iggy 9th editon (lower GI)

A nurse cares for a client who had a colostomy placed in the ascending colon 2 weeks ago. The client states, The stool in my pouch is still liquid. How should the nurse respond?

The stool will always be liquid with this type of colostomy.

An older female client has been prescribed esomeprazole (Nexium) for treatment of chronic gastric ulcers. What teaching is particularly important for this client?

Increase intake of calcium and vitamin D.

After teaching a client who has a femoral hernia, the nurse assesses the clients understanding. Which statement indicates the client needs additional teaching related to the proper use of a truss?

I will put on the truss before I go to bed each night.

A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, My doctor told me that the fecal occult blood test was negative for colon cancer. I dont think I need the colonoscopy and would like to cancel it. How should the nurse respond?

A negative fecal occult blood test does not rule out the possibility of colon cancer.

After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the clients understanding. Which menu selection indicates that the client correctly understands the dietary teaching?

Broiled chicken with brown rice, steamed broccoli, glass of apple juice

The student nurse learns about risk factors for gastric cancer. Which factors does this include?

Achlorhydria Chronic atrophic gastritis Helicobacter pylori infection Pernicious anemia

A nurse teaches a client who is at risk for colon cancer. Which dietary recommendation should the nurse teach this client?

Add vegetables such as broccoli and cauliflower to your new diet.

A nurse is preparing to administer pantoprazole (Protonix) intravenously. What actions by the nurse are most appropriate?

Administer the drug through a separate IV line. Infuse pantoprazole using an IV pump. Use an in-line IV filter when infusing.

A client who had a partial gastrectomy has several expected nutritional problems. What actions by the nurse are best to promote better nutrition?

Administer vitamin B12 injections. Ask the provider about folic acid replacement. Provide iron supplements for the client.

The student nurse studying stomach disorders learns that the risk factors for acute gastritis include which of the following?

Alcohol Caffeine Corticosteroids NSAIDS

A client has dumping syndrome after a partial gastrectomy. Which action by the nurse would be most helpful?

Arrange a dietary consult.

For which client would the nurse suggest the provider not prescribe misoprostol (Cytotec)?

Client who is pregnant

A nurse assessing a client with colorectal cancer auscultates high-pitched bowel sounds and notes the presence of visible peristaltic waves. Which action should the nurse take?

Contact the provider and recommend computed tomography.

A nurse cares for a middle-aged male client who has irritable bowel syndrome (IBS). The client states, I have changed my diet and take bulk-forming laxatives, but my symptoms have not gotten better. I heard about a drug called Amitiza. Do you think it might help? How should the nurse respond?

Unfortunately, lubiprostone is approved only for use in women.

A client is being taught about drug therapy for Helicobacter pylori infection. What assessment by the nurse is most important?

Willingness to adhere to drug therapy

A nurse assesses clients at a community health center. Which client is at highest risk for the development of colorectal cancer?

A 72-year-old who eats fast food frequently

A client has a gastrointestinal hemorrhage and is prescribed two units of packed red blood cells. What actions should the nurse perform prior to hanging the blood?

Ask a second nurse to double-check the blood. Prime the IV tubing with normal saline. Take and record a set of vital signs. Teach the client about reaction manifestations.

An emergency room nurse cares for a client who has been shot in the abdomen and is hemorrhaging heavily. Which action should the nurse take first?

Assess and maintain a patent airway.

An older client has gastric cancer and is scheduled to have a partial gastrectomy. The family does not want the client told about her diagnosis. What action by the nurse is best?

Assess family concerns and fears.

An emergency room nurse assesses a client after a motor vehicle crash and notes ecchymotic areas across the clients lower abdomen. Which action should the nurse take first?

Assess for abdominal guarding or rigidity.

A nurse cares for a client who has a nasogastric (NG) tube. Which actions should the nurse take?

Assess for proper placement of the tube every 4 hours. Disconnect suction when auscultating bowel peristalsis. Monitor the clients skin around the tube site for irritation.

After teaching a client who is recovering from a colon resection, the nurse assesses the clients understanding. Which statements by the client indicate a correct understanding of the teaching?

I will use warm water and a soft washcloth to clean around the stoma. I might start bicycling and swimming again once my incision has healed. Cutting the flange will help it fit snugly around the stoma to avoid skin breakdown.

A client has a recurrence of gastric cancer and is in the gastrointestinal clinic crying. What response by the nurse is most appropriate?

Id like to know what you are feeling now.

A client with a bleeding gastric ulcer is having a nuclear medicine scan. What action by the nurse is most appropriate?

Inform the client a second scan may be needed.

A nurse cares for a client who has a family history of colon cancer. The client states, My father and my brother had colon cancer. What is the chance that I will get cancer? How should the nurse respond?

You should have a colonoscopy more frequently to identify abnormal polyps early.

A client with peptic ulcer disease is in the emergency department and reports the pain has gotten much worse over the last several days. The clients blood pressure when lying down was 122/80 mm Hg and when standing was 98/52 mm Hg. What action by the nurse is most appropriate?

Start a large-bore IV with normal saline.

14. A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the client reports constant abdominal pain. Which action should the nurse take next?

Assess the clients bowel sounds.

A nurse cares for a client who is recovering from a hemorrhoidectomy. The client states, I need to have a bowel movement. Which action should the nurse take?

Stay with the client while providing privacy.

A nurse teaches a client who is recovering from a colon resection. Which statement should the nurse include in this clients plan of care?

Take a stool softener to promote softer stools for ease of defecation.

A nurse assesses a client who is recovering from a hemorrhoidectomy that was done the day before. The nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area. Which action should the nurse take?

Determine when the client last voided.

A nurse assesses a male client with an abdominal hernia. Which abdominal hernias are correctly paired with their physiologic processes?

Direct inguinal hernia A peritoneum sac passes through a weak point in the abdominal wall Ventral hernia Results from inadequate healing of an incision Incarcerated hernia Contents of the hernia sac cannot be reduced back into the abdominal cavity

A nurse cares for a client who has a new colostomy. Which action should the nurse take?

Empty the pouch frequently to remove excess gas collection.

A nurse caresfor a client newly diagnosed with colon cancer who has become withdrawn from family members. Which action should the nurse take?

Encourage the client to verbalize feelings about the diagnosis.

4. A nurse plans care for a client who is recovering from an inguinal hernia repair. Which interventions should the nurse include in this clients plan of care?

Encouraging ambulation three times a day Encouraging normal urination Providing ice bags and scrotal support

A nurse assesses a client who is prescribed alosetron (Lotronex). Which assessment question should the nurse ask this client?

Have you been experiencing any constipation?

A nurse cares for a client with colon cancer who has a new colostomy. The client states, I think it would be helpful to talk with someone who has had a similar experience. How should the nurse respond?

I will make a referral to the United Ostomy Associations of America.

A client is scheduled for a total gastrectomy for gastric cancer. What preoperative laboratory result should the nurse report to the surgeon immediately?

International normalized ratio (INR): 4.2

A nurse working with a client who has possible gastritis assesses the clients gastrointestinal system. Which findings indicate a chronic condition as opposed to acute gastritis?

Intolerance of fatty foods Pernicious anemia

A nurse cares for a client who states, My husband is repulsed by my colostomy and refuses to be intimate with me. How should the nurse respond?

Lets talk to the ostomy nurse to help you and your husband work through this.

The nurse caring for clients with gastrointestinal disorders should understand that which category best describes the mechanism of action of sucralfate (Carafate)?

Mucosal barrier fortifier

The nurse is caring for a client with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the clients abdomen is tense and rigid. What action takes priority?

Notify the health care provider immediately.

A client had an upper gastrointestinal hemorrhage and now has a nasogastric (NG) tube. What comfort measure may the nurse delegate to the unlicensed assistive personnel (UAP)?

Performing frequent oral care

A nurse inserts a nasogastric (NG) tube for an adult client who has a bowel obstruction. Which actions does the nurse perform correctly?

Performs hand hygiene and positions the client in high-Fowlers position, with pillows behind the head and shoulders Checks for correct placement by checking the pH of the fluid aspirated from the tube Connects the NG tube to intermittent medium suction with an anti-reflux valve on the air vent

A nurse answers a clients call light and finds the client in the bathroom, vomiting large amounts of bright red blood. Which action should the nurse take first?

Put on a pair of gloves.

A nurse is teaching a client about magnesium hydroxide with aluminum hydroxide (Maalox). What instruction is most appropriate?

Report diarrhea to your provider.

A client has a pyloric obstruction and reports sudden muscle weakness. What action by the nurse takes priority?

Request an electrocardiogram (ECG).

A nurse caresfor a client who has been diagnosed with a small bowel obstruction. Which assessment findings should the nurse correlate with this diagnosis?

Serum potassium of 2.8 mEq/L Abdominal pain in upper quadrants Serum sodium of 121 mEq/L

A client with peptic ulcer disease asks the nurse about taking slippery elm supplements. What response by the nurse is best?

Slippery elm is often used for this disorder.

A nurse plans care for a client who has chronic diarrhea. Which actions should the nurse include in this clients plan of care?

Using premoistened disposable wipes for perineal care Turning the client from right to left every 2 hours Applying a barrier cream to the skin after cleaning

A nurse assesses a client with irritable bowel syndrome (IBS). Which questions should the nurse include in this clients assessment?

Which food types cause an exacerbation of symptoms? Where is your pain and what does it feel like? Do you experience nausea associated with defecation?

A nurse assesses a client who is prescribed 5-fluorouracil (5-FU) chemotherapy intravenously for the treatment of colon cancer. Which assessment finding should alert the nurse to contact the health care provider?

White blood cell (WBC) count of 1500/mm3