Chapter 47: Management of Patients With Gastric and Duodenal Disorders

The health care provider prescribes a combination of three drugs to treat peptic ulcer disease. The nurse, preparing to review the drug actions and side effects with the patient, understands that the triple combination should be in which of the following order?

Bismuth salts, antibiotics, and proton pump inhibitors

The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which of the following characteristics would the nurse be most likely to find?

Black and tarry appearance

A patient sustained second- and third-degree burns over 30% of the body surface area approximately 72 hours ago. What type of ulcer should the nurse be alert for while caring for this patient?

Curling's ulcer

Symptoms associated with pyloric obstruction include all of the following except:

Diarrhea

Which of the following appears to be a significant factor in the development of gastric cancer?

Diet

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

Alcohol abuse and smoking.

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer.

Omeprazole (Prilosec)

Which of the following represents the medication classification of a proton (gastric acid) pump inhibitor?

Omeprazole (Prilosec)

The nurse recognizes that the patient diagnosed with a duodenal ulcer will likely experience:

Pain 2 to 3 hours after a meal.

Which of the following is the most successful treatment for gastric cancer?

Peptic ulcers

Why are antacids administered regularly, rather than as needed, in peptic ulcer disease?

To keep gastric pH at 3.0 to 3.5

A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. The nurse suspects:

Vasomotor symptoms associated with dumping syndrome

A client is prescribed tetracycline to treat peptic ulcer disease. Which of the following instructions would the nurse give the client?

"Be sure to wear sunscreen while taking this medicine."

A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which of the following explanations from the nurse would be most accurate?

"Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery."

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which of the following diseases/conditions?

- Frequently monitoring hemoglobin and hematocrit levels - Observing stools and vomitus for color, consistency, and volume - Checking the blood pressure and pulse rate every 15 to 20 minutes

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.

- Ingestion of strong acids - Irritating foods - Overuse of aspirin

Peptic ulcer disease occurs more frequently in people with which blood type?

- O

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen?

10 to 14 days

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

32.7

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?

A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain to his right shoulder. The intial appropriate action by the nurse is to

Assess the client's abdomen and vital signs.

A patient has a BMI ranger greater than 40 kg/m2. What would this patient's obesity classification be?

Class III

Which of the following clients is at highest risk for peptic ulcer disease?

Client with blood type O

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

Drink liquids only between meals.

A nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. The client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15 to 30 minutes after meals. The nurse suspects the client has:

Dumping syndrome.

Which of the following surgical procedures for obesity utilizes a prosthetic device to restrict oral intake?

Gastric banding

The nurse is conducting a community education program on peptic ulcer disease prevention. The nurse concludes that the most common cause of peptic ulcers is which of the following?

Gram-negative bacteria

Review the following four examples of ideal body weight (IBW), actual weight, and body mass index (BMI). Using three criteria for each example, select the body weight that indicates morbid obesity.

IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2

A patient is in the hospital for the treatment of peptic ulcer disease. The nurse finds the patient vomiting and complaining of a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate?

Perforation of the peptic ulcer

Which of the following is a true statement regarding gastric cancer?

Most patients are asymptomatic during the early stage of the disease.

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol (Cytotec). What information from the nurse would be most accurate about misoprostol?

Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)

Which of the following bariatric surgical procedures is optimal for long-term weight loss?

Roux-en-Y

Which of the following are signs/symptoms of perforation?

Sudden, severe upper abdominal pain

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, and labored breathing; the client also appears to be confused. Which of the following complications has the client most likely developed?

Hemorrhage

The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included in the care plan? (Select all that apply.)

Removal of the tumor

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?

Six small meals daily with 120 mL fluid between meals