Chapter 48: Assessment of the Gastrointestinal System
The primary health care provider documents that a client has a bruit over the abdominal aorta. What teaching will the nurse provide for assistive personnel (AP) based on this assessment finding?
"Avoid washing the client's abdomen too aggressively."
An older adult has had an instance of drug toxicity and asks why this happens, since the client has been on this medication for years at the same dose. What response by the nurse is best?
"Changes in your liver cause drugs to be metabolized differently."
A client is scheduled for a colonoscopy and the nurse has provided instructions on the bowel cleansing regimen. What statement by the client indicates a need for further teaching?
"It's a good thing I love orange and cherry gelatin."
The assistive personnel note that a client had a dark stool. What stool test would the nurse obtain for this client?
Occult blood test
The nurse working with clients who have gastrointestinal problems knows that which laboratory values are related to which organ functions or dysfunctions? (Select all that apply.)
Ammonia: liver Lipase: pancreas
A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. What action by the nurse is appropriate?
Assess the client's gag reflex.
A client had an endoscopic retrograde cholangiopancreatography (ERCP). The nurse teaches the client and family about the signs of potential complications which include what problems? (Select all that apply.)
Cholangitis Pancreatitis Perforation Sepsis
The nurse is aware of the most recent American Cancer Society Screening Guidelines for colon cancer, which include which accepted testing modalities for people over the age of 50? (Select all that apply.)
Colonoscopy every 10 years Computed tomography (CT) colonography every 5 years Flexible sigmoidoscopy every 5 years
The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include? (Select all that apply.)
Decreased hydrochloric acid production Diminished sensation that can lead to constipation Fat not digested as well in older adults Pancreatic vessels become calcified
The nurse is interviewing a client who reports having abdominal cramping, bloating, and diarrhea after drinking milk or ingesting other dairy products. What health problem does the client most likely have?
Lactose intolerance
To promote comfort and the passage of flatus after a colonoscopy, in what position does the nurse place the client?
Left lateral
A nurse is assessing a client reporting right upper quadrant (RUQ) abdominal pain. What technique would the nurse use to assess this client's abdomen?
Lightly palpate the RUQ last.
The nurse knows that a client with prolonged prothrombin time (PT) values (not related to medication) probably has dysfunction in which organ?
Liver
A nurse cares for a client who is recovering from a colonoscopy. Which actions would the nurse take? (Select all that apply.)
Obtain vital signs every 15 to 30 minutes until alert. Assess the client for rectal bleeding and severe pain Confirm the client has a ride home and plans to rest.
A client is having an esophagogastroduodenoscopy (EGD) and has been given midazolam hydrochloride. The client's respiratory rate is 8 breaths/min. What action by the nurse is appropriate?
Provide physical stimulation.
A client had a colonoscopy and biopsy yesterday and calls the gastrointestinal clinic to report a spot of bright red blood on the toilet paper today. What response by the nurse is appropriate?
Remind the client that a small amount of bleeding is possible.
