Chapter 50 (Biliary Diseases [GI])

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client? A. Assisting the client to turn, cough, and deep breathe every 2 hours B. Teaching the client to choose low-fat foods from the menu C. Assisting the client to ambulate the evening of the operative day D. Performing range-of-motion (ROM) leg exercises hourly while the client is awake

A R:Assessment should focus on the client's respiratory status. If a traditional surgical approach is planned, the high abdominal incision required during surgery may interfere with full respiratory excursion. The other nursing actions are also important, but are not as high a priority as ensuring adequate ventilation.

Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray? A: vanilla pudding b: steamed vegetables c: hot roast beef and gravy d: jello with strawberries

C R: the diet after the diagnosis of this typically maintains the low fat and lean meat variety rather than any foods like high fat option seen here that could cause discomfort.

A nurse should monitor blood glucose levels for a patient diagnosed with hyperinsulinism. What blood value does the nurse recognize as inadequate to sustain normal brain function? A. 50 mg/dL B. 90 mg/dL C. 30 mg/dL D. 70 mg/dL

C R:Hyperinsulinism is caused by overproduction of insulin by the pancreatic islets. Occasionally, tumors of nonpancreatic origin produce an insulinlike material that can cause severe hypoglycemia and may be responsible for seizures coinciding with blood glucose levels that are too low to sustain normal brain function

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder?

edema and inflammation

A client is scheduled for a cholecystogram for later in the day. What is the nurse's understanding on the diagnostic use of this exam?

to better visualize the gallbladder and the collecting ducts

A student nurse is preparing a plan of care for a client with chronic pancreatitis. What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority? A. Anxiety B. Impaired nutrition: less than body requirements C. Disturbed body image D. Nausea

B R:While each diagnosis may be applicable to this client, the priority nursing diagnosis is impaired nutrition: less than body requirements. The physician, nurse, and dietitian emphasize to the client and family the importance of avoiding alcohol and foods that have produced abdominal pain and discomfort in the past. Oral food or fluid intake is not permitted during the acute phase.

The nurse is caring for a client with suspected chronic pancreatitis. Which diagnostic test or imaging does the nurse recognize as the most useful in diagnosing this condition? A: MRI B: ERCP C: Ultrasound D: just look at them

C: ERCP (Endoscopic retrograde cholangiopancreatography) R: t provides details about the anatomy of the pancreas and the pancreatic and biliary ducts. It is also helpful in obtaining tissue for analysis and differentiating pancreatitis from other conditions, such as carcinoma (Muniraj, Aslanian, Farrell, et al., 2015).