gi 102
Which of the following statements indicates that a client understands the need for routine screening to detect colorectal cancer?
Correct response: "I need to have an annual digital examination after age 40." Explanation: The American Cancer Society (Canadian Cancer Society and Health Canada) recommends an annual digital examination after age 40 for the purpose of detecting colorectal cancer. The CEA test is performed on clients who have already been treated for colorectal cancer. It helps monitor a client's response to treatment as well as detect metastasis or recurrence. Proctosigmoidoscopy is recommended every 3 to 5 years for people older than age 50. A barium enema is not a screening test.
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?
Correct response: Encourage plenty of fluids. Explanation: The nurse should encourage plenty of fluids because adequate fluid intake is necessary to avoid dehydration that may be caused by the bowel preparation and to prevent fecal impaction after the procedure. The client may be placed on a low-residue diet 1 to 2 days before the procedure to reduce the contents in the GI tract. Fiber intake is limited in a low-residue diet. Because dairy products leave a residue, they aren't allowed the evening before the test. Clear liquids only are allowed the evening before the test.
The client is scheduled to have an upper gastrointestinal tract series of X-rays. Following the X-rays, what should the nurse instruct the client to do?
You Selected: Follow a clear liquid diet. Correct response: Take a laxative. Explanation: The client should take a laxative after an upper gastrointestinal series to stimulate a bowel movement. This examination involves the administration of barium, which must be promptly eliminated from the body because it may harden and cause an obstruction. A clear liquid diet would have no effect on stimulating removal of the barium. The client should not have nausea, and an antiemetic would not be necessary; additionally, the antiemetic will decrease peristalsis and increase the likelihood of eliminating the barium. An enema would be ineffective because the barium is too high in the gastrointestinal tract.
A nurse is assessing a client who underwent esophagogastroduodenoscopy (EGD) for postoperative complications. Which sign or symptom would indicate a potential complication of this procedure?
You Selected: absent gag reflex Correct response: severe abdominal pain Explanation: In EGD, a physician inserts a fiberoptic endoscope via the mouth to visualize the esophagus, stomach, and duodenum. Severe abdominal pain, though rare, signals the complication of perforation. Sore throat, drooling, and an absent gag reflex are normal findings after an EGD. The endoscope can cause the sore throat. Clients may drool until the gag reflex returns and they're able to swallow their saliva. Before performing the procedure, the physician administers a local anesthetic that inactivates the gag reflex, so the reflex may be absent for a period after the procedure.
When preparing a client for a scheduled colonoscopy, the nurse should tell the client that this procedure will involve:
Correct response: cleansing the bowel with laxatives. Explanation: A colonoscopy is the visual examination of the large bowel using a flexible endoscope inserted into the client's rectum. Typically, the client will be placed on a liquid diet 24 hours before the procedure and kept NPO after midnight the night before the procedure. The bowel is cleansed through the use of laxatives. A client does not usually receive antibiotics before a colonoscopy. However, antibiotics may be used prior to bowel surgery to decrease the risk of infection. A sedative or analgesic may be given IV to decrease anxiety during the procedure and promote conscious sedation. However, the nurse would not administer an opioid when preparing this client.
