Chp. 37 Disorders of Gastrointestinal Function

A client who ate a large meal and then went to weightlifting class states "feeling very uncomfortable" and reports gastric reflux. What is the nurse's best response to the client?

"There is backward movement of gastric contents into the esophagus that occurs soon after eating."

During a lecture discussing nausea and vomiting, the nurse reviews the role of the chemoreceptor trigger zone which may be stimulated (causing vomiting) by which factors? Select all that apply.

-Chemotherapeutic agents -Salmanella food poisoning -Increased intracranial pressure

Select the client at greatest risk for developing colorectal cancer.

A 64-year-old female whose mother had colorectal cancer

Which individual most likely faces the greatest risk of developing Clostridium difficile colitis?

A 79-year-old hospital client who is being treated with broad-spectrum antibiotics

What manifestations would a nurse expect while assessing a client who has recently developed peritonitis?

A board-like abdomen

Which client should the nurse observe most closely for the signs and symptoms of paralytic ileus?

A client who is first day postoperative following gallbladder surgery

A nurse is reviewing the admission assessment data of a client diagnosed with acute gastritis. The nurse determines that the condition most likely occurred as a result of:

Arthritis treated with high levels of nonsteroidal anti-inflammatory (NSAIDs) agents

An older adult client presents with loose mucus-filled stools. The nurse suspects the client has Clostridium difficile. What is a priority assessment for the nurse?

Ask the client about his or her antibiotic use.

Symptoms of gastric cancer include vague epigastric pain, which makes early detection difficult. The nurse would expect a client to undergo which diagnostic examination to determine the location of the gastric cancer?

Barium x-ray

Which characteristic differentiates inflammatory diarrhea from the non-inflammatory type?

Bloody stools caused by invasion of intestinal cells

A client diagnosed with inflammatory diarrhea is having multiple small, bloody stools with a fever. Which could be a likely cause of this inflammatory diarrhea?

C. difficile

Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description?

Cobblestone

An older adult client has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which potential problem would the nurse anticipate in this client?

Colonization of Clostridium difficile

An older adult client expresses concern about straining to pass stools that are small and hard. What term will the health care provider use to document this in this client's chart?

Constipation

A client who is diagnosed with Zollinger-Ellison syndrome will exhibit which symptoms?

Diarrhea with fat deposits

A geriatric client is having infrequent stools with a history of watery diarrhea, fecal soiling, and fecal incontinence. Which intervention would be a priority assessment for nurse to perform?

Digital rectal examination

A client is admitted with chronic gastritis. The nurse expects which invasive test to be performed to establish the presence of Helicobacter pylori (H. pylori)?

Endoscopic biopsy

Pharmacologic treatment for peptic ulcers has changed over the past several decades. The nurse knows that the goal for pharmacologic treatment is focused on:

Eradicating Helicobacter pylori (H. pylori)

The nurse is teaching her client with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component?

Fat

Good hand-washing techniques are important in health care. The nurse knows that bacterial infections can be prevented by good hand washing techniques. Which route of transmission is most common for Clostridium difficile?

Fecal-oral transmission

A teenager who has a history of achalasia will likely complain of which clinical manifestation?

Feeling like there is food stuck in the back of the throat

A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be:

Fistula formation

Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:

Fistula formation

In the balance of secretions in the gastric mucosa by the parietal cells, which ion is produced to buffer the production of hydrochloric acid?

HCO3-

The most common forms of peptic ulcer are duodenal and gastric ulcers. What are the most common risk factors for peptic ulcer disease?

Helicobacter pylori (H. pylori)

A client is diagnosed with Crohn disease. The nurse instructs the client on which type of dietary needs?

High-calorie, vitamin, and protein diet

Crohn disease is a recurrent inflammatory disease that can affect any area of the bowel. Characteristic of Crohn disease are granulomatous lesions that are sharply demarcated from the surrounding tissue. The nurse caring for a client with newly diagnosed Crohn disease would know to include what in the teaching?

Information on sulfasalazine, including dosage, route, frequency, and side effects of the drug

A client presents for follow-up with ongoing treatment for peptic ulcer disease. What is the most likely goal of this client's pharmacologic treatment?

Inhibiting gastric acid production

Diverticulitis is the herniation of tissue of the large intestine through the muscularis layer of the colon. It is often asymptomatic and is found in approximately 80% of people over the age of 85. Diverticulitis is often asymptomatic, but when symptoms do occur, what is the most common complaint of the client?

Lower left quadrant pain with nausea and vomiting

Crohn disease not only affects adults but also can occur in children. The nurse assesses for which major manifestation in children with Crohn disease?

Malnutrition

An ultrasound confirms appendicitis as the cause of a client's sudden abdominal pain. Which etiologic process is implicated in the development of appendicitis?

Obstruction of the intestinal lumen

Atrophic gastritis and decreased secretion of intrinsic factor are more common with aging. The subsequent deficiency of vitamin B12 can cause which condition to occur? Select all that apply.

Peripheral neuropathy Pernicious anemia

A client is admitted with an abrupt onset of referred pain to the epigastric area, with an episode of nausea. On the nurse's initial assessment, the client is lying still and taking shallow breaths, with a rigid abdomen. Which problem is the client experiencing?

Peritonitis

After several months of persistent heartburn, an adult client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to be prescribed for this client's GERD?

Proton pump inhibitors; avoiding large meals; remaining upright after meals

A nurse is completing an abdominal assessment on a client suspected to have appendicitis. When the nurse applies and then releases pressure in the client's right lower quadrant, the client experiences tenderness. The nurse is documenting the presence of:

Rebound tenderness

Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn disease and ulcerative colitis. Which pattern describes Crohn's disease?

Skip lesions

Which meal choice is most likely to exacerbate an individual's celiac disease?

Spaghetti with meatballs and garlic bread

The cause of gastric carcinomas has been influenced by which factors? Select all that apply.

Strain of Helicobacter pylori (H. pylori)• Environmental factors• Family history

The client who has experienced third-degree burns is susceptible to which specific type of gastrointestinal (GI) ulceration?

Stress

A nurse administering a client's medication tells the client that a proton pump inhibitor has been added. When the client asks the purpose of the medication, the nurse responds that it is to prevent:

Stress ulcer

Following the analysis of colonoscopy with biopsy, a client is diagnosed with colorectal cancer. Which treatment modality will be the mainstay of this client's treatment regimen?

Surgery

A client experiencing fulminant disease of ulcerative colitis would be at risk for developing which complication associated with colonic dilation?

Toxic megacolon

The body uses common physiologic responses that are common to gastrointestinal (GI) disorders. A nurse would expect to see which physiologic response known to be protective by removing noxious agents from the body?

Vomiting

One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. Because it is possible to get a false-positive result on these tests, the nurse would instruct the client to:

avoid nonsteroidal anti-inflammatory drugs (NSAIDs) for 1 week prior to testing.

A 68-year-old man who has smoked for at least 50 years reports that lately he feels as though food is "getting stuck" in his throat. At first this was a problem just with dry food, but now his morning oatmeal is getting stuck. On questioning, he reports drinking at least five alcoholic beverages nearly every day. His problem is most likely:

squamous cell carcinoma of the esophagus.

A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:

surgery to release the bowel.