prepU N444 - chapter 40 gastric ulcers

The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage?

hematemesis

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed?

hemorrhage

The nurse is cautiously assessing a client admitted with peptic ulcer disease. The nurse is aware that which complications occur in 20% to 30% of clients with this diagnosis?

hemorrhage or perforation

During assessment of a patient with gastritis, the nurse practitioner attempts to distinguish acute from chronic pathology. One criteria, characteristic of gastritis would be the:

immediacy of the occurence

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.

ingestion of strong acids, irritating foods, overuse of aspirin

The nurse visits the home of a client recovering from acute gastritis. Which observation indicates that teaching about the disorder was effective?

medications placed in a pillbox

A client comes to the clinic reporting pain in the epigastric region. What assessment question during the health interview would most help the nurse determine if the client has a peptic ulcer?

"does your pain resolve when you have something to eat"

The nurse is teaching a client about peptic ulcers. The client understands the provided education when stating which of the following?

"hemorrhage and gastritis are the most common complications"

A client with an H. pylori infection asks why bismuth subsalicylate is prescribed. Which response will the nurse make?

"it aids in the healing of the stomach lining"

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.)

"it can be caused by ingestion of strong acids", "you may have ingested some irritating foods", "it is possible that you are overusing aspirin"

A client with gastric ulcers caused by H. pylori is prescribed metronidazole. Which client statement indicates to the nurse that teaching about this medication was effective?

"it might cause a metallic taste in my mouth"

A nurse is teaching a client who has experienced an episode of acute gastritis. The nurse knows further education is necessary when the client makes which statement?

"my appetite should come back tomorrow"

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen?

10 - 14 days

The nurse is providing preoperative care for a client with gastric cancer who is having a resection. What is the nursing management priority for this client?

correcting nutritional deficits

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition?

peptic ulcers

Which of the following is the most successful treatment for gastric cancer?

removal of the tumor

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?

six small meals daily with 120mL fluid between meals

A client with peptic ulcer disease has been prescribed sucralfate. What health education should the nurse provide to this client?

take the medication 2 hours before or after other medications

A nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache, and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect?

vasomotor symptoms associated with dumping syndrome

The nurse is caring for a client with a duodenal ulcer. Which assessment findings indicate to the nurse that the client is experiencing perforation from the ulcer? Select all that apply.

vomiting, tender and rigid abdomen, sudden drop in blood pressure, abdominal pain referred to the right shoulder

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse?

assess the client's abdomen and vital signs

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

drink liquids only between meals

A client who had a Roux-en-Y bypass procedure for morbid obesity ate a chocolate chip cookie after a meal. After ingestion of the cookie, the client reported cramping pains, dizziness, and palpitation. After having a bowel movement, the symptoms resolved. What should the nurse educate the client about regarding this event?

dumping syndrome

A client with gastric cancer is planning to receive chemotherapy. Which medication will be used as the primary agent to improve the tumor response rate?

fluorouracil

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?

a partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum

The nurse is caring for a client who has developed dumping syndrome while recovering from a gastrectomy. What recommendation should the nurse make to the client?

eat several small meals daily spaced at equal intervals

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description?

black and tarry

A client with peptic ulcer disease has a blood pressure of 88/40 mm Hg, dizziness, and nausea. Which complication will the nurse suspect is occurring with this client?

bleeding from the ulcer

A nurse is teaching a client with gastritis about the need to avoid the intake of caffeinated beverages. The client asks why this is so important. Which explanation from the nurse would be most accurate?

caffeine stimulates the CNS and thus gastric activity and secretions, which need to be minimized to promote recovery

A client diagnosed with gastritis is asking the nurse why famotidine is being prescribed instead of cimetidine, which they have been prescribed in the past. Which statement by the nurse is appropriate for this client?

it has fewer drug interactions

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply.

nizatidine, famotidine, cimetidine

Which medication classification represents a proton (gastric acid) pump inhibitor? You

omeprazole

During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take?

notify the primary health care provider

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience

pain 2 - 3 hours after meal