Ch. 50 biliary disorders

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should the nurse administer to the client before surgery?

Packed red blood cells Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Medical Management, p. 1452.

A nurse manager prepares teaching for staff nurses who care for clients with diabetes. Which statements will the nurse manager include when discussing the differences between the endocrine and exocrine functions of the pancreas? Select all that apply.

"Internal secretion of hormones is the function of the endocrine pancreas." "The endocrine pancreas secretes hormones through a ductless gland." "The exocrine pancreas secretes hormones from excretory ducts." "The exocrine pancreas secretes pancreatic enzymes into the GI tract." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1429.

When reviewing the history of a client with pancreatic cancer, the nurse would identify which of the following as a possible risk factor?

History of pancreatitis Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1450.

The nurse should assess for an important early indicator of acute pancreatitis. What prolonged and elevated level would the nurse determine is an early indicator?

Serum lipase Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Assessment and Diagnostic Findings, p. 1442.

A client admitted with severe epigastric abdominal pain radiating to the back is vomiting and reports difficulty breathing. Upon assessment, the nurse determines that the client is experiencing tachycardia and hypotension. Which actions are priority interventions for this client? Select all that apply.

Administer pain-relieving medication Administer electrolytes Administer plasma Assist the client to a semi-Fowler position Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1434.

The nursing student has just reviewed material in the course textbook regarding pancreatitis. The student knows that a major symptom of pancreatitis that causes the client to seek medical care is:

Severe abdominal pain Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1441.

A nurse is caring for a client with mild acute pancreatitis. Which health care provider prescriptions will the nurse question as it relates to evidence based practices in the treatment of acute pancreatitis? Select all that apply.

Full liquid diet as tolerated. Nasogastric tube to intermittent wall suction for removal of gastric secretions. Initiate parenteral feedings first and advance to enteral feedings as tolerated. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1442.

A client who is 24 hours post op from laparoscopic cholecystectomy calls the nurse and reports pain in the right shoulder. How should the nurse respond to the client's report of symptoms?

"Apply a heating pad to your shoulder for 15 minutes hourly as needed." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1437.

A nurse cares for a client with interstitial pancreatitis. What client teaching will the nurse include when planning care for the client?

"Inflammation is confined to only the pancreas." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Acute Pancreatitis, pp. 1440-1441.

A nurse should monitor blood glucose levels for a patient diagnosed with hyperinsulinism. What blood value does the nurse recognize as inadequate to sustain normal brain function?

30 mg/dL Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Hyperinsulinism, p. 1453.

The nurse knows that the serum amylase concentration returns to normal within which time frame?

48 hours Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1442.

Pharmacologic therapy frequently is used to dissolve small gallstones. It takes about how many months of medication with UDCA or CDCA for stones to dissolve?

6 to 12 Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Pharmacologic Therapy, p. 1434.

A patient is receiving pharmacologic therapy with ursodeoxycholic acid or chenodeoxycholic-cholic acid for treatment of small gallstones. The patient asks the nurse how long the therapy will take to dissolve the stones. What is the best answer the nurse can give?

6 to 12 months Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Pharmacologic Therapy, p. 1434.

A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority?

Acute pain related to biliary spasms Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Pain and Biliary Colic, pp. 1431-1432.

A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client?

Administering morphine I.V. as ordered Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Relieving Pain and Discomfort, p. 1443.

A client who had developed jaundice 2 months earlier is brought to the ED after attending a party and developing excruciating pain that radiated over the abdomen and into the back. Upon assessment, which additional symptom would the nurse expect this client to have?

Bile-stained vomiting Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1442.

A nurse is reviewing the health care provider orders for a client admitted with acute pancreatitis. The health care provider has ordered intravenous calcium chloride infusions for the client. What does the nurse understand is the reason for this order?

Calcium binds to fatty acids when auto digestion of the pancreas occurs. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1448.

The nurse is caring for a client with a biliary disorder who has an elevated amylase level. If this elevation correlates to dysfunction, which body process does the nurse recognize may be impaired?

Carbohydrate digestion Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, The Exocrine Pancreas, p. 1429.

A nurse discusses risk factors of cholelithiasis with a client. Which risk factors will the nurse include in the teaching? Select all that apply.

Changes in weight Cystic fibrosis Diabetes Obesity Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1431.

A patient is admitted to the hospital with a possible common bile duct obstruction. What clinical manifestations does the nurse understand are indicators of this problem? (Select all that apply.)

Clay-colored feces Pruritus Jaundice Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1452.

Which is a clinical manifestation of cholelithiasis?

Clay-colored stools Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1432.

A 70-year-old client is admitted with acute pancreatitis. The nurse understands that the mortality rate associated with acute pancreatitis increases with advanced age and attributes this to which gerontologic consideration associated with the pancreas?

Decreases in the physiologic function of major organs Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1441.

Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes mellitus. Which of the following explains the cause of this secondary diabetes?

Dysfunction of the pancreatic islet cells Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Assessment and Diagnostic Findings, p. 1445.

A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder?

Edema and inflammation Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, pp. 1441-1442.

When caring for the patient with acute pancreatitis, the nurse must consider pain relief measures. What nursing interventions could the nurse provide? (Select all that apply.)

Encouraging bed rest to decrease the metabolic rate Withholding oral feedings to limit the release of secretin Administering parenteral opioid analgesics as ordered Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Nursing Management, p. 1443.

When the nurse is caring for a patient with acute pancreatitis, what intervention can be provided in order to prevent atelectasis and prevent pooling of respiratory secretions?

Frequent changes of positions Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Improving Breathing Pattern, p. 1443.

Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels?

Frequent vomiting, leading to loss of fluid volume Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1444.

A nurse is preparing a client for surgery. During preoperative teaching, the client asks where is bile stored. The nurse knows that bile is stored in the:

Gallbladder Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, The Gallbladder, p. 1428.

A student nurse is preparing a plan of care for a client with chronic pancreatitis. What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority?

Impaired nutrition: less than body requirements Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1445.

A client is scheduled for a cholecystogram for later in the day. What is the nurse's understanding on the diagnostic use of this exam?

It visualizes the gallbladder and bile duct. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1432.

Clinical manifestations of common bile duct obstruction include all of the following except:

Light-colored urine Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1452.

Which enzyme aids in the digestion of fats?

Lipase Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1429.

A critical care nurse is caring for a client with acute pancreatitis. One potentially severe complication involves the respiratory system. Which of the following would be an appropriate intervention to prevent complications associated with the respiratory system?

Maintain the client in a semi-Fowler's position. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chart 50-4, p. 1447.

A nurse is planning care for a client with acute pancreatitis. Which client outcome does the nurse assign as the highest priority?

Maintaining normal respiratory function Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1443-1444.

A nurse admits a woman reporting severe right upper quadrant pain after eating dinner. What client risk factors lead the nurse to suspect gallbladder disease? Select all that apply.

Multiparous Obese Older than 40 years old History of diabetes mellitus Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1431.

A client diagnosed with acute pancreatitis is being transferred to another facility. The nurse caring for the client completes the transfer summary, which includes information about the client's drinking history and other assessment findings. Which assessment findings confirm the diagnosis of acute pancreatitis?

Pain with abdominal distention and hypotension Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1445.

Which condition is the major cause of morbidity and mortality in clients with acute pancreatitis?

Pancreatic necrosis Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1444.

Which condition is most likely to have a nursing diagnosis of fluid volume deficit?

Pancreatitis Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Intensive Care, p. 1442.

Which of the following conditions is most likely to involve a nursing diagnosis of fluid volume deficit?

Pancreatitis Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Intensive Care, p. 1442.

Because clients with pancreatitis cannot tolerate high-glucose concentrations, total parental nutrition (TPN) should be used cautiously with them. Which of the following interventions has shown great promise in the prognosis of clients with severe acute pancreatitis?

Providing intensive insulin therapy Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Intensive Care, p. 1443.

A client with pancreatitis is admitted to the medical intensive care unit. Which nursing intervention is most appropriate?

Reserving an antecubital site for a peripherally inserted central catheter (PICC) Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Medical Management, p. 1442.

A client comes to the ED with severe abdominal pain, nausea, and vomiting. The physician plans to rule out acute pancreatitis. The nurse would expect the diagnosis to be confirmed by an elevated result on which laboratory test?

Serum amylase Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1442.

The nurse should assess for an important early indicator of acute pancreatitis, which is a prolonged and elevated level of:

Serum lipase Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Assessment and Diagnostic Findings, p. 1442.

A nursing instructor is explaining the pathophysiology and clinical manifestations of pancreatitis to a group of nursing students. The instructor evaluates the teaching as effective when a student correctly identifies which symptom as that most commonly reported by clients with pancreatitis?

Severe, radiating abdominal pain Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1441-1442.

The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason?

To reduce gastric and pancreatic secretions Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Nursing Implications, p. 1433.

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery?

Vitamin K Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Medical Management, p. 1452.

A client with chronic pancreatitis is treated for uncontrolled pain. Which complication does the nurse recognize is most common in the client with chronic pancreatitis?

Weight loss Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1445.

A nurse is caring for a client admitted with acute pancreatitis. Which nursing action is most appropriate for a client with this diagnosis?

Withholding all oral intake, as ordered, to decrease pancreatic secretions Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Medical Management, p. 1442.

A client is treated for gastrointestinal problems related to chronic cholecystitis. What pathophysiological process related to cholecystitis does the nurse understand is the reason behind the client's GI problems?

Reduced or absent bile as a result of obstruction impacts digestion. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, pp. 1433-1434.

A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client?

Relieving abdominal pain Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Pain Management, p. 1442.

Which intervention should be included in the plan of care for a client who has undergone a cholecystectomy?

Assessing the color of the sclera every shift Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1439.

Which foods should be avoided following acute gallbladder inflammation?

Cheese Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1434.

Which term most precisely refers to the incision of the common bile duct for removal of stones?

Choledocholithotomy Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2017, Chapter 50: Cholecystitis

A very ill client with acute cholecystitis is scheduled for surgery. The surgeon plans to create an incision in the common bile duct to remove stones. The nurse correctly documents this surgery in the electronic medical record using which term?

Choledochostomy Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1437.

What is the most appropriate nursing diagnosis for the client with acute pancreatitis?

Deficient fluid volume Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Intensive Care, p. 1442.

A nurse is providing preoperative teaching to a client undergoing a cholecystectomy. Which topic should the nurse include in her teaching plan?

Increase respiratory effectiveness. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Improving Respiratory Status, p. 1438.

What is a major concern for the nurse when caring for a patient with chronic pancreatitis?

Maintaining normal respiratory function Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1443-1444.

A nurse is preparing a client for endoscopic retrograde cholangiopancreatography (ERCP). The client asks what this test is used for. Which statements by the nurse explains how ERCP can determine the difference between pancreatitis and other biliary disorders? Select all that apply.

"It can evaluate the presence and location of ductal stones and aid in stone removal." "It can assess the anatomy of the pancreas and the pancreatic and biliary ducts." "It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1433.

A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct?

"Maintain a high-carbohydrate, low-fat diet." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Improving Nutritional Status, p. 1444.

A nurse cares for an older adult client and teaches the client about age-related changes of the biliary tract. What statements will the nurse include when discussing age-related changes that occur in the pancreas of the older adult? Select all that apply.

"The pancreas develops fibrous material with age." "The pancreas develops fatty deposits with age." "The pancreas decreases secretion of enzymes with age." "The pancreas decreases bicarbonate secretion with age." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1430.

Ursodeoxycholic acid (UDCA) has been used to dissolve small, radiolucent gallstones. Which duration of therapy is required to dissolve the stones?

6 to 12 months Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1434.

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client?

Assisting the client to turn, cough, and deep breathe every 2 hours Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1438.

A client has a tumor of the head of the pancreas. What clinical manifestations will the nurse assess? Select all that apply.

Clay-colored stools Dark urine Jaundice Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1452.

Sixty to eighty percent of pancreatic tumors occur in the head of the pancreas. Tumors in this region obstruct the common bile duct. Which of the following clinical manifestations would indicate a common bile duct obstruction associated with a tumor in the head of the pancreas? Choose all that apply.

Clay-colored stools Dark urine Jaundice Pruritis Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018.

A nurse cares for a client who is post op open cholecystectomy. Upon assessment, the nurse notes the client's abdomen feels firm to palpation. What is the nurse's priority action?

Contact the health care provider Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1439.

The nurse is caring for a client with suspected chronic pancreatitis. Which diagnostic test or imaging does the nurse recognize as the most useful in diagnosing this condition?

ERCP Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1445.

The nurse cares for a client with gallstones that need to be removed but is not a surgical candidate or endoscopic candidate. What procedure does the nurse recognize as being a possible treatment option for the client?

ESWL Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1435.

A nurse has admitted a client suspected of having acute pancreatitis. The nurse knows that mild acute pancreatitis is characterized by:

Edema and inflammation Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1441.

A nurse is caring for a client in the emergency department who is reporting severe abdominal pain. The client is diagnosed with acute pancreatitis. Which laboratory value indicates further investigation?

Elevated troponin Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chart 50-3, p. 1441.

Which dietary modification is used for a client diagnosed with acute pancreatitis?

Elimination of coffee Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chart 50-4, p. 1447.

The patient admitted with acute pancreatitis has passed the acute stage and is now able to tolerate solid foods. What type of diet will increase caloric intake without stimulating pancreatic enzymes beyond the ability of the pancreas to respond?

High-carbohydrate, low-protein, low-fat diet Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chart 50-4, p. 1447.

Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray?

Hot roast beef sandwich with gravy Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Nutritional and Supportive Therapy, p. 1434.

Which is a gerontological consideration associated with the pancreas?

Increased amount of fibrous material Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1430.

From the following profiles of clients, which client would be most likely to undergo the diagnostic test of cholecystography?

Mark, suspected of having stones in the gallbladder Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Oral Cholecystography, p. 1433.

A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN?

Measure blood glucose concentration every 4 to 6 hours Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1444.

A client is admitted to the health care center with hyperglycemia, a 15-pound weight loss, and reports of vague upper and midabdominal pain that increases in intensity at night. The client' health history indicates alcoholism, smoking of a pack of cigarettes daily, and diabetes for the past 20 years. Upon examination the nurse finds swelling in the feet and abdominal ascites. Based on the clinical manifestations, which condition is the most likely diagnosis?

Pancreatic carcinoma Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1450.

A client recovers from an episode of gallbladder inflammation and the client's diet is advanced from a low-fat liquid diet. Which meals will the nurse recommend to the client? Select all that apply.

Roasted chicken, mashed potatoes, and green beans. Marinated lean steak, steamed rice, and roasted zucchini. Oatmeal with a cooked fruit compote and hot tea. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Nutritional and Supportive Therapy, p. 1434.

A nurse is teaching a client about the cause of acute pancreatitis. The nurse evaluates the teaching as effective when the client correctly identifies which condition as a cause of acute pancreatitis?

Self-digestion of the pancreas by its own proteolytic enzymes Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1441.

The nurse is admitting a patient to the intensive care unit with a diagnosis of acute pancreatitis. What does the nurse expect was the reason the patient came to the hospital?

Severe abdominal pain Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1441.

Which is the most common report by clients with pancreatitis?

Severe, radiating abdominal pain Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1441-1442.

A patient with acute pancreatitis puts the call bell on to tell the nurse about an increase in pain. The nurse observes the patient guarding; the abdomen is board-like and no bowel sounds are detected. What is the major concern for this patient?

The patient has developed peritonitis. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1442.

The physician has written the following orders for a new client admitted with pancreatitis: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN) . Which does the nurse attribute as the reason for NPO status?

To avoid inflammation of the pancreas Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chart 50-4, p. 1446.

A client is admitted to the health care center with severe abdominal pain rated 10 on a 1-to-10 scale, tachycardia, hypertension, and muscle spasms. The nurse immediately administers morphine sulfate 4 mg slow intravenous pyelogram (IVP), as ordered. The nurse plans for which goal after administration of this mediation?

To increase the client's pain threshold Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chart 50-4, p. 1446.

A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk?

Use incentive spirometry every hour. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Preoperative Measures, p. 1436.

The nurse knows that the client with cholelithiasis can have a nutritional deficiency. The obstruction of bile flow due to cholelithiasis can interfere with the absorption of

Vitamin A Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Vitamin Deficiency, p. 1432.

A client has a nasogastric (NG) tube for suction and is NPO after a pancreaticoduodenectomy. Which explanation made by the nurse is the major purpose of this treatment?

"The tube allows the gastrointestinal tract to rest." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1452.

A nurse cares for a client who is post op cholecystectomy due to the development of cholesterol stones. The client asks the nurse, "Why did I develop these stones?" What is the nurse's best response?

"The stones formed from a component in the bile and are caused by bile acid and fat abnormalities in the bloodstream." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, pp. 1430-1431.

The nurse identifies a potential collaborative problem of electrolyte imbalance for a client with severe acute pancreatitis. Which assessment finding alerts the nurse to an electrolyte imbalance associated with acute pancreatitis?

Muscle twitching and finger numbness Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chart 50-4, p. 1448.

The nurse is caring for a client with acute pancreatitis who is admitted to the intensive care unit to monitor for pulmonary complications. What is the nurse's understanding of the pathophysiology of pulmonary complications related to pancreatitis?

Pancreatitis can elevate the diaphragm and alter the breathing pattern. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1443.

When caring for a client with acute pancreatitis, the nurse should use which comfort measure?

Positioning the client on the side with the knees flexed Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chart 50-4, p. 1447.

A nurse cares for a client who is post op open cholecystectomy and has a T-tube in place. Which clinical situation will the nurse notify the health care provider about as a possible complication of the surgery?

Significantly reduced bile output from the T-tube. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1435.

A client is instructed to follow a low-fat diet after an inflammatory attack of the gallbladder. Which vitamins will the nurse recommend the client supplement due to the client's dietary restrictions? Select all that apply.

A D K Essential fatty acids Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1439.

A patient is suspected to have pancreatic carcinoma and is having diagnostic testing to determine insulin deficiency. What would the nurse determine is an indicator for insulin deficiency in this patient? (Select all that apply).

An abnormal glucose tolerance Glucosuria Hyperglycemia Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1450.

A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find?

Elevated urine amylase levels Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Assessment and Diagnostic Findings, p. 1442.

What concepts does the nurse understand about gerontologic considerations related to acute pancreatitis? Select all that apply.

As the client ages, there is an increased mortality rate for acute pancreatitis. As the client ages, there is an increased risk for the development of multiple organ dysfunction syndrome. As the client ages, the pattern of complications related to acute pancreatitis changes.

A client with calculi in the gallbladder is said to have

Cholelithiasis Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Disorders of the Gallbladder, p. 1430.

A nursing student has learned about many collaborative interventions to achieve pain relief for clients with acute pancreatitis. Which of the following are appropriate? Choose all that apply.

Encourage bed rest to decrease the client's metabolic rate. Teach the client about the correlation between alcohol intake and pain. Withhold oral feedings to limit the release of secretin. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Pain Management, p. 1442.

A client with suspected biliary obstruction due to gallstones reports changes to the color of his stools. Which stool color does the nurse recognize as common to biliary obstruction?

Gray Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Changes in Urine and Stool Color, p. 1432.

A nurse cares for a client with a disorder of the endocrine function of the pancreas. Which hormones or enzymes may be impacted by this disorder? Select all that apply.

Insulin Glucagon Somatostatin Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1429.

A client who has been having recurrent attacks of severe abdominal pain over the past few months informs the physician about a 25-pound weight loss in the past year. The nurse attributes which factor as the most likely cause of this weight loss?

Skipping meals out of fear of painful attacks Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1445.

A client with acute pancreatitis reports muscle cramping in the lower extremities. What pathophysiology concept represents the reason the client is reporting this?

Tetany related to hypocalcemia Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1448.

A patient is admitted to the hospital with possible cholelithiasis. What diagnostic test of choice will the nurse prepare the patient for?

Ultrasonography Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Ultrasonography, p. 1432.

What is a major concern for the nurse when caring for a patient with chronic pancreatitis?

Weight loss Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Clinical Manifestations, p. 1445.

Ursodeoxycholic acid (UDCA) has been used to dissolve small, radiolucent gallstones. Which duration of therapy is required to dissolve the stones?

7 months Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1434.

One difference between cholesterol stones (left) and the stones on the right are that the ones on the right account for only 10% to 25% of cases of stones in the United States. What is the name of the stones on the right?

Pigment Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Figure 50-2, p. 1431.

The nurse cares for a client with cholecystitis with severe biliary colic symptoms. Which nursing intervention best promotes adequate respirations in a client with these symptoms?

Place the client in semi-Fowler's position. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1432.

The digestion of carbohydrates is aided by

amylase. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1429.

A client discharged after a laparoscopic cholecystectomy calls the surgeon's office reporting severe right shoulder pain 24 hours after surgery. Which statement is the correct information for the nurse to provide to this client?

"This pain is caused from the gas used to inflate your abdominal area during surgery. Sitting upright in a chair, walking, or using a heating pad may ease the discomfort." Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, p. 1437.

A nurse is teaching a client and the client's family about chronic pancreatitis. Which are the major causes of chronic pancreatitis?

Alcohol consumption and smoking Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Chronic Pancreatitis, p. 1445.

This example of cholesterol gallstones (left side of picture) is the result of decreased bile acid synthesis and increased cholesterol synthesis in the liver, which in turn, form stones. Cholesterol stones account for what percentage of cases of gallbladder disease in the United States?

75% Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Pathophysiology, p. 1430.

Management of a patient with ascites includes nutritional modifications and diuretic therapy. Which of the following interventions would a nurse expect to be part of patient care? Select all that apply.

Aldactone, an aldosterone-blocking agent would be used. Daily salt intake would be restricted to 2 grams or less. The diuretic will be held if the serum sodium level decreases to <134 m Eq/L. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Monitoring and Managing Potential Complications, p. 1444.

A nursing student has been assigned to care for a client with pancreatic cancer. The student is aware that the risk for pancreatic cancer is most directly proportional to

Age Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Cancer of the Pancreas, p. 1450.

Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because they

cannot tolerate a high glucose concentration. Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2017, Chapter 50: Pancreatitis: Medical Management

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:

yellow sclerae. Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Assessment and Management of Patients With Biliary Disorders, Maintaining Skin Integrity and Promoting Biliary Drainage, p. 1439.