PrepU Chapter 46: Management of Patients with Gastric & Duodenal Ulcers

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement?

"I have learned some relaxation strategies that decrease my stress."

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

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

A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:

Alcohol abuse and smoking

The nurse practitioner suspects that a patient may have a gastric ulcer after completing a history and physical exam. Select an indicator that can be used to help establish the distinction between gastric and duodenal ulcers.

Amount of hydrochloric acid (HCL) secretion in the stomach

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer?

Awakening in pain

The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included in the care plan? Select all that apply.

Checking the blood pressure and pulse rate every 15 to 20 minutes Observing stools and vomitus for color, consistency, and volume

Which ulcer is associated with extensive burn injury?

Curling ulcer

Which of the following appears to be a significant factor in the development of gastric cancer?

Diet

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

Drink liquids only between meals

Which term refers to the first portion of the small intestine?

Duodenum

Review the following four examples of ideal body weight (IBW), actual weight, and body mass index (BMI). Using three criteria for each example, select the body weight that indicates morbid obesity.

IBW = 145 lbs; weight = 290 lbs; BMI = 31 kg/m2

The nurse in the ED admits a client with suspected gastric outlet obstruction. The client's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order?

Nasogastric tube insertion

Which medication classification represents a proton (gastric acid) pump inhibitor?

Omeprazole

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition?

Peptic ulcers

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?

Six small meals daily with 120 mL fluid between meals

A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal?

Slows gastric emptying

A client is admitted with a gastrointestinal bleed. What client symptom may indicate a peptic ulcer perforation to the nurse?

Sudden, severe upper abdominal pain

A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect?

Vasomotor symptoms associated with dumping syndrome

A client admitted for treatment of a gastric ulcer is being prepared for discharge. The client will follow a regimen of antacid therapy. Discharge teaching should include which instructions? Choose all that apply.

"Continue to take antacids even if your symptoms subside." "You may be prescribed H2-receptor antagonists for up to 1 year."

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.)

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

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen?

10 to 14 days

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse?

Assess the client's abdomen and vital signs

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description?

Black and tarry

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

Dumping syndrome

A client has given a confirmed diagnosis of gastric cancer. Which procedure is important to assess tumor depth?

Endoscopic ultrasound

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist?

Endoscopy

Which medication is classified as a histamine-2 receptor antagonist?

Famotidine

A client with peptic ulcer disease wants to know nonpharmacologic ways to prevent recurrence. Which of the following measures would the nurse recommend? Select all that apply.

Following a regular schedule for rest, relaxation, and meals Substituting decaffeinated products for all forms of coffee Avoidance of alcohol Smoking cessation

Which diagnostic test would be used first to evaluate a client with upper GI bleeding?

Hemoglobin and hematocrit

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed?

Hemorrhage

The nurse is cautiously assessing a client admitted with peptic ulcer disease because the most common complication that occurs in 10% to 20% of clients is:

Hemorrhage

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.

Irritating foods Ingestion of strong acids Overuse of aspirin

Which is a true statement regarding gastric cancer?

Most clients are asymptomatic during the early stage of the disease

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply.

Nizatidine Famotidine Cimetidine

Peptic ulcer disease occurs more frequently in people with which blood type?

O

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer.

Omeprazole

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and 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

Which of the following interventions are appropriate for clients with gastritis? Select all that apply.

Provide general education about how to prevent recurrences Use a calm approach to reduce anxiety Discourage cigarette smoking Notify the physician of indicators of hemorrhagic gastritis

Which of the following is the most successful treatment for gastric cancer?

Removal of the tumor