PP GI Disorders

3″ to 4″.

A nurse must administer an enema to an adult client. The appropriate depth for inserting an enema into an average-sized adult is:

Bluish discoloration in periumbilical area

A client is diagnosed with pancreatitis. Which assessment would be of most concern to the nurse?

Obtain a health history. Inspect the abdomen, noting the shape, contours, and any visible peristalsis or pulsations. Auscultate bowel sounds in all four quadrants. Percuss all four abdominal quadrants. Gently palpate all four quadrants, saving the painful area for last.

A client arrives to the emergency department with suspected appendicitis. The admitting nurse performs an assessment. Order the following steps according to the sequence in which they are performed. All options must be used.

auscultate bowel sounds.

A client had a nephrectomy 2 days ago and is now complaining of abdominal pressure and nausea. The first nursing action should be to:

semi-Fowler's

A client has a percutaneous endoscopic gastrostomy tube in place for tube feedings. Before starting a continuous feeding, the nurse would place the client in which position?

green, leafy vegetables

A client has been placed on long-term sulfasalazine therapy for treatment of ulcerative colitis. The nurse should encourage the client to eat which foods to help avoid the nutrient deficiencies that may develop as a result of this medication?

nausea

A client has been prescribed propantheline as part of the treatment for a peptic ulcer. The nurse should assess the client for:

"It is important that I take this drug on an empty stomach."

A client has had sucralfate prescribed as treatment for peptic ulcer disease. Which statement indicates that the client understands how to take the medication?

anorexia, nausea, vomiting

A client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note:

low Fowler's

A client has just returned from surgery for a gastrectomy. The nurse should position the client in which position?

Maintain a patent airway. Control hemorrhaging. Replace fluids. Relieve the client's anxiety.

A client has massive bleeding from esophageal varices. In what order from first to last should the nurse and care team provide care for this client?

Report bile-colored drainage from any incision.

A client has undergone a laparoscopic cholecystectomy. Which instruction should the nurse include in the discharge teaching?

black and tarry.

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be:

"You are not allowed anything by mouth so that your pancreas can rest."

A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. Based on the diagnosis of acute pancreatitis the nurse will provide which explanation for the prescribed interventions?

bloody, diarrheal stools.

A client is admitted with a diagnosis of ulcerative colitis. The nurse should assess the client for:

increased serum amylase and lipase levels

A client is admitted with acute pancreatitis. The nurse should monitor which laboratory values?

"I will empty my pouch when it is about one-third full."

A client is learning about caring for an ileostomy. Which statement would indicate that the client understands how to care for the ileostomy pouch?

increasing fluid intake to prevent dehydration.

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of:

tarry stools

A client is suspected of having a slow gastrointestinal bleed. The nurse should evaluate the client for which sign?

have the client flex the head when the tube is above the oropharynx.

A client is to have a nasogastric (NG) tube inserted. When inserting the tube, the nurse should:

ulcerative colitis

A client presents to the emergency department with reports of acute GI distress, bloody diarrhea, weight loss, and fever. A family history of which of the following would be significant to this client's diagnosis?

absence of abdominal distention

A client who had a splenectomy yesterday has a nasogastric (NG) tube. What should the nurse assess to determine the effectiveness of the NG tube?

hot chocolate

A client who has been diagnosed with gastroesophageal reflux disease (GERD) reports heartburn. To decrease the heartburn, the nurse should instruct the client to eliminate which item from the diet?

30 minutes before meals and at bedtime.

A client who has been treated for diverticulitis is being discharged on oral propantheline bromide. The nurse should instruct the client to take the drug:

hypokalemia

A client who has been vomiting for 2 days has a nasogastric tube inserted. The nurse notes that over the past 10 hours the tube has drained 2 L of fluid. The nurse should further assess the client for:

Encourage plenty of fluids.

A client with Crohn's disease is scheduled for a barium enema. What should the plan of care include today to prepare for the test tomorrow?

subnormal serum glucose and elevated serum ammonia levels.

A client with acute liver failure exhibits confusion, a declining level of consciousness, and slowed respirations. The nurse finds him very difficult to arouse. The diagnostic information which best explains the client's behavior is:

Place an intravenous line.

A client with acute pancreatitis has a blood pressure of 88/40 mm Hg, heart rate of 128 bpm, respirations of 28 breaths/min, and Grey Turner's sign. What prescription should the nurse implement first?

metallic taste.

A client with amebiasis, an intestinal infection, is ordered metronidazole. When teaching the client about adverse reactions to this drug, the nurse should mention:

well-balanced normal nutrients, low-sodium diet

A client with cirrhosis should be encouraged to follow which diet?

"Has your partner had recent forceful vomiting?"

A client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been "spitting up blood." A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client's wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is:

water

A client with peptic ulcer disease is ordered aluminum-magnesium complex. When teaching about this antacid preparation, the nurse should instruct the client to take it with:

Limit gastric acid secretion.

A client with peptic ulcer disease is taking ranitidine. What is the expected outcome of this drug?

"You can lead a long and fairly healthy life if you are compliant with your medications." "You seem frustrated. Would you like to talk?" "You have the right to refuse any medications. Would you like to discuss your feelings about this disease?"

A nurse is administering medications to a client diagnosed with hepatitis B. When the nurse hands the client his/her medications, the client says, "I would rather not take that pill or any others. I know there is no cure for hepatitis B." The nurse recognizes that the client is expressing feelings of hopelessness about the diagnosis. Select the best responses by the nurse. Select all that apply.

Increased urine output

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia?

alcohol abuse and smoking.

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

"I need to use laxatives regularly to prevent constipation."

A nurse is teaching an elderly client about developing good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required?

Enterostomal nurse

A surgeon is discussing surgery with a client diagnosed with colon cancer. The client is visibly shaken over the possibility of a colostomy. Based on the client's response, the surgeon should collaborate with which health team member?

"The lack of an enzyme to break down lactose."

After teaching the parents of a child with lactose intolerance about the disorder, the nurse determines that the teaching was effective when the mother used which statement to describe the condition?

"I can make a small pin hole in the bag to let the gas out, so I don't have to change the appliance frequently."

An enterostomy nurse is providing an in-service session on caring for colostomies. Which statement by a nurse indicates the need for further teaching?

Encourage the client to suck on hard candy.

During the assessment of a client's mouth, the nurse notes the absence of saliva. The client reports having pain behind the ear. The client has been nothing-by-mouth (NPO) for several days but now can have liquids. What should the nurse do next?

Monitor the client for nausea, vomiting, and abdominal distention.

Following a subtotal gastrectomy, a client has a nasogastric (NG) tube connected to low suction. What should the nurse do?

orthostatic hypotension.

Following an earthquake, a client who was rescued from a collapsed building is seen in the emergency department. He has blunt trauma to the thorax and abdomen. The nursing observation that most suggests the client is bleeding is:

These findings are normal for a client with an ileal conduit.

Following the formation of an ileal conduit, the nurse notes that the client's urinary drainage appliance contains pale yellow urine with large amounts of mucus. How should the nurse interpret these data?

increased gastric emptying.

Metoclopramide is ordered as a premedication for a client about to undergo a gastroduodenoscopy. The expected therapeutic effect is:

"I try to eat smaller amounts of food more often throughout the day."

The nurse is evaluating the lifestyle modifications a client has made to prevent gastroesophageal reflux. Which statement indicates that the client understands how to prevent reflux?

urine retention

The client is receiving propantheline bromide to treat cholecystitis. The nurse should evaluate the client's response to the medication by observing for which adverse effect?

take the pills at the same time each day.

The client with diverticulitis is treated with antibiotics. The nurse should instruct the client to:

The client has a temperature of 100° F (37.8° C). The client has epigastric pain. The client experiences hematemesis.

The nurse is caring for a client who has had a gastroscopy. Which findings indicate that the client is developing a complication related to the procedure? Select all that apply.

severe abdominal pain.

The nurse assigns an unlicensed assistive personnel (UAP) to provide care for a client with peptic ulcer disease. Concerned about possible ulcer perforation, the nurse should instruct the UAP to report to the nurse immediately if the client has:

"I will avoid lying down after a meal."

The nurse instructs the client on health maintenance activities to help control symptoms from a hiatal hernia. Which statement would indicate that the client has understood the instructions?

notify the health care provider.

The nurse is assessing a client who has been admitted to the hospital with chest pain. The client has been taking simvastatin 40 mg daily for 3 years. The nurse notes that the client has yellow sclerae and a dark skin color. The client tells the nurse that urine is getting darker. The nurse should:

age abdominal surgery diabetes mellitus

The nurse is caring for a 70-year-old male client after a colectomy. The client has received chemotherapy prior to surgery and has hypertension and diabetes mellitus. Which factors put this client at risk for sepsis? Select all that apply.

metabolic acidosis

The nurse should assess the client with severe diarrhea for which acid-base imbalance?

Anticipate that emotional stress can increase intestinal peristalsis.

What knowledge should guide the nurse when caring for client with a new ileostomy?

Acute pain

When caring for a client with nonresectable colon cancer, which nursing diagnosis requires the nurse to function collaboratively to achieve the best outcome related to client comfort?

smoking cigarettes

Which activity should the nurse encourage the client with a peptic ulcer to avoid?

maintain adequate nutrition through oral or parenteral feedings.

Which expected outcome about nutrition would be appropriate for a client who has had a total gastrectomy for gastric cancer? The client will:

yellowed sclera

Which finding is normal for a client during the icteric phase of hepatitis A?

an 80-year-old client who has poor oral hygiene and is dehydrated

Which hospitalized client is at risk to develop parotitis?

being 5 feet, 3 inches (160 cm) tall and weighing 190 lb (86.2 kg). Any factor that increases intra-abdominal pressure, such as obesity, can contribute to the development of hiatal hernia. Other factors include abdominal straining, frequent heavy lifting, and pregnancy.

Which risk factor would most likely contribute to the development of a client's hiatal hernia?

profuse vomiting

Which sign or symptom is related primarily to small-bowel obstruction rather than large-bowel obstruction?

"I should avoid alcohol and caffeine."

Which statement indicates that the client with a peptic ulcer understands the dietary modifications to follow at home?

Irrigate the tube with cola.

While a client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client's family how to deal with it at home, what should the nurse do?

To keep gastric pH at 3.0 to 3.5

Why are antacids administered regularly, rather than as needed, in peptic ulcer disease?

cover the incision with a dressing moistened with sterile normal saline solution.

client's abdominal incision eviscerates. The nurse should first: