection, for which the patient is taking tetracycline. The nurse anticipates the provider will prescribe which medication?

Nystatin (Nystop)

The nurse is called to the room of a patient who is vomiting and notes the vomitus has an appearance like coffee grounds. Which action should the nurse take first?

Obtain patient's vital signs

The nurse is beginning to teach a patient with GERD about lifestyle changes that can be implemented to minimize the symptoms of the disease. Which instructions will the nurse include?

Reducing caffeine and alcohol consumption may alleviate symptoms of the disease.

A patient with inflammatory bowel disease (IBD) arrives at the clinic for a yearly exam. the patient states, "I feel wonderful. I haven't had any symptoms in 6 months!" The nurse charts the patient disease as being in which stage?

Remission

Malabsorption can be a major in Crohn's disease when which portion of the intestine is involved?

Small intestine

A 70-year-old patient experiences fecal incontinence. Which gastrointestinal structure involves fecal incontinence?

Sphincter

Which characteristics of pain is the nurse to likely find while interviewing a patient with a duodenal ulcer?

Stabbing and radiating up to the shoulder

Which diagnostic test does the nurse expect the health care provider to prescribe for a patient with diarrhea and an intestinal infection?

Stool culture test

Which medication are included in the prescription of a patient who has severe episodes of gastroesophageal reflux disease (GERD)? (select all that apply)

Sucralfate (Carafate) Rabeprazole (Aciphex) Esomeprazole (Nexium) Metoclopramide (Reglan)

Which event can alter a patient's guaiac test results?

The patient consumed organ meant before the test

A patient diagnosed with esophageal cancer has been undergoing radiation therapy. The patient's white blood cell level is increased, oxygen requirements have increased, and lung sounds have decreased. A chest x-ray image shows aspiration pneumonia. The nurse concludes that this is a result of which problem associated with radiation treatment for esophageal cancer?

Tracheoesophageal fistula

A patient has been prescribed misoprostol (Cytotec) to prevent nonsteroidal antiinflammatory drugs (NSAID) induced ulcer. Which instruction is the most important to give the patient?

Use a reliable form of contraception

Which signs and symptoms indicate carcinoma of the esophagus? (select all that apply)

Weight loss Hemorrhage Odynophagia Tracheoesophageal fistula