NU144- Chapter 46: Management of Patients With Gastric and Duodenal Disorders

anchlorhydria

lack of hydrochloric acid in digestive secretions of the stomach

pyloroplasty

surgical procedure to increase the opening of the pyloric orifice

melena

tarry or black stools indicative of occult blood in stools

serosa

thin membrane that covers the outer surface of the stomach visceral peritoneum covering the outer surface of the stomach

peritoneum

thin membrane that lines the inside of the wall of the abdomen and covers all of the abdominal organs

hematemesis

vomiting of blood

The nurse is assessing an 80-year-old client for signs and symptoms of gastric cancer. The nurse differentiates which as a sign/symptom of gastric cancer in the geriatric client, but not in a client under the age of 75?

Agitation

A client 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 client?

Curling's ulcer

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 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.

gastric outlet obstruction

any condition that mechanically impedes normal gastric emptying there is obstruction of the channel of the pylorus and duodenum through which the stomach empties also called pyloric obstruction

gastritis

inflammation of the stomach

antrectomy

removal of the pyloric (antrum) portion of the stomach with anastomosis (surgical connection) either to the duodenum (gastroduodenostomy or Billroth I) or to the jejunum (gastrojejunostomy or Billroth II)

A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate?

"Caffeine stimulates the central nervous system and thus gastric activity and secretions, which need to be minimized to promote recovery."

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."

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 nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching?

"I will have to take vitamin B12 shots up to 1 year after surgery."

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

10 to 14 days

A nursing student is preparing a teaching plan about peptic ulcer disease. The student knows to include teaching about the percentage of clients with peptic ulcers who experience bleeding. The percentage is

15%

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems?

Acute gastritis

A client is admitted with a new onset of pyloric obstruction. What client symptoms should the nurse anticipate? Select all that apply.

Anorexia Nausea and vomiting Epigastric fullness

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.

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

Which of the following clients is at highest risk for peptic ulcer disease?

Client with blood type O

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

Clients with Type O blood are at higher risk for which of the following GI disorders?

Duodenal ulcers

The nursing student approaches his instructor to discuss the plan of care for his client diagnosed with peptic ulcer disease. The student asks what is the most common site for peptic ulcer formation? The instructor would state which one of the following?

Duodenum

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

Which of the following is the most common complication associated with peptic ulcer?

Hemorrhage

Rebleeding may occur from a peptic ulcer and often warrants surgical interventions. Signs of bleeding include which of the following?

Mental confusion

Which is a true statement regarding gastric cancer?

Most clients are asymptomatic during the early stage of the disease.

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

A client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond?

Notify the health care provider.

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 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 manifestations are associated with a deficiency of vitamin B12? Select all that apply.

Pernicious anemia Macrocytic anemia Thrombocytopenia

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

Place the client in a recumbent position with the legs elevated.

The nurse is teaching a client with peptic ulcer disease who has been prescribed misoprostol. What information from the nurse would be most accurate about misoprostol?

Prevents ulceration in clients taking nonsteroidal anti-inflammatory drugs (NSAIDs)

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

Removal of the tumor

steatorrhea

fatty stool typically malodorous with an oily appearance and floats in water

duodenum

first portion of the small intestine, between the stomach and the jejunum

stenosis

narrowing or tightening of an opening or passage in the body

pylorus

opening between the stomach and the duodenum

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience

pain 2 to 3 hours after a meal.

The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which characteristic would the nurse be most likely to find?

Black and tarry appearance

A 66-year-old African-American client has recently visited a physician to confirm a diagnosis of gastric cancer. The client has a history of tobacco use and was diagnosed 10 years ago with pernicious anemia. He and his family are shocked about the possibility of cancer because he was asymptomatic prior to recent complaints of pain and multiple gastrointestinal symptoms. On the basis of knowledge of disease progression, the nurse assumes that organs adjacent to the stomach are also affected. Which of the following organs may be affected? Choose all that apply.

Liver Pancreas Duodenum

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

pyrosis

a burning sensation in the stomach and esophagus that moves up to the mouth commonly called heartburn

Helicobacter pylori (H. pylori)

a spiral-shaped Gram-negative bacterium that colonizes the gastric mucosa is involved in most cases of peptic ulcer disease

A morbidly obese client asks the nurse if medications are available to assist with weight loss. The nurse knows that the client would not be a candidate for phentermine if the following is part of the client's health history:

Coronary artery disease

The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage?

Hematemesis

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 client with a peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. Which statement by the client indicates the best understanding of the medication regimen?

"The medications will kill the bacteria and stop the acid production."

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

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

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

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply.

Severe peptic ulcers Extreme gastric hyperacidity Gastrin-secreting tumors of the pancreas

A healthcare provider prescribes a combination of drugs to treat reoccurring peptic ulcer disease, and the client asks the nurse the reason for all the medications. What teaching should the nurse review with the client?

The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori.

hematochezia

bright red, bloody stools

omentum

fold of the peritoneum that surrounds the stomach and other organs of the abdomen

dyspepsia

indigestion upper abdominal discomfort associated with eating

dumping syndrome

physiologic response to rapid emptying of gastric contents into the small intestines, manifested by nausea, weakness, sweating, palpitations, syncope, and diarrhea

gastric

refers to the stomach