Upper GI

the nurse determines that teaching for the patient with PUD has been effective when the patient makes which statement?

I have learned some relaxation strategies that decrease my stress

A patient who has been vomiting for several days from an unknown cause is admitted to the hospital. What should the nurse anticipate with first be included in interprofessional care?

IV replacement of fluids and electrolytes

What physiologically occurs with vomiting?

Immediately before the act of vomiting, activation of the parasympathetic nervous system causes increased salivation, increased gastric motility, and relaxation of the lower esophageal sphincter.

what statement by a patient with dumping syndrome should lead the nurse to determine that further teaching is needed

"I should eat bread and jam with every meal"

what type of bleeding will a patient with PUD with a slow upper GI source of bleeding have?

Melena

a patient scheduled for biopsy of a painful tongue ulcer. based on knowledge of risk factors for oral cancer, what should the nurse specifically ask the patient about during a history?

use of any type of tobacco products

A patient treated for vomiting is to begin oral intake when the symptoms have subsided. To promote rehydration the nurse plans to administer which fluid first?

water

vagotomy

severing of the parasympathetic nerve to decrease gastric emptying

how should the nurse teach the patient with a hiatal hernia or GERD to control symptoms?

sleep with the head of the bed elevated on 4-6 inch blocks

which infection or inflammation is found related to systemic disease and cancer chemotherapy?

stomatitis

which esophageal disorder is described as a precancerous lesion and is associated with GERD?

Barrett's esophagus

Which patient is at highest risk of having a gastric ulcer

55 y/o female smoker with nausea and vomiting

what should the nurse emphasize when teaching patients at risk for upper GI bleeding to prevent bleeding episodes?

the use of OTC medications of any kind should be avoided

Regardless of the precipitating factor, what causes the injury to mucosal cells in peptic ulcers

acid back diffusion into the mucosa

which type of gastritis is most likely to occur in a college student who has an isolated drinking binge?

acute gastritis

the nurse is planning to teach the patient with GERD about foods or beverages that decrease LES pressure. What should be included in this list?

alcohol, chocolate, fatty foods and cola sodas

when caring for a patient with acute exacerbation of a peptic ulcer, a nurse finds the patient doubled over in bed with shallow, grunting reparations. which action should the nurse take first?

assess the patient's abdomen and vital signs

a patient with a history of peptic ulcer disease is hospitalized with symptoms of a perforation. during the initial assessment, what should the nurse expect the patient to report?

sudden, severe generalized abdominal and back pain

what is an accurate description of eosinophilic esophagitis?

swelling of the esophagus from an allergic response to food or environmental triggers

a patient with gastric outlet obstruction has been treated with NG decompression. After the first 24hrs, the patient develops nausea and increased upper abdominal bowel sounds. What is the priority action by the nurse?

check the patency of the NG tube

corticosteroid medications are associated with the development of peptic ulcers because of which probable pathophysiologic mechanism?

the rate of mucus cell renewal is decreased

what is the rationale for treating acute exacerbation of PUD with NG intubation?

remove stimulation for HCl acid and pepsin secretion by keeping the stomach empty

the nurse evaluates the management of the patient with Upper GI bleeding is effective when assessment and laboratory findings reveal which result?

decreasing BUN

a patient with oral cancer has a history of heavy smoking, excessive ETOH intake, and personal neglect. During the patient's early postoperative course, what does the nurse anticipate that the patient may need?

drug therapy to prevent substance withdrawal symptoms

what does the nurse include when when teaching a patient with newly diagnosed PUD

eat as normally as possible, eliminating foods that cause pain or discomfort

a patient with esophageal cancer is scheduled for partial esophagectomy. Which nursing intervention is likely to be of highest priority preoperatively?

encourage a high-calorie, high-protein diet

which medications are used to decrease gastric or HCl secretion?

famotidine-pepcid, omeprazole-prilosec, misoprostol-cytotec

what are characteristics of gingivitis?

formation of abscess with loosening of teeth

a large amount of children at a public school have suddenly developed profuse diarrhea and bloody stools. the school nurse suspects food poisoning related to food from the school cafeteria and requests analysis and culture of which food?

ground beef

older patients may have cardiac or renal insufficiency and may be more susceptible to problems from vomiting and antiemetic drug side effects. What nursing intervention is most important to implement with these patients?

hourly visual checks or use a sitter to keep the patient safe

Which laboratory finding should the nurse expect in the patient with persistent vomiting?

increase pH, decreased Potassium, increased hematocrit

ondansetron (Zofran) is prescribed for a patient with cancer chemotherapy-induced vomiting. What should the nurse understand about this drug?

it relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying

a patient with upper GI bleeding and Selena is treated with several drugs. Which drug should the nurse recognize as a priority to administer before, during and potentially after endoscopy

iv esomeprazole - Nexium

a patient with cancer of the stomach at the lesser curvature undergoes a total gastrectomy with an esophagojejunostomy. postoperatively, what should the nurse teach the patient to expect?

lifelong administration of cobalamin

nursing management of the patient with chronic gastritis includes teaching the patient to?

maintain a nonirritating diet with six small meals a day

following a patient's esophagogastrotomy for cancer of the esophagus, what is most important for the nurse to do?

maintain the patient in semi-fowlers or fowlers position

Following a Billroth II procedure, a patient develops dumping syndrome. The nurse explains that the symptoms associated with this problem are caused by

movement of fluid into the small bowel from concentrated food and fluids moving rapidly into the intestine

While caring for a patient following a subtotal gastrectomy with a gastroduodenostomy anastomosis, the nurse determines that the NG tube is obstructed. which action should the nurse take first?

notify the surgeon to reposition or replace the tube

pyloroplasty

often performed after vagotomy

characteristic unique to duodenal ulcers

pain is relieved with eating food, increased gastric acid secretion occurs, there is burning and cramping in the mid-epigastric area

when caring for a patient following a glossectomy with dissection of the floor of the mouth and a radial neck dissection for cancer of the tongue, what is the nurse's primary concern?

patent airway

which statements are characteristic of the uses of antacids for PUD?

patients frequently noncompliant with use, high dose and frequency may stimulate release of gastrin

a patient is admitted to the ED with profuse bright-red hematemesis. During the initial care of the patient, what is the nurse's first priority?

perform a focused nursing assessment of the patient's status

billroth II

removal of distal two thirds of stomach with anastomosis to jejunum

billroth I

removal of the distal two thirds of stomach with anastomosis to duodenum