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After a subtotal gastrectomy for cancer of the stomach, a client develops dumping syndrome. The client says, "What does it mean when the health care provider said that I am experiencing dumping syndrome?" What information should the nurse include in a response to this question? 1 Nausea resulting from a full stomach 2 Reflux of gastric contents into the esophagus 3 Buildup of flatulence within the large intestine 4 Rapid passage of concentrated fluid into the small intestine

4 Rapid passage of concentrated fluid into the small intestine

What kind of pain could an issue with the gallbladder commonly present as? (Cholecystitis) A. Right lower quadrant B. mid-epigastric radiates to RUQ or right scapula C. periumbilical pain D. mid-epigastric radiates to back

B. mid-epigastric radiates to RUQ or right scapula

NO caffine and coffee with which PUD?

Crohns

Avoid spicy foods with...

Inflammatory bowel disease (colitis/chrons)

Ulcerative colitis affects...

Just the mucosa layer of GI tract (inner layer)

The surgeon is the _______ of the surgical team

Leader preform surgery effictively and safety

Chrons disease is located...

Occurs anywhere along the GI tract

What kind of pain does gastric ulcers cause?

PAIN IS HIGH IN THE EPIGASTRUM burning or gaseous pain

Patient assessment findings that require follow up (gallbladder)

Right upper quadrant tenderness Dark amber colored urine Patient oral temperature 100.4F

Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori? a. Sucralfate (Carafate), nystatin (Mycostatin), and bismuth (Pepto-Bismol) b. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) c. Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix) d. Metoclopramide (Reglan), bethanechol (Urecholine), and promethazine (Phenergan)

b. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)

A family member of a 28-year-old patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will a. decrease nausea and vomiting. b. inhibit development of stress ulcers. c. lower the risk for H. pylori infection. d. prevent aspiration of gastric contents.

b. inhibit development of stress ulcers.

What kind of pain does duodenal ulcers cause?

burning or cramplike pain in midepigastric or back

The patient with chronic gastritis is being put on a combination of medications to eradicate Helicobacter pylori. Which drugs does the nurse know will probably be used? a. Antibiotic(s), antacid, and corticosteroid b. Antibiotic(s), aspirin, and antiulcer/protectant c. Antibiotic(s), proton pump inhibitor, and bismuth d. Antibiotic(s) and nonsteroidal antiinflammatory drugs (NSAIDs)

c. Antibiotic(s), proton pump inhibitor, and bismuth

Crohn's Disease is differentiated from other inflammatory bowel disorders by which finding? a. Diarrhea b. Malabsorption of nutrients. c. Bowel segments that are cobblestone in appearance. d. Absence of inflammation or ulceration

c. Bowel segments that are cobblestone in appearance.

A patient who had a gastroduodenostomy (Billroth I operation) for stomach cancer reports generalized weakness, sweating, palpitations, and dizziness 15 to 30 minutes after eating. What long-term complication does the nurse suspect is occurring? a. Malnutrition b. Bile reflux gastritis c. Dumping syndrome d. Postprandial hypoglycemia

c. Dumping syndrome

Fluticasone is a...

corticosteroid

Dexamethosone is a ...

corticosteroid treats inflammation

A 62-year-old man patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about a. substitution of acetaminophen (Tylenol) for the NSAID. b. use of enteric-coated NSAIDs to reduce gastric irritation. c. reasons for using corticosteroids to treat the rheumatoid arthritis. d. misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa.

d. misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa.

A patient was admitted with epigastric pain because of a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care? a. Back pain 3 or 4 hours after eating a meal b. Chest pain relieved with eating or drinking water c. Burning epigastric pain 90 minutes after breakfast d. Rigid abdomen and vomiting following indigestion

d. Rigid abdomen and vomiting following indigestion

With bacterial conjunctivitis, the patient should...

discard all opened or used lens care products or cosmetics

Dumping syndrome is (in peptic ulcer disease) ...

dizzy, cramping, urge to defecate, not drinking fluids during eating Eat small frequent meals High in proteins and fat Low in carbs Lie down after meals

Duodenal ulcers are greater in ________

men

Gastric ulcers are greater in ______

women

Avoid fiber with...

IBD (Ulcerative Colitis or Crons)

Jaundice is found when ...

No bile flow to duodenum, bilirubin accumulates in blood (obstruction of bile flow)

Gastric ulcers cause discomfort _________ hours after meal

1-2

When should you take sucralfate?

1-2 hrs before or after antiacid MOST EFFECTIVE AT LOW pH Protects esophagus, stomach, and duodenum BINDS WITH PROTIENS / STIMULATES SECRETION OF MUCUS

Duodenal ulcers cause discomfort _________ hours after meal

2-5

TO administer ear drops to a baby, pull the pinna....

Down and back

The nurse is completing patient education for a patient to be discharged after undergoing an open cholecystectomy. Which statement by the patient indicates effective teaching by the nurse? 1. "I must take my pain meds every 4 hours" 2. "I can get in the pool and go swimming in 2 weeks" 3. I need to limit my activity to prevent getting tired" 4. "I should not be carrying the laundry baskets upstairs"

4. "I should not be carrying the laundry baskets upstairs"

Which clinical manifestation would support a diagnosis of allergic​ conjunctivitis? A. Itching B. Sore throat C. Photophobia D. Yellow discharge

A. Itching

Ulcerative colitis and Crohns disease share these manifestations/complications:

Abdominal pain Diarrhea cancer c. diff perforation

Chrons disease affects...

Affects the whole bowel lining (all layers)

What is the role of the circulating nurse in surgery?

Assists in positioning the patient Counts sponges and instruments Reviews the preoperative assessment Implements plan of care

The nurse is caring for a client with cholecystitis. Which clinical manifestation would the nurse expect the client to exhibit? A. Dysphagia B. Fever C. Hiccups D. Bradycardia

B. Fever

A patient with chronic peptic ulcer disease underwent a gastric resection 1 month ago and is reporting nausea, bloating, and diarrhea 30 minutes after eating. What condition is this patient most likely experiencing? A. Gastroparesis B. Fascia dehiscence C. Dumping Syndrome D. Somogyi effect

C. Dumping Syndrome

What to avoid with peptic ulcer disease?

Caffeine

PUD is more common in population of

Caucasion / jewish genetics

RUQ pain is associated with

Cholecystitis

Cobblestoning is associated with...

Chron's disease Patches along GI tract

Severe weight loss is assoicated with

Chrons disease

Methotrexate is most useful in patients with ...

Chrons disease who cannot stop corticosteroid use without a flare up or in whom other drugs have been ineffective

How to clean the eyes?

Clean from inner to outer canthus Clean eyes which different corners of towel

The nurse is teaching a client with cholelithiasis about a new prescription for ursodiol. Which client statement indicates to the nurse that the teaching was​ successful? A. "If I take this for a long time it might damage my​ liver, so I will need checkups of my liver​ function." B. "There is a good chance I will experience​ diarrhea, so I might need my dosage​ reduced." C. "This medicine should take away the orange color from my​ skin." D. "I might have some slight diarrhea or​ constipation, but that is a normal side effect of the​ medicine."

D. "I might have some slight diarrhea or​ constipation, but that is a normal side effect of the​ medicine."

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? A. Bradycardia B. Numbness in the legs C. Nausea and vomiting D. A rigid, board-like abdomen

D. A rigid, board-like abdomen

How do proton pump inhibtors work?

Decrease secretion Omeprazole Pantoprazole

Primary manifestation of ulcerative colitis is...

Diharrhea As many as 20 a day

Ursodiol and Chenodiol are effective by...

Dissolving gallstones Used or patients that cannot get surgery to remove

4 F's Risk Factors:

Female Fat Fertile Forty

Duodenal ulcers are found in ...

Fist 1-2 cm of duodenum

Aspirin can increase risk of....

GI bleed when peptic ulcer disease is present

Proton pump inhibitors are more effective than ...

H2 recceptor blockers in reducing gastric acid secretion and promoting ulcer healing

Famotidine is a...

H2 receptor blocker Relieves epigastric pain reduces secretion

What are the three major complications of Peptic ulcer disease?

Hemorrhage Perforation Gastric outlet obstruction

Which medication will substitute penicillin (amoxicillin) if the patient has an allergy?

Metronidazole is used instead of amoxicillin in the triple drug regimen

Dantrolene is a...

Muscle relaxant Treatment for malignant hypothermia!!!

What medications cannot be taken with Peptic ulcer disease?

NO NSAIDS unless administered with PPI, H2 receptor, or misoprostol

The scrub nurses role in surgery is ...

Prepares surgical set up Maintains surgical asepsis Drape and handle instruments Assist surgeon by passing equipment and supplies

Misoprostol is effective by...

Preventing stomach ulcers while taking NSAIDS

How does sucralfate work?

Protects lining esophagus stomach and duodenum (antiulcer medication)

The anethesists role in surgery is ...

Provides anethesia to the patient

Where is pain with choleysistis?

RUQ

Avoid what kind of foods with IBD?

Spicy foods

Ulcerative colitis is located...

Starts in rectum and continuous up the colon LLQ

If patient is dx with peptic ulcer disease but also takes aspirin for pain, the patient should...

Talk to doctor or prescriber for pain med alternative

ORAL erythromycin or azithromycin is used for ...

Treats clamydial conjunctivitis Not topical, ORAL

Acute otitis media is an infection of the ...

Tympanum, ossicles, and space of the middle ear Swelling occurs in the auditory tube and traps bacteria

Affects the mucosa and submucosa of the colon and rectum a. Ulcerative colitis b. Crohn's disease

Ulcerative colitis

NPO with which PUD?

Ulcerative colitis

Rectal bleeding is common with...

Ulcerative colitis (20 poops a day)

To administer ear drops to a pt over 3yrs of age, pull the pinna...

Up and back

You'd rather have ___________ than chrons disease

ulcerative colitis


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