Sherpath Module 5: Stomach Disorders

A patient tells the nurse that calcium carbonate has been effective in treating the discomfort associated with peptic ulcer disease. Which response would the nurse provide?

"Calcium carbonates causes rebound acid secretion, which will make symptoms worse."

A patient is prescribed sucralfate to treat symptoms of peptic ulcer disease. Which information would the nurse include when teaching the patient about this medication?

"Do not take an antacid at the same time as sucralfate."

The nurse is teaching a patient how to prevent recurrent chronic gastritis symptoms. Which statement by the patient demonstrates a correct understanding of the nurse's instruction?

"I should avoid alcohol and tobacco."

The nurse is instructing a patient experiencing dumping syndrome about dietary intake. Which statement by the patient indicates the need for further teaching?

"I will drink plenty of water with meals."

A patient asks the nurse how an infection such as Helicobacter pylori causes gastric ulcers. Which information would the nurse provide about this organism?

"It produces an enzyme that alters the acidity of the stomach."

Which response would the nurse use when a patient with gastritis asks, "Why am I taking this drug called sucralfate?"

"It strengthens the mucosal lining of the stomach."

The nurse has placed a nasogastric (NG) tube in a patient with upper GI bleeding to administer gastric lavage. The patient asks the nurse about the purpose of the NG tube for the procedure. Which response would the nurse provide?

"Water goes down the tube to clean out your stomach"

After surgical resection of a malignant gastric tumor, a patient reports epigastric pain, feelings of fullness, and hiccups. The patient's heart rate is 110 beats/min, and the blood pressure is 104/72 mm Hg. Which complication would the nurse suspect Acute gastric dilation ? The nurse knows that the priority nursing intervention would be to Irrigate or replace NG tube per physician orders .

1. Acute gastric dilation 2. Irrigate or replace NG tube per physician orders

A patient's endoscopy report reveals a reddened and thick mucosal membrane around the stomach with prominent rugae. Which condition is associated with these findings?

Acute gastritis

A patient with gastric cancer will be scheduled to undergo surgery to remove the tumor after the patient gains at least 5 lb of body weight. The patient is not drinking the vanilla-flavored enteral supplements that have been prescribed. Which action would the nurse take?

Ask the patient if a change of flavor would make the supplement more palatable

The nurse is caring for a patient who has just returned from an endoscopic procedure. The patient's spouse verbalizes that the patient must be hungry. Which action would the nurse take?

Assess for gag reflex

The nurse is monitoring a patient with gastric cancer for signs and symptoms of upper GI bleeding. Which change in vital signs is indicative of blood loss?

BP decrease from 140/90 to 105/68

Which clinical finding is associated with upper GI bleeding? Select all that apply. One, some, or all responses may be correct.

Bright red or coffee-ground vomitus Dizziness or light-headedness Decreased blood pressure

Which patient finding 3 hours after eating indicates late dumping syndrome?

Confusion

A patient with a duodenal ulcer receives a prescription for pantoprazole tablets. The patient has a small-bore nasogastric (NG) tube and is NPO. Which action would the nurse take?

Contact the health care provider to discuss giving omeprazole or lansoprazole instead

A patient with peptic ulcer disease has developed a pyloric obstruction, and the health care provider orders placement of a nasogastric (NG) tube. For which purpose would the nurse place a NG tube in this patient?

Decompression of the stomach

A patient has been diagnosed with gastric cancer. Which finding would suggest to the nurse that the cancer is at an advanced stage? Select all that apply. One, some, or all responses may be correct.

Enlarged lymph nodes Iron deficiency anemia Nausea and vomting

Which nursing action is the priority for the patient with a stress ulcer?

Evaluating heart rate and blood pressure

A nurse is caring for a patient who underwent total gastrectomy for gastric cancer. The patient reports dizziness, light-headedness, palpitations, excessive sweating, and confusion 2 hours after eating food. Which complication of total gastrectomy would the nurse suspect as the cause of the patient's symptoms?

Excessive insulin release

The nurse is caring for a patient who has granular, dark vomitus that resembles coffee grounds. Which type of ulcer would the nurse suspect in this patient?

Gastric

Which statement would the nurse associate with acute gastritis?

Gastric bleeding may occur and manifest as hematemesis or melena

A 70-year-old patient reports a long history of indigestion and acid reflux treated with over-the-counter medications. The patient has had a recent 15-lb weight loss and reports increasing nausea and vomiting. The nurse palpates an epigastric mass and enlarged lymph nodes. Which condition would the nurse suspect in this patient?

Gastric cancer

A patient being evaluated reports sharp, burning left-sided upper epigastric pain, which worsens after eating. The nurse notes epigastric tenderness, a soft abdomen, and normally active bowel sounds. Which condition would the nurse suspect?

Gastric ulcer

A patient has been diagnosed with gastritis. Which information describes this condition?

Gastritis is the inflammation of the stomach mucosa

Which complication of peptic ulcer disease is more common in older adults?

Hemorrhage

The nurse is caring for a patient with a nasogastric (NG) tube who has undergone open-approach surgery for gastric cancer. Which finding is associated with acute gastric dilation?

Hiccups

The admission assessment for a patient with acute gastric bleeding indicates a blood pressure of 82/40 mm Hg, pulse of 124/min beats/min, and respiratory rate of 26 breaths/min. Which admission prescription would the nurse implement first?

Infuse a 500 ml LR bolus

A nurse is caring for a patient who has undergone surgical resection of a malignant gastric tumor. The patient reports vertigo, tachycardia, syncope, pallor, and increased perspiration within 30 minutes after eating. Which action would the nurse recommend to this patient?

Lie down

The laboratory report of a patient with acute gastritis states there are traces of blood in the stool. Which term would the nurse use to document this finding?

Melena

A patient who has peptic ulcer disease has developed pyloric obstruction. The nurse would monitor the patient's laboratory values closely to assess for which complication?

Metabolic alkalosis

The nurse is reviewing the medications prescribed for a patient with peptic ulcer disease (PUD). Which drug treats Helicobacter pylori infection?

Metronidazole

Which layer of the gastric wall is first affected by adenocarcinoma?

Mucosa

A patient is admitted with chronic peptic ulcer disease (PUD). Which finding suggests a possible pyloric obstruction?

N/V

The nurse is caring for a patient who has acute gastritis. Which class of medication is likely to increase the patient's risk for bleeding?

NSAIDs

A postoperative patient is experiencing delayed gastric emptying. Which treatment would the nurse anticipate?

Nasogastric suctioning

The nurse caring for a patient with a duodenal ulcer finds the patient lying in the fetal position. The patient reports experiencing a sudden onset of sharp pain. Which action would the nurse take?

Notify the health care provider immediately

The nurse is performing a health history on a patient who is newly diagnosed with peptic ulcer disease (PUD). Which condition in the patient's history may be related to a cause of PUD?

Osteoarthritis

Which patient is at increased risk for gastric cancer? Patient A: Stress ulcers Patient B: Atrophic gastritis Patient C: Barrett syndrome Patient D: Curling ulcers

Patient B

A patient is admitted to the ICU with perforation of a duodenal ulcer. Which prescribed action would the nurse implement first?

Place an NG tube and connect it to suction

A patient who has been diagnosed with rheumatoid arthritis also has a history of peptic ulcer disease (PUD). The health care provider has prescribed misoprostol to help prevent further gastric damage. Which concurrent condition should be ruled out before starting this medication?

Pregnancy

Which finding would occur in a patient who has advanced gastric cancer?

Progressive weight loss

The nurse is preparing to insert a nasogastric (NG) tube for a patient who is scheduled to have surgery for gastric cancer. Which purpose of placing the tube would the nurse explain to the patient?

Remove secretions, and empty the stomach

A patient has been discharged home after surgery for gastric cancer, and a case manager will follow up with the patient. Which information is a priority for the hospital nurse to provide to the case manager?

Schedule of the patient's follow-up examinations and x-ray assessments

A patient is experiencing bleeding related to peptic ulcer disease (PUD). Which action would the nurse take?

Start a large-bore IV

The nurse is caring for a patient with peptic ulcer disease (PUD). Which assessment finding suggests a surgical emergency? Select all that apply. One, some, or all responses may be correct.

Sudden, sharp pain in the mid-epigastrium Assuming the knee-chest position Tender, rigid, board-like abdomen

The nurse is caring for an older-adult man who reports stomach pain and heartburn. Which characteristic would lead the nurse to suspect the ulcer was duodenal rather than gastric in location?

The pain occurs 3 hours after meals and at night

A nurse who is caring for a patient after conventional open approach surgery elevates the head of the bed. Which rationale supports this intervention?

To prevent aspiration

Which intervention would the nurse include in the plan of care for a patient after an open partial gastrectomy? Select all that apply. One, some, or all responses may be correct.

Verifying placement and function of the nasogastric tube Reminding the patient to perform pulmonary exercises Examining the surgical site regularly Auscultating the lungs and bowel sounds

A patient who underwent partial gastrectomy for gastric cancer has a shiny, smooth tongue with characteristic "beefy appearance." The patient states, "I feel like my tongue is on fire." Which nutrient deficiency would the nurse suspect?

Vitamin B12