Med Surg Chapter Fifty Nine

b

A patient with chronic cholecystitis reports pruritus, clay-colored stools, and voiding dark, frothy urine. Which laboratory analysis is a priority in the nurse's assessment of this patient? A. Liver function tests B. Total bilirubin C. Lipase level D. White blood cell count

b

A 68-year-old patient presents to the ED the day after Thanksgiving, stating that he has "eaten and drunk quite a bit." He states that about 1 hour ago he experienced a sudden onset of pain in the left upper quadrant that radiates to his left flank. He rates the pain as an 8 on a 0-to-10 scale. The patient is admitted with acute pancreatitis. Which laboratory finding corroborates the diagnosis of acute pancreatitis? A. Serum lipase, 150 U/L B. Serum amylase, 200 U/L C. White blood cells, 6000 mcL D. Serum glucose, 80 mg/dL

a, c, d, e

A client had an open Whipple procedure yesterday for pancreatic cancer. Which nursing interventions are appropriate for this client? Select all that apply. A. Monitor and document the client's nasogastric tube drainage B. Place the client in a side-lying position to promote wound drainage C. Assess the abdomen for signs of peritonitis D. Monitor the client's hemoglobin and hematocrit E. Check the client's blood glucose frequently

eructation

Belching

calculous cholecystitis

Chemical irrigation and inflammation resulting from gallstones (cholelithiasis)

a, b, c, d, e, f

In preparing to care for the patient, which conditions does the nurse recognize as potential complications of acute pancreatitis? (Select all that apply.) A. Pancreatic infection B. Pleural effusion C. Diabetes mellitus D. Acute kidney failure E. Hemorrhage F. Pneumonia

c

In the care of a patient with acute pancreatitis, which assessment parameter requires immediate nursing intervention? A. Heart rate of 105 beats/min B. Blood pressure of 102/76 mm Hg C. Respiratory rate of 28 breaths/min D. Serum glucose of 136 mg/dL

dyspepsia

Indigestion

cholecystitis

Inflammation of the gallbladder

pruritus

Itching of the sun

boring

Pain that feels that it is going through the body

Blumberg's sign

Rebound tenderness when deep palpation is performed

cholecystectomy

Surgical removal of the gallbladder

c

The nurse closely monitors the client with acute pancreatitis for which complication? A. Duodenal ulcer B. Infection C. Pneumonia D. Heart failure

b

The nurse is providing discharge instructions for a client who has undergone a laparoscopic cholecystectomy. Which instruction will the nurse include in the discharge teaching? A. Keep dressings in place for 4 weeks B. Report bile-colored drainage from any of the incisions C. Expect dark, tarry stools after surgery D. Be aware that no dietary changes will be necessary

b

The patient has been NPO but is now tolerating food. Which nutrition teaching point should the nurse be sure to include? A. Expect to experience nausea and vomiting as you begin to consume foods. B. Small and frequent meals are best. C. Low-carbohydrate, high-protein, and high-fat foods should be consumed. D. Use of alcohol and caffeine should be consumed in moderation.

a

When the patient is asked about pain, he says that it is intense and continuous. He states that sometimes when he curls up in a fetal position the pain eases. Which intervention should be implemented for pain relief? A. PCA morphine sulfate B. PCA meperidine (Demerol) C. Oral hydromorphone (Dilaudid) D. IM fentanyl (Sublimaze)

c, e

Which foods will the nurse teach the client with chronic pancreatitis to avoid? Select all that apply. A. Blueberries B. Green beans C. Bacon D. Baked fish E. Fried potatoes

d

Which patient is more likely to develop gallstones? A. 55-year-old African-American male with a history of diabetes mellitus B. 62-year-old Hispanic/Latino female with a history of irritable bowel syndrome C. 45-year-old Caucasian female with a family history of gallstones D. 60-year-old obese, American-Indian female with a history of diabetes mellitus

icterus

Yellow discoloration of the sclera