Chapter 59

Symptoms of IBS typically begin in young adulthood.

True

The liver is the most commonly injured organ in blunt and penetrating trauma.

True

The most common signs of CRC are rectal bleeding, anemia, and a change in stool.

True

The most common symptom of IBS is pain in the left lower quadrant of the abdomen

True

The schilling test measures urinary excretion of Vitamin B12 for diagnosis of pernicious anemia and a variety of other malabsorption sydromes.

True

The spleen is the most commonly injured organ in blunt and penetrating trauma.

True

To reduce the risk of CRC, diets should be low in fat, low in refined carbohydrates, and high in fiber.

True

Volvulosous is twisting of the intesting within itself.

True

An obstruction high in the small intestine often results in metabolic alkalosis.

True.

Emergency care of a patient with abdominal trauma includes which interventions?

Type and cross-matching of four to eight units of blood; Measurement of arterial blood gases; Continuous hemodynamic monitoring; Insertion of a Foley catheter

Acquired as a result of increased intraabdominal pressure.

Umbilical

Which key feature does the nurse most likely find when performing a physical assessment on a patient with a small-bowel obstruction?

Visible peristaltic waves in the upper and middle abdomen.

Which statement about the care of a patient with a colostomy is correct?

A slight amount of edema is normal in the initial postoperative period.

Which observation of a patient with an intestinal obstruction does the nurse report immediately?

Abdominal pain changing from colicky to constant disscomfort.

Which drug is the drug of choice for the treatment of IBS when pain is the predominant symptom?

Amitriptyline (Elavil)

The nurse is teaching a patient about colostomy care. Which information does the nurse include in the teaching plan?

An antifungal cream or powder can be used if a fungal rash develops.

After colostomy surgery, which intervention does the nurse employ?

Apply a pouch system as soon as possible.

Which interventions apply to patients with hypovolemia related to an intestinal obstruction?

Assess for edema from third-spacing.

The nurse is teaching a patient with IBS about complementary and alternative therapies for the disease. Which patient statements indicate that teaching has been effective?

"I should exercise regularly to help manage the disease." "Peppermint oil has been used to expel gas and relax spastic intestinal muscles."

Which statement by a patient indicates an understanding of surgical management of hemorrhoids?

"Urinary retention is a complication of surgical resection of the hemorrhoid."

Which discharge instruction does the nurse include for a patient after abdominoperitoneal (AP) resection?

"Use a soft pillow to sit on whenever you sit down."

What does care of a patient with an nasogastric (NG) tube require?

Assessment of proper placement at least every 4 hours; Cleansing of the nose with the same type of skin protectant used for ostomy skin care before applying the NG tube securing device; Confirmation of NG tube placement by x-ray if it is repositioned; Aspiration of contents of the NG tube and irrigation of the tube with 30 mL of normal saline every 4 hours; Questioning the patient about the passage of flatus

Which drug is used to treat tropical sprue?

Bactrim

A patient with a colostomy may safely include which food item in the diet?

Chicken noodle soup

Which sign/symptom is a patient who had an AP resection instructed to report to the health care provider immediately?

Constant perineal odor and pain.

Which activity does the nurse tell the patient to avoid after surgery for a hernia repair?

Coughing

Which intervention is contraindicated in the nonsurgical management of hemorrhoids?

Diets low in fiber and fluids

The nurse is teaching a patient about how to control gas and odor from a colostomy. Which information does the nurse include?

Do not chew gum

What do postoperative measures for a male patient who has had an inguinal herniorrhaphy include?

Elevating the scrotum on a pillow.

Which discharge information does the nurse include for the patient who has had an intestinal obstruction caused by fecal impaction?

Encourage the patient to report abdominal distention, nausea or vomiting, and constipation.

A plug of fat in the femoral canal enlarges and eventually pulls the peritoneum and often the urinary bladder into the sac.

Femoral

Which statement about intra-abdominal pressure (IAP) monitoring is correct?

High IAP leads to increased afterload and decreased preload.

Cannot be repplaced back into the abdominal cavity.

Incarcerated

Occurs at the site of a previous surgical incision.

Incisional

Which information does the nurse include when teaching a patient with new onset hemorrhoids about prevention of hemorrhoid flare up?

Increase the fiber in your diet to prevent constipation; Maintain a healthy weight; Increase your amount of fluid intake; Prolonged sitting or standing will not affect the development of hemorrhoids;

Sac formed from the peritoneum that contains a portion of the intestine omentum. Hernia pushes downward at an angle into the inguinal canal.

Indirect inguinal

Once the ABCs of the patient with abdominal trauma have been stabilized, the nurse focuses on risks of hemorrhage, shock, and peritonitis.

True

Which NG tube can be connected to low intermittent suction?

Levin

The nurse immediately reports to the surgeon all about which sign/symptom related to a colostomy?

Liquid stool immediately postoperatively

The nurse is performing an abdominal assessment on a patient suspected of having an abdominal hernia. The nurse auscultates the abdomen and determines the absence of bowel sounds. What does the nurse suspect in this patient?

Obstruction and strangulation

What does nursing care of a patient with intestinal obstruction who reports discomfort in the early diagnostic period consist of?

Placing the patient in a semi-Fowler's positiion

Pancreatic enzymes are necessary for absorption of vitamnin B12

True

Contents of the sac can be replaced into the abdominal cavity by gentle pressure.

Reducible

A patient with abdominal trauma has a positive Ballance's sign. What does the nurse suspect in the patient?

Ruptured spleen

The nurse is teaching a patient about what to expect after a descending colon colostomy. The nurse tells the patient to expect the stool to have what kind of form?

Similar to that of stool expelled from the rectum.

Blood supply to the herniated bowel segment is cut off.

Strangulated

Which are true statements about caring for a patient with a truss?

The truss is only used after the hernia has been reduced by the physician; Powder should be applied to the skin under the truss daily;

A hydrogen breath test may be used in the diagnostic phase of the disease.

True

A newer group of drugs used to manage IBS are the muscarinic (M3) receptor antagonists which act by inhibiting intestinal motility.

True

A positive test result for occult blood in the stool confirms bleeding in the GI tract

True

CRC is one of the most prevalent malignancies in the United States.

True

Carcinoembryonic antigen (CEA), an oncofetal antigen, is elevated in many people with CRC.

True

Colonoscopy with biopsy is the definitive test for the diagnosis of CRC

True

Constipation is a classic symptom of Diahrrhea

True

Crohn's disease can cause a mechanical obstruction.

True

Deficiencies of bile salts can lead to malabsorption of fats and fat-soluble vitamins.

True

Ecchymoses in the distribution of a lap seat belt should be reported to the health care provider immediately because the bowel may be injured

True

Gastric surgery is one of the most common causes of malabsorption and maldigestion.

True

Hematochezia is the passage of red blood via the rectum.

True

Hemoglobin and hematocrit values are usually decreased as a result of the intermittent bleeding associated with the tumor.

True

Hypokalemia is the most common electrolyte disturbance that predisposes the patient to intestinal obstruction.

True

Hypovolemia is a common complication of intestinal obstruction.

True

IBS is the most common digestive disorder seen in clinical practice.

True

Intussusception is telescoping of a segment of the intestine within itself.

True

Irritable bowel syndrome (IBS) is a functional GI disorder characterized by chronic or recurrent diarrhea, constipation, and/or abdominal pain and bloating.

True

No actual pathophysiologic changes occur in IBS.

True

Nonmechanical obstruction is also known as paralytic ileus or adynamic ileus.

True

Obstipation is the term which refers to no passage of stool.

True