Chapter 38, 40, and 41 Study Aids

After 24 hours, the patient's condition improved. She says that a friend has suggested she consider having surgery. She asks if surgery will cure her UC. What is the best response for the nurse to make?

Removing the entire colon can cure UC

Which aspect of the patient's symptoms do you think are of greatest concern? -recurrence of the pain 2 to 3 hours after antacids -black, sticky stools -being awakened by pain -location of the pain

black, sticky stools

Gastritis and _____________ from peptic ulcer disease are the two most common causes of upper GI tract bleeding.

hemorrhage

Greater than 5 to 6 bowel sounds heard in less than 30 seconds is considered a standard used to document bowel sounds that are ________________.

hyperactive

The patient asks why she is not allowed to eat or drink. What is the reason for keeping the patient NPO?

To provide bowel rest and permit more rapid resolution of the flare-up of symptoms

True of False Atrophy of the taste buds is an excepted age-related change of the gastrointestinal system.

True

True or False Absorption is the major function of the small intestine, and occurs when small molecules, vitamins, and minerals pass through the walls of the small intestine and into the bloodstream.

True

True or False Celiac disease is a disorder of malabsorption caused by an autoimmune response to consumption of products that contain the protein gluten.

True

The etiology of cancer of the colon and rectum is predominantly _____________________, a malignancy arising from the epithelial lining of the intestine.

adenocarcinoma

In Crohn's disease, the common clinical manifestations include abdominal pain and _____________.

diarrhea

___________ syndrome may occur as a result of any surgical procedure that involves the removal of a significant portion of the stomach or includes resection or removal of the pylorus.

dumping

__________________ is indigestion, an upper abdominal discomfort associated with eating.

dyspepsia

_____________________is a chronic functional disorder characterized by recurrent abdominal pain associated with diarrhea, constipation, or both.

irritable bowel syndrome

Digestive enzymes secreted by the pancreas include trypsin (aids protein digestion), amylase (aids starch digestion), and __________ which aids fat digestion.

lipase

Tumors of the small intestine are uncommon, of these approximately 64% are __________________.

malignant

The correct sequence to perform an abdominal assessment is to perform inspection, auscultation, __________ and palpation.

percussion

Three hours after the patient was admitted to the medical/surgical unit, he complains of increased abdominal pain. The nurse notes that his abdomen is rigid and tender. What is the most likely explanation for the assessment findings?

The ulcer has most likely perforated

________________, the most common cause of acute surgical abdomen in the United States, is the most common reason for emergency abdominal surgery.

Appendicitis

Intrinsic factor, which is secreted by the gastric mucosa, cannot be absorbed without the presence of vitamin ________.

B12

True or False Chyme, which is partially digested food mixed with gastric secretions, can stay in the small intestine for 3 to 6 hours, allowing for continued breakdown and absorption of nutrients.

True

True or False Decompression of the bowel through a nasogastric tube is necessary for all patients with small bowel obstruction.

True

True or False Diarrhea is defined as the increased frequency of more than three bowel movements per day.

True

True or False Most peptic ulcers result from infection with the gram-negative bacteria H. pylori, which may be acquired through ingestion of food and water.

True

True or False Preparation of a patient for a barium enema study may begin 48 hours prior to the test.

True

True or False Proton pump inhibitors may be administered for at least 1 year in patients with risk factors for peptic ulcer disease.

True

True or False The vast majority of gastric cancers are acquired and not inherited.

True

_____________ is a burning sensation in the stomach and esophagus that moves up to the mouth.

pyrosis

What is the most likely explanation for the patient's joint pain?

the joint pain is manifestation of the patient's IBD

Sigmoidoscopy

to aid in biopsy for confirmation of diagnosis

CT scan

to detect complications such as fistulas, intestinal obstructions, or abscess formations

Upper GI series

to determine the location in the ileum

Barium enema

to view segments of strictures separated by normal bowel

_____________, an abdominal discomfort associated with eating, is the most common symptom of patients with gastrointestinal dysfunction.

Dyspepsia

What should the nurse advise the patient about her activity?

She may maintain activity as she tolerates, even during exacerbations

Straining at stool initiates the ____________ maneuver that results in a potentially dangerous increase in BP.

valsalva

True or False Older adults tend to have increased gastric motility.

False

True or False The most common site for a peptic ulcer formation is in the pylorus.

False

True or False The patient with irritable bowel syndrome (IBS) should select foods low in fiber in order to minimize intestinal irritation.

False

Which instructions should the nurse give to the patient? -consume 8 ounces of milk whenever the heartburn begins -avoid drinking alcohol -avoid taking ibuprofen, aspirin, and related medications like naproxen (Aleve) -decrease caffeine intake -avoid smoking tobacco

-avoid drinking alcohol -avoid taking ibuprofen, aspirin, and related medications like naproxen (Aleve) -decrease caffeine intake -avoid smoking tobacco

What should the nurse advise the patient about her diet? -avoid milk products -avoid red meat -eat a low-residue (low-fiber) diet -eat a low-carbohydrate diet -eat a high-protein, high-calorie diet

-avoid milk products -eat a low-residue (low-fiber) diet -eat a high-protein, high-calorie diet

What hallmarks might indicate a diagnosis of toxic megacolon? -dilation of the colon -hypotension -hypertension -lack of abdominal distention -tachycardia -electrolyte imbalance -alter mental status -hyperactive bowel sounds

-dilation of the colon -hypotension -tachycardia -electrolyte imbalance -alter mental status

The nurse suspects that the patient may have peptic ulcer disease. Can you identify the patient's contributing risk factor(s) for peptic ulcer disease? -he is in the 40 to 60-year-old age group -he has been taking NSAIDs for pain -he is been under stress at work -he has been taking antacids for heartburn -he has Zollinger-Ellison syndrome -he says his stools have been black and sticky -he has a history of cigarette use

-he is in the 40 to 60-year-old age group -he has been taking NSAIDs for pain -he is been under stress at work

Which of the following could have contributed to her UC? -stress and anxiety -immune system response -smoking -allergic reactions -age

-stress and anxiety -immune system response -allergic reactions

What is included in "triple therapy" for peptic ulcers?

A proton-pump inhibitor (PPI) and two antibiotics

True or False Diverticula may occur anywhere in the small intestine or colon, but most commonly occur in the ascending colon.

False

True or False Norepinephrine stimulates gastric secretions and motility

False

The nurse is instructing the patient about famotidine. Which statement should the nurse include in the teaching?

Famotidine works to reduce the production of acid in the stomach

The nurse is developing a plan of care for the patient. What nursing diagnosis should the nurse identify as the highest priority?

Fluid volume deficit related to diarrhea and decreased fluid intake

The patient asks the nurse what caused her IBD. What is the most accurate response for the nurse to make?

IBD is caused by the body's immune system attacking the intestine