PrepU

What environment does a patient with acute pancreatitis need?

quiet, restful environment

The client with acute gastritis s/s:

rapid onset -- abdominal discomfort, headache, lassitude, nausea, anorexia, vomiting, and hiccuping, which can last from a few hours to a few days.

What is the nurses primary goal in a patient with pancreatitis?

relieving abdominal pain

A client who is post op from open abdominal surgery is at risk for internal bleeding, which may manifest as what?

rigidity of the abdomen

For a client with an ostomy, maintaining what is a priority?

skin integrity

If the common bile duct is obstructed, the bilirubin level is?

elevated

Appendicitis is characterized by what s/s?

epigastric or umbilical pain along with nausea, vomiting, and low-grade fever

Ulcerative colitis is characterized by what s/s?

exacerbations and remissions of severe bloody diarrhea

Azotorrhea refers to what?

excess of nitrogen in the feces or urine

Why does hypovolemic shock occur in acute pancreatitis?

fluid shifts

Because acute pancreatitis causes nausea and vomiting, the nurse should try to prevent what?

fluid volume deficit

excruciating upper right quadrant pain that radiates to the back or right shoulder is characteristic of what?

gallstones

How should the nurse wash the area around the stoma?

gently with a facecloth and mild soap

What does Prilosec do?

heals peptic ulcer

Tenesmus refers to what?

ineffectual straining at stool

A pilonidal sinus is a what?

infection in the hair follicles in the sacrococcygeal area above the anus

Diverticulitis refers to what?

inflammation of a diverticulum from obstruction (by fecal matter) resulting in abscess formation

Borborygmus is what?

intestinal rumbling caused by the movement of gas through the intestines that accompanies diarrhea

A client with ribbon-like stool may have a...

large-bowel obstruction

Peritonitis presents with what s/s?

a rigid, board-like abdomen, tenderness, and fever

A patient would need a barium enema to identify what?

a tumor in the colon

What is the most commonly used therapy for peptic ulcers?

antibiotics, proton-pump inhibitors, and bismuth salts

Barium swallow test is most appropriate to detect what?

any abnormalities in the esophagus

Anorexia and periumbilical pain are characteristic of what?

appendicitis

Peptic ulcer disease is characterized by what s/s?

dull, gnawing pain in the midepigastrium or the back that worsens with eating

After a Roux-en-Y gastric bypass, the client should be keeping total serving sizes to less than what?

1 cup

The faceplate opening of a stoma should be no more than ___ to ___ larger than the stoma?

1/8 to 1/6

Morbid obesity is body weight that is more than ___ pounds greater than the ideal body weight?

100

How long should a client s/p Roux-en-Y bypass be withholding fluids before meals?

15 minutes

Early manifestations of dumping syndrome occur within how long after eating?

15 to 30 minutes

Morbid obesity is a term applied to people who are more than ______ times their ideal body weight?

2

Morbid obesity is a term applied to those whose body weight index (BMI) exceeds what?

30

Medications to dissolve stones usually take how long to work?

6 to 12 months

How long do H2 antagonists need to be used for?

6 weeks.

The nurse should instruct a client with diverticulosis to drink at least how much water per day?

8 to 10 large glasses

How long should a client s/p Roux-en-Y bypass be withholding fluids after meals?

90 minutes after eating

What breads, cereals, and grains should a patient s/p Roux-en-Y gastric bypass surgery eat?

<2 g of fiber per serving

Epigastric pain occurring 90 minutes to 3 hours after eating indicates what?

duodenal ulcer

An anorectal abscess is common in clients with what disease?

Crohn's

A physician suspects that a client has peptic ulcer disease. What diagnostic procedure would the nurse most likely prepare to assist?

Endoscopy

What are the r/f for colon cancer?

Family history, older than 40 years, a high-fat, high-protein, low-fiber diet

What is the most common complication of PUD?

Hemorrhage

A client discharged after a laparoscopic cholecystectomy calls the surgeon's office reporting severe right shoulder pain 24 hours after surgery. What information should you give your patient about pain?

If pain occurs in the right shoulder or scapular area (from migration of the carbon dioxide used to insufflate the abdominal cavity during the procedure), the nurse may recommend using a heating pad for 15 to 20 minutes hourly, sitting up in a bed or chair, or walking.

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?

NG for decompression

A patient with IBD would be prescribed what diet?

Oral fluids and a low-residue, high-protein, high-calorie diet with supplemental vitamin therapy and iron replacement

H2 receptor antagonists treat what?

PUD

Fluids should not be taken with meals in IBS because they cause what?

abdominal distention.

What is the predominant clinical feature of acute pancreatitis?

abdominal pain

Hypovolemic shock is a major factor in what disease?

acute pancreatitis

The client with diverticulosis should include unprocessed bran in the diet because it does what?

adds bulk

Preoperative preparation includes

adequate hydration, correction of prothrombin deficiency with vitamin K, and treatment of anemia

the endoscopic retrograde cholangiopancreatography (ERCP) visualizes what?

biliary structures and pancreas via endoscopy

The client with gallstones has what colored stool?

clay-colored

why might a client with Zollinger-Ellison syndrome have hypercalcemia?

co-existing parathyroid adenomas or hyperplasia and may therefore

If a nurse suspects internal bleeding in a client what is her priority nursing intervention?

contact HCP

Signs of hemorrhage following surgery include:

cool skin, confusion, increased heart rate, labored breathing, and blood in the stool

Why do patient with cancer on the head of the pancreas need vit k before surgery?

correct prothrombin deficiency

A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk?

cough, deep breath, incentive spirometry (every hour), repositioning (every 2 hours)

Because a client with a total gastrectomy will receive enteral feedings or parenteral feedings, he should do what each day?

daily weight

The excretion of bile pigments by the kidneys makes urine very

dark

Why do patients with IBD also have a significantly increased risk of osteoporosis?

decreased bone mineral density.

A high-fiber diet is prescribed to help control what issues with IBS?

diarrhea and constipation

Acute gastritis is often caused by what

diet (food that is irritating, too highly seasoned, or contaminated with disease-causing microorganisms)

Acute gastritis is often caused by what?

dietary indiscretion (a person eats food that is irritating, too highly seasoned, or contaminated with disease-causing microorganisms)

The primary symptom of achalasia is what?

difficulty swallowing (liquids and solids)

Hemorrhoids are what?

dilated veins outside or inside the anal sphincter

How can a nurse promote a quiet & restful environment?

discourage frequent visits from family and friends

What are oral bile acids used for?

dissolve gallstones

After a Roux-en-Y gastric bypass, the client should not do what?

drink fluids with meals

What position should a patient with peptic ulcer perforation be put in?

on the side with the head slightly elevated

Signs and symptoms of perforation includes

sudden, severe upper abdominal pain (persisting and increasing in intensity); pain may be referred to the shoulders, especially the right shoulder, because of irritation of the phrenic nerve in the diaphragm

Inflammation of the pancreas in pancreatitis causes a response that elevates what?

temperature a

An anal fistula (fistula in ano) is a what?

tract that forms in the anal canal

Signs and symptoms if dumping syndrome include what?

vertigo, tachycardia, syncope, sweating, pallor, palpitations, diarrhea, nausea, and the desire to lie down

Clients with carcinoma of the head of the pancreas typically require what before surgery?

vitamin K

What is the highest care priority for a client with esophageal cancer?

patent airway

What SE should you monitor a client for that is taking medication to dissolve stones?

GI symptoms, pruritus, headache

The nurse should place the client with acute pancreatitis in what position?

side-lying position with knees flexed

The nurse can create an adequate seal and prevent leakage of fecal material from under the faceplate by using what?

skin barrier

Cholecystography will be most appropriate for detection of what?

stones in the gallbladder

The client with diverticulosis should avoid the use of what medications?

laxatives or enemas

Pain caused by diverticulitis is in what quadrant?

left lower quadrant

A patient would undergo a radionuclide image test what?

lesions in the live

After a total gastrectomy, a client will need to take vitamin B12 shots for how long?

life

An anal fissure (fissure in ano) is a what?

linear tear in the anal canal tissue

Diverticulitis has what onset?

moderate onset

Indicators of pyloric obstruction are:

nausea, vomiting, distended abdomen, and abdominal pain.

Why is a correctly sized faceplate important?

protects the skin from exposure to fecal material

Omeprazole (Prilosec) is what class of drug?

proton pump inhibitor

Rapid growth of cancer cells in the esophagus may do what?

put pressure on trachea (jeopardizing the airway)

When does abdominal pain d/t pancreatitis usually reach peak intensity?

several hours after onset of the illness

Signs of penetration and perforation are:

severe abdominal pain, rigid and tender abdomen, vomiting, elevated temperature, and increased heart rate

Patients with IBD also have a significantly increased risk of what?

osteoporotic fractures

Dehiscence of the surgical wound is characterized by what s/s?

pain and a pulling or popping feeling at the surgical site

What are the characteristics/s of diverticulitis?

pain, nausea, vomiting, fever, and chills

where does fluid shift to in acute pancreatitis?

peritoneum

What is the major cause of morbidity and mortality in clients with acute pancreatitis?

pancreatic necrosis

Nausea and vomiting may occur as a result of what in pancreatitis?

pancreatic tissue damage from activation of pancreatic enzymes

Elevated serum and urine amylase, lipase, and liver enzyme levels accompany what disease?

pancreatitis

What factors are associated with the development of pancreatic cancer?

pancreatitis, DM, a high-fat diet, cigarette smoking, coffee

Zollinger-Ellison syndrome (ZES) s/s:

peptic ulcers, gastric hyperacidity, and gastrin-secreting benign or malignant tumors of the pancreas, diarrhea and steatorrhea, hypercalcemia

A rigid, boardlike abdomen is a sign of what?

peritonitis (life-threatening condition)

Dietary B12 is absorbed in the stomach, and the inability to absorb it could lead to what after a gastrectomy?

pernicious anemia

Eliminating wrinkles in the faceplate protects the skin surrounding the stoma from what?

pressure

Why should a patient with pancreatitis be placed in the side-lying position with the knees flexed?

promotes comfort by decreasing pressure on the abdominal muscles