Gastrointestinal Problems and Medications

One hour before meals and at bedtime

A client with a gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. The nurse would schedule the medication for which times?

"The medications will kill the bacteria and stop the acid production."

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. Which statement by the client indicates the best understanding of the medication regimen?

Reduction of steatorrhea

A client with chronic pancreatitis has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?

Checking the frequency and consistency of bowel movements

A client with Crohn's disease is scheduled to receive an infusion of infliximab. What intervention by the nurse will determine the effectiveness of treatment?

Gray-blue color at the flank. Abdominal guarding and tenderness and Left upper quadrant pain with radiation to the back.

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply.

Increase intake of fluids, including juices.

A client diagnosed with viral hepatitis is complaining of "no appetite" and "losing my taste for food." What instruction would the nurse give the client to provide adequate nutrition?

This is a normal, expected event.

A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?

Malaise

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding?

Administer stool softeners as prescribed. Encourage a high-fiber diet to promote bowel movements without straining. Apply cold packs to the anal-rectal area over the dressing until the packing is removed.

A client has just had a hemorrhoidectomy. Which nursing interventions are appropriate for this client? Select all that apply.

Assessing for the return of the gag reflex

A client suspected of having a duodenal ulcer has undergone esophagogastroduodenoscopy. The nurse would place highest priority on which item as part of the client's care plan?

Relief of epigastric pain

A client with gastritis who uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking misoprostol. The nurse determines that the misoprostol is having the intended therapeutic effect if which finding is noted?

An episode of diarrhea

A client with gastroenteritis has an as-needed prescription for loperamide hydrochloride. For which condition would the nurse administer this medication?

Nausea and vomiting

A client with gastroenteritis has an as-needed prescription for ondansetron. For which condition(s) would the nurse administer this medication?

Vomiting following cancer chemotherapy

A client with gastroesophageal reflux disease has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition?

Lying recumbent following meals

A client with hiatal hernia chronically experiences heartburn following meals. The nurse would plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia?

Heartburn

A client with peptic ulcer disease has been taking omeprazole for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?

Fluid and electrolyte imbalance

A client with severe Crohn's disease has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery?

Irrigating the nasogastric tube

A client with severe ulcer disease in the distal stomach undergoes a gastrojejunostomy (Billroth II procedure). Which postoperative prescription would the nurse question and verify?

Confusion

An older client with peptic ulcer disease recently has been taking cimetidine. The nurse monitors the client for which most frequent central nervous system side effect of this medication?

"I will take the cimetidine with my meals." "I'll know the medication is working if my diarrhea stops." "Taking the cimetidine with an antacid will increase its effectiveness."

The nurse determines that the client needs further instruction on cimetidine if which statements were made? Select all that apply.

"This medication would only be taken with water."

The nurse has given instructions to a client with biliary disease who has just been prescribed cholestyramine. Which statement by the client indicates a need for further instruction?

"I'm glad I don't have to lie still for this procedure."

The nurse has taught the client with suspected gallbladder disease about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs further information if the client makes which statement?

Document the findings.

The nurse is assessing a client 24 hours after a cholecystectomy. The nurse notes that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is most appropriate?

Fever. Complaints of indigestion. Pain in the upper right quadrant after a fatty meal.

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? Select all that apply.

Pain relieved by food intake

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse would assess the client for which manifestation of duodenal ulcer?

Notify the surgeon.

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention?

Sweating and pallor

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence?

A rigid, boardlike abdomen

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer?

Coffee. Chocolate. Peppermint. Fried chicken

The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items would the nurse include on this list? Select all that apply.

Purple discoloration of the stoma

The nurse is providing care for a client with a bowel obstruction who had a transverse colostomy created. Which observation requires immediate notification of the primary health care provider?

Limit the fluids taken with meals.

The nurse is providing discharge instructions to a client following gastrectomy and would instruct the client to take which measure to assist in preventing dumping syndrome?

I need to increase the fiber in my diet.

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction?

Pasta with sauce

The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to the client?

" Maintain NPO (nothing by mouth) status." Encourage coughing and deep breathing. Give hydromorphone intravenously as prescribed for pain.

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply.

Ask the client to extend the arms.

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How would the nurse assess for its presence?

"I need to limit my intake of dietary liber."

The nurse provides instructions to a client about measures to treat irritable bowel syndrome (IBS). Which statement by the client indicates a need for further teaching?

"I ate shellfish about 2 weeks ago at a local restaurant."

The primary health care provider has determined that a client has contracted hepatitis A based on flulike symptoms and jaundice. Which statement made by the client supports this medical diagnosis?