CH. 43 Digestive and GI

The nurse conducts education related to test preparation for a client scheduled to undergo an abdominal ultrasonography. The nurse should give the client which instruction? Avoid exposure to sunlight for at least 6 to 8 hours before the test. Restrict eating of solid food for 8 to 12 hours before the test. Do not undertake any strenuous exercise for 24 hours before the test. Do not consume anything sweet for 24 hours before the test.

Restrict eating of solid food for 8 to 12 hours before the test.

Stool Color: Spinach

Green

The nurse is assessing a client who is stating gastrointestinal upset and a feeling of bloating. Which type of meal would the nurse anticipate causing these types of symptoms?

Hamburger and French fries

5-6 bowel sounds in less than 30 seconds is classified as?

HYPERactive

Stool Color: when suspected lower rectal or anal bleeding

streaking of blood on the surface of the stool or if blood is noted on toilet tissue

hydrogen breath test determines?

the amount of hydrogen expelled in the breath after it has been produced in the colon and absorbed into the blood.

Which enzyme aids in the digestion of protein?

trypsin

The client describes a test previously completed to detect a small bowel obstruction prior to admission to the hospital. The client states that the test involved insertion of a tube through the nose and lasted over 6 hours. The nurse determines which test name should be documented?

upper GI enteroclysis

The nurse provides client education to a client about to undergo hydrogen breath testing. The nurse evaluates that the client understands the test when the client makes which statement? "I should avoid antibiotics for 1 month before the test." "The test will detect the presence of oral cancer." "First, I will drink a cherry flavored liquid." "The test will detect the presence of staph."

"I should avoid antibiotics for 1 month before the test."

A home care nurse is caring for a client with reports of epigastric discomfort who is scheduled for a barium swallow. Which statement by the client indicates an understanding of the test? "I'll take a laxative to clear my bowels before the test." "There is no need for special preparation before the test." "I'll avoid eating or drinking anything 6 to 8 hours before the test." "I'll drink full liquids the day before the test."

"I'll avoid eating or drinking anything 6 to 8 hours before the test."

A client asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers: "It detects a protein normally found in the blood." "It determines functionality of the liver." "It indicates if a cancer is present." "It tells the physician what type of cancer is present."

"It indicates if a cancer is present."

The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response? "If the health care provider massages over the exact painful area, the pain will disappear." "The area may determine the severity of the pain." "This determines the pain medication to be ordered." "Often the area of pain is referred from another area."

"Often the area of pain is referred from another area."

The nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment?

1. Inspection 2. auscultation 3. percussion 4. palpation

Endoscopic retrograde cholangiopancreatography (ERCP): 1. uses what? 2. to view what?

1. endoscope & xrays 2. bile duct, pancreatic ducts, and gallbladder

When completing a nutritional assessment of a patient who is admitted for a GI disorder, the nurse notes a recent history of dietary intake. This is based on the knowledge that a portion of digested waste products can remain in the rectum for how many days after a meal is digested?

3 days

The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment? Drowsiness Abdominal distention Sore throat Thirst

Abdominal distention

What digestive enzyme aids in the digesting of starch?

Amylase

The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete prior to this assessment?

Ask the client to empty the bladder.

An older adult client is admitted to an acute care facility for treatment of an acute flare-up of a chronic gastrointestinal condition. In addition to assessing the client for complications of the current illness, the nurse monitors for age-related changes in the gastrointestinal tract. Which age-related change increases the risk of anemia? Decrease in intestinal flora Atrophy of the gastric mucosa Dulling of nerve impulses Increase in bile secretion

Atrophy of the gastric mucosa

When assisting with preparing a client scheduled for a barium swallow, which of the following would be appropriate to include? Avoid smoking for at least 12 to 24 hours before the procedure. Take three cleansing enemas before the procedure. Take vitamin K before the procedure. Avoid the intake of red meat before the procedure.

Avoid smoking for at least 12 to 24 hours before the procedure.

During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring? Rectal fissure Bowel perforation Colonic polyp Infection

Bowel perforation

When examining the skin of a client who is dehydrated due to fluid losses from the gastrointestinal tract, which of the following would be most important? Checking if the skin is discolored Examining the sclera if it is yellow Checking if the mucous membranes are dry Observing for distended abdominal veins

Checking if the mucous membranes are dry

A client is scheduled for several diagnostic tests to evaluate gastrointestinal function. After teaching the client about these tests, the nurse determines that the client has understood the teaching when the client identifies which test as not requiring the use of a contrast medium? Computer tomography Small bowel series Upper GI series Colonoscopy

Colonoscopy

Stool Color: Cocoa

Dark red or brown

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test? Encourage plenty of fluids. Order a high-fiber diet. Serve the client his usual diet. Serve dairy products.

Encourage plenty of fluids.

The nurse is investigating a client's report of pain in the duodenal area. Where should the nurse perform the assessment? Hypogastrium in the right or left lower quadrant Periumbilical area, followed by the right lower quadrant Left lower quadrant Epigastric area and consider possible radiation of pain to the right subscapular region

Epigastric area and consider possible radiation of pain to the right subscapular region

The nurse is working in a diagnostic testing unit focusing on gastrointestinal studies. For which testing procedure is the nurse correct to assess the gag reflex before offering fluids? Colonoscopy Esophagogastroduodenoscopy Sigmoidoscopy Peritoneoscopy

Esophagogastroduodenoscopy

Which of the following is a function of the stomach? Select all that apply. -Secretion of bile -Food storage -Secretion of digestive fluids -Secretion of digestive enzymes -Propels partially digested food into small intestine

Food storage Secretion of digestive fluids Propels partially digested food into small intestine

A few hours after eating hot and spicy chicken wings, a client presents with lower chest pain. He wonders if he is having a heart attack. How should the nurse proceed first? Explain that fatty foods can mimic chest pain. Administer an over-the-counter antacid tablet. Call for an immediate electrocardiogram. Further investigate the initial complaint.

Further investigate the initial complaint.

Gastrin has which of the following effects on gastrointestinal (GI) motility? Increased motility of the stomach Relaxation of the colon Contraction of the ileocecal sphincter Relaxation of gastroesophageal sphincter

Increased motility of the stomach

When examining the abdomen of a client with reports of nausea and vomiting, what would the nurse do first?

Inspection

A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The health care provider begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption?

Intrinsic factor

After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. What should the nurse do based on the assessment findings? -Listen longer for the sounds. -Call the health care provider to report absent bowel sounds. -Return in 1 hour and listen again to confirm findings. -Document that the client is constipated.

Listen longer for the sounds.

While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure?

Liver

A client with a recent history of rectal bleeding is being prepared for a colonoscopy. Initially, how should the nurse position the client for this test?

Lying on the left side with knees bent

Stool Color: Barium

Milky White

A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow? Observing the color of urine. Monitoring the volume of urine. Placing any stool passed in a specific preservative. Monitoring the stool passage and its color.

Monitoring the stool passage and its color.

What part of the GI tract begins the digestion of food?

Mouth

bowel sounds heard every 5-20 seconds are?

NORMAL

The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland?

Pancreas

The nurse is assisting the health care provider with a gastric acid stimulation test for a client. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions? Glycopyrronium bromide Acetylcysteine Atropine Pentagastrin

Pentagastrin

What enzyme is secreted by the gastric mucosa?

Pepsin

Enzymes/Secretions That Digest Protein (5)

Pepsin Trypsin Aminopeptidase Dipeptidase Hydrochloric

A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as a part of the test preparation. Which of the following measures should the nurse take once the solution is administered? Instruct the client to have low-residue meals. Provide saline gargles to the client. Permit the client to drink only clear liquids. Allow the client to ingest fat-free meal.

Permit the client to drink only clear liquids.

Enzymes/Secretions That Digest Fat (Triglyceride) (4)

Pharyngeal lipase Steapsin Pancreatic lipase Bile

What solutions are considered the most effective bowel cleansing preparatory agent?

Polyethylene glycol

Which diagnostic produces images of the body by detecting the radiation emitted from radioactive substances? Computed tomography (CT) Fibroscopy Positron emission tomography (PET) Magnetic resonance imaging (MRI)

Positron emission tomography (PET)

The nurse cares for a client after an endoscopic examination and prepares the client for discharge. The nurse includes which instruction? Resume regular diet. Avoid driving for 24 hours. Continue a clear liquid diet. Increase fluid intake.

Resume regular diet.

Enzymes That Digest Carbohydrates (5)

Ptyalin (salivary amylase) Amylase Maltase Sucrase Lactase

A group of students are studying for an examination on the gastrointestinal (GI) system and are reviewing the structures of the esophagus and stomach. The students demonstrate understanding of the material when they identify which of the following as the opening between the stomach and duodenum?

Pyloric sphincter

The nurse is scheduling gastrointestinal (GI) diagnostic testing for a client. Which GI test should be scheduled first? Small bowel series Barium enema Barium swallow Radiography of the gallbladder

Radiography of the gallbladder

Following ingestion of carrots or beets, the nurse would expect which alteration in stool color?

Red

Stool Color: Carrots, beets, red gelatin

Red

A client is scheduled for bowel resection with anastomosis involving the large intestine. Because of the surgical site, the nurse formulates the nursing diagnosis of Risk for infection. To complete the nursing diagnosis statement, the nurse should add which "related-to" phrase? Related to the presence of a nasogastric (NG) tube postoperatively Related to the presence of bacteria at the surgical site Related to malnutrition secondary to bowel resection with anastomosis Related to major surgery required by bowel resection

Related to the presence of bacteria at the surgical site

The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client? Gastric analysis A sigmoidoscopy Serum antibodies for H. pylori A complete blood count including differential

Serum antibodies for H. pylori

After teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders, the instructor determines that the teaching was successful when the students identify which of the following structures as possibly being affected? Stomach Liver Large Intestine Ileum

Stomach

The nurse is preparing to examine the abdomen of a client who reports a change in bowel pattern. The nurse would place the client in which position?

Supine with knees flexed

Specific disease processes and ingestion of certain foods and medications may change the appearance of the stool. If blood is shed in sufficient quantities into the upper gastrointestinal (GI) tract, it produces which change in the stool appearance (WHAT COLOR WILL IT BE)?

Tarry-black

What would the nurse recognize as preventing a client from being able to take a fecal occult blood test (FOBT)? The client regularly takes aspirin The client took an ibuprofen tablet this morning The client has hemorrhoidal bleeding The client had a hamburger for dinner the night before

The client has hemorrhoidal bleeding

The nurse is assisting the health care provider with a colonoscopy for a client with rectal bleeding. The health care provider requests the nurse to administer glucagon during the procedure. Why is the nurse administering this medication during the procedure? To relieve anxiety during the procedure for moderate sedation. To relax colonic musculature and reduce spasm. The client is probably hypoglycemic and requires the glucagon. To reduce air accumulation in the colon.

To relax colonic musculature and reduce spasm.

A client is scheduled to have an endoscopic retrograde cholangiopancreatography. Which structures are visualized during this procedure?

common bile duct, pancreatic duct, and biliary tree

Stool Color: Meat/Protein

dark brown

While completing an abdominal assessment, the nurse will use which landmark as the upper boundary for auscultating bowel sounds? Symphysis pubis Xiphoid process T12 to L3 vertebrae Umbilicus

Xiphoid process

Stool Color: Senna

Yellow

no bowel sounds heard in 3-5 minutes is classified as?

absent

hydrogen breath test aides in the diagnosis of?

bacterial overgrowth in the intestine and short bowel syndrome.

Stool Color: when blood entering the lower portion of the GI tract or passing rapidly through it

bright or dark red

hydrogen breath test evaluates?

carbohydrate absorption

The nurse prepares a client for a barium enema. The nurse should place the client on which diet prior to the procedure?

clear liquids day before

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure of the upper GI tract. The nurse determines which nursing intervention is advised for this client? measure fluid output for at least 24 hours after the procedure monitor for any breathing-related disorder or discomforts monitor for cramping or abdominal distention do not give any food and fluids until the gag reflex returns

do not give any food and fluids until the gag reflex returns

Cystic fibrosis, a genetic disorder characterized by pulmonary and pancreatic dysfunction, usually appears in young children but can also affect adults. If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?

duodenum

What is the first region of the small intestine and the site where bile and pancreatic enzymes enter?

duodenum

hearing 1-2 bowel sounds in 2 minutes means bowel sounds are what?

hypoactive

Which response is a parasympathetic response in the GI tract? decreased motility increased peristalsis decreased gastric secretion blood vessel constriction

increased peristalsis

The nurse prepares to administer the lavage solution to a client having a colonoscopy completed. The nurse stops and notifies the physician when noting that the client has which condition? congestive heart failure inflammatory bowel disease pulmonary hypertension chronic obstructive pulmonary disease

inflammatory bowel disease

When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are

normal

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for? occult blood. recent foods ingested. pilonidal cyst. ingestion of bismuth.

recent foods ingested.

Which procedure is performed to examine and visualize the lumen of the small bowel?

small bowel enteroscopy

A nurse is teaching a client with malabsorption syndrome about the disorder and its treatment. The client asks which part of the GI tract absorbs food. What is the nurse's best response?

small intestine

The nurse recognizes which change of the GI system is an age-related change? hypertrophy of the small intestine increased mucus secretion increased motility weakened gag reflex

weakened gag reflex

A client reports having red stools lately. What will the nurse ask during assessment questioning?

"Have you been eating beets?"

Which of the following is the primary function of the small intestine? Secretion Peristalsis Digestion Absorption

Absorption

The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds?

HYPERactive

The nurse is providing instructions to a client scheduled for a gastroscopy. What should the nurse be sure to include in the instructions? Select all that apply. The throat will be sprayed with a local anesthetic. The client must fast for 8 hours before the examination. The health care provider will be able to determine if there is a presence of bowel disease. The client must have bowel cleansing prior to the procedure. After gastroscopy, the client cannot eat or drink until the gag reflex returns (1 to 2 hours).

The client must fast for 8 hours before the examination. The throat will be sprayed with a local anesthetic. After gastroscopy, the client cannot eat or drink until the gag reflex returns (1 to 2 hours).

A client is to have an upper GI procedure with barium ingestion and abdominal ultrasonography. While scheduling these diagnostic tests, the nurse must consider which factor? The client may eat a light meal before either test. The ultrasonography should be scheduled before the GI procedure. The upper GI should be scheduled before the ultrasonography. Both tests need to be done before breakfast.

The ultrasonography should be scheduled before the GI procedure.

fibroscopy (gastrointestinal)/EGD

intubation of a part of the GI system with a flexible, lighted tube to assist in diagnosis and treatment of diseases of that area & direct visualization of the esophageal, gastric, and duodenal mucosa through a lighted endoscope (gastroscope)

What is a barium swallow?

A test that involves filling the esophagus Stomach and small intestines with a barium solution in preparation for an x-ray to define the anatomy of the upper digestive tract that checks for problems in the throat, esophagus, stomach, and part of the small intestine

The nurse is to obtain a stool specimen from a client who reported that he is taking iron supplements. The nurse would expect the stool to be which color?

BLACK

Which of the following is the most definitive means of assessing for liver disease? Cholecystography Biopsy Paracentesis Ultrasonography

Biopsy

Stool Color: Bismuth, iron, licorice, charcoal

Black

Which term describes a gastric secretion that combines with vitamin B12 so that it can be absorbed?

intrinsic factor

The nurse is teaching the client about the upcoming endoscopic retrograde cholangiopancreatography (ERCP). Although the nurse instructs on several pertinent points of care, which is emphasized? The client will receive antibiotics before and after the procedure. The client will need to be repositioned frequently throughout the procedure in order to prevent injury. The client will have moderate sedation. The client will fast prior to the procedure.

The client will need to be repositioned frequently throughout the procedure in order to prevent injury.

A client with diabetes begins to have digestive problems and is told by the physician that they are a complication of the diabetes. Which of the following explanations from the nurse is most accurate?

The pancreas secretes digestive enzymes.