Med Surg Chapter 47 Quiz

A patient is scheduled for a Billroth 1 procedure for ulcer management. What does the nurse understand will occur when his produce is performed?

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

A patient has a Class II classification of obesity. What level of health risk foes this pose for the patient?

Severe risk

A patient taking metronidazole (flagyl) for the treatment of H pylori states that the medication is causing nausea. What suggestion can then ruse provide to the patient to alleviate the is problem?

Take the medication with meals to decrease the nausea

The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included int he care plan?

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

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply)

- It can be caused by ingestion of strong acids - You may have ingested some irritating foods - Is it possible that you are overusing aspirin

A patient comes to the clinic with the complaint, "I think i have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? (select all that apply)

- Burning sensation localized in the back or mid-epigastrium - Feeling of emptiness that precedes meals from 1 to 3 hours - Severe gnawing pain that increases in severity as the day progresses

The nurse is educating a patient about the discharge medication. When should the nurse instruct the patient to take the antacid medication?

1 to 3 hours after the meal

The nurse is caring for a patient who has been diagnosed with gastritis To promote fluid balance when treating gastritis, the nurse knows that what minimal daily intake of fluids is required?

1.5 L

The stomach pouch created by gastric bypass or bonding surgery can holdup to ______ mL of food and fluids.

30

Antidiarrheal

Bismuth subsalicylate (Pepto Bismol)

How does bariatric surgery work?

By restricting a patient's ability to eat and by restricting ingested nutrient absorption

Antibiotics

Clarithromycin (Biaxin)

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

Class III

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

The nurse is educating a patient with peptic ulcer disease about he disease process. What decreases the secretion of bicarbonate form the pancreas into the duodenum, resulting in increase acidity of the duodenum?

Drinking carbonated beverages

A patient who had a Roux-en-Y bypass procedure for mobid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the patient complained of cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the patient be educated about regarding this event?

Dumping Syndrome

__________________ is the bacillus commonly associated with the formation of gastric, and possibly duodenal, ulcers.

Helicobacter pylori

The most common complication of peptic ulcer disease that occurs in 10% to 20% of patients is __________________.

Hemorrhage

_____________, __________________, ______________, and ________________ are some of the major potential complications of peptic ulcer.

Hemorrhage, perforation, penetration, pyloric obstruction

Name two conditions that a re specifically related to peptic ulcer development

Hypersecretion of acid pepsin and a weakened gastric mucosal barrier predispose to peptic ulcer development.

Prostaglandin E1 analogue

Misoprostol (cytotec)

A frequently prescribed proton pump inhibitor of gastric acid is _______________.

Nexium

Proton pump Inhibitor

Pantoprazole (Protonix)

Explain why patients who has gastritis due to a vitamin deficiency usually have malabsorption of vitamin b12

Patient with gastritis due to a vitamin deficiency exhibit antibodies against intrinsic factor, which interferes with vitamin b12 absorption.

A patient is in the hospital of rate treatment of peptic ulcer disease. The nurse finds the patient committing 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

The nurse is caring for a patient who is suspected to have developed a peptic ulcer hemorrhage. Which action would the nurse perform first?

Place the patient in a recumbent position with the legs elevated

Describe the clinical manifestations associated with peptic ulcer perforation

When peptic ulcer perforation occurs, the patient experiencing severe upper abdominal pain, vomiting, fainting, and an extremely tender abdomen that can be board like in rigidity; signs of shock will be present (hypotension and tachycardia)

Describe the priority intervention of a corrosive acid or alkali.

Dilue and neutralize the offending agent. To neutralize a corrosive acid, use common antacids such as milk and aluminum hydroxide. To neutralize an alkali,use diluted lemon juice or diluted vinegar

List sever findings characteristic of Zollinger-Ellison Syndrome.

Hypersecretion of gastric juice, multiple duodenal ulcers, hypertrophied duodenal glands, and gastrinomas (islet cell tumors) in the pancreas

Peptic ulcers occur with the most frequency in those between the ages of _______ and __________.

40 and 60

The average weight loss after bariatric surgery is about _____________% of previous body weight.

60%

What does the term "stress" ulcer mean?

A stress ulcer refers to acute mucosal ulceration of the duodenal or gastric area that occurs after a stressful event.

What is the difference between Cushing and Curling's ulcer in terms of cause and location?

Cushing's ulcers, which are common in patients with brain trauma, usually occur in the esophagus, stomach, or duodenum. Curling's ulcers occur most frequently after extensive burns and usually involve the antrum of the stomach and duodenum.

A patient is complaining of diarrhea after having bariatric surgery. What nonpharmacologic treatment can the nurse suggest to decrease the incidence of diarrhea?

Decrease the fat content in the diet.

The most common site for peptic ulcer formation is the __________________.

Duodenum

Explain the current theory about diet modification for peptic ulcer disease.

The objective of the ulcer diet is to avoid over secretion and hyper motility in the gastrointestinal tract. Extremes of temperature should deb avoided, as well as overstimulation by meat extractives, coffee (including decaffeinated), alcohol, and diets rich in milk and crew. Current therapy recommend three regular meals per day if an antacid or histamine blocker is taken

Histamine 2 receptor antagonist

Famotidine (Pepcid)