Chapter 38 Gastrointestinal Assessment 2

A patient's history includes long-term treatment for arthritis and atherosclerosis. During a follow-up visit, the nurse finds that the patient has upper gastrointestinal bleeding. Which medication in the patient's prescriptions may be responsible for this condition?

Aspirin

Which sequence should the nurse follow when examining a patient's abdomen?

Inspection first, then auscultation, percussion, and palpation

A patient reports hematemesis and burning pain in the stomach. The nurse suspects the patient to have peptic ulcer disease. Which diagnostic test is appropriate to confirm the diagnosis?

Upper GI endoscopy

The nurse expects that a magnetic resonance imaging (MRI) study will be prescribed for a patient with what history?

Colorectal cancer

The nurse reviews the liver function test results of four patients and identifies that which patient's findings are abnormal?

Patient C

The nurse recognizes that which test is performed to diagnose celiac disease in a patient?

Video capsule endoscopy (VCE)

After a patient has undergone an esophagogastroduodenoscopy (EGD), what is the nursing priority?

Keep the patient nothing by mouth (NPO) until the gag reflex returns.

The nurse reviews a patient's medical record and determines that the patient's level of aspartate aminotransferase liver enzyme is normal based on what laboratory result?

18 U/L

Which clinical manifestation does the nurse expect to observe in a patient with ascites?

Accumulation of fluid within the abdominal cavity

Which nursing intervention is beneficial for a patient who is scheduled for a sigmoidoscopy procedure?

Administering an oral lavage solution to the patient on the evening before and 4-6 hours before the procedure

A patient is scheduled for a radiologic study of the upper gastrointestinal tract. When preparing the patient for the test, what is the most important nursing action?

Ask the patient about allergies to drugs, iodine, or other contrast media

A patient with liver fibrosis is scheduled for a closed biopsy procedure. What should the nurse include in the procedural plan of care? Select all that apply.

Assessing the vital signs Instructing the patient to not breathe during needle insertion Instructing the patient to lie in the supine position during the procedure Instructing the patient to raise the right arm over the head during the procedure

The experienced nurse observes a novice nurse who is performing an abdominal assessment on a patient. Which action by the novice nurse may result in false assessment findings?

Auscultates the abdomen after palpation

The nurse is preparing to examine a patient's abdomen. Which procedure should the nurse perform first?

Auscultation

A patient's assessment findings include an elevated alkaline phosphatase (ALP) level. The nurse recalls that the level rises because of what conditions? Select all that apply.

Biliary tract obstruction Stones in common bile duct

The nurse is providing post-procedural care to a patient who had a colonoscopy. The nurse should report what assessment finding to the primary health care provider immediately?

Blood in the feces

A nurse assesses an elderly patient who reports abdominal pain. Which assessment finding may indicate a serious gastrointestinal disorder?

Bright red blood in the stool

The nurse is caring for patient who is scheduled for a liver biopsy. Which interventions are appropriate to be included on the patient's plan of care? Select all that apply.

Check the bleeding time. Check the prothrombin time. Instruct the patient to expire fully and not breathe when the needle is inserted.

A patient with a family history of colon cancer undergoes a screening colonoscopy. After the procedure, the nurse should perform which interventions? Select all that apply.

Obtain vital signs Assess for abdominal cramping Assess for abdominal distention Monitor for signs of rectal bleeding

The nurse is caring for a patient who states, "I am unable to swallow food, and I feel like food gets stuck in my esophagus." What condition is the patient experiencing?

Dysphagia

The nurse is assessing a patient who reports pain when swallowing and difficulty swallowing. The patient has a history of smoking for the past 15 years. What is the most likely cause of the symptoms in this patient?

Esophageal cancer

A patient experiences difficulty in defecation due to constipation. A recommended treatment is the Valsalva maneuver. The nurse recognizes that it is important to obtain what history information prior to assisting the patient with this maneuver? Select all that apply.

Hemorrhoids Cardiac problems Abdominal surgery

A patient is being admitted to the hospital with gastrointestinal (GI) problems. When taking the patient's history, the nurse should obtain information related to what GI-related conditions? Select all that apply.

Hemorrhoids Lactose intolerance Abdominal distention Nausea and vomiting

After a patient has had an esophagogastroduodenoscopy (EGD), which is the most important nursing action

Keeping the patient nothing by mouth (NPO) until the gag reflex returns.

The nurse is performing an abdominal examination of a patient. The nurse auscultates relatively high pitched and loud gurgling sounds in the stomach and recognizes that this is indicative of what?

Normal finding

A patient reports severe pain in the right upper quadrant of the abdomen. Which assessment techniques should the nurse use when examining the liver? Select all that apply.

Percussion Deep palpation

The nurse inspects, auscultates, and palpates a patient's abdomen and notes no obvious abnormalities, except pain. When the nurse palpates the abdomen for rebound tenderness, there is severe pain. The nurse suspects what condition?

Peritoneal inflammation

The nurse is performing a focused abdominal assessment of a hospitalized patient. To palpate the patient's liver, where should the nurse palpate the patient's abdomen?

Right upper quadrant

A patient is suspected to have acute pancreatitis after presenting to the emergency department with severe abdominal pain. The nurse identifies that which important diagnostic laboratory value peaks in 24 hours and then drops to normal in 48 to 72 hours?

Serum amylase

The nurse suspects a cobalamin deficiency in a patient based on what assessment finding?

Smooth, red, and slick tongue

A patient experiences severe abdominal pain. The nurse performs a physical examination and finds that there is tenderness in the left upper quadrant. Which organs could cause this tenderness? Select all that apply.

Spleen Stomach

When a patient reports foul-smelling stool, what condition should the nurse suspect?

Steatorrhea

The nurse is assessing a patient who has constipation. Which information should the nurse obtain to assess the patient's elimination pattern? Select all that apply.

Use of laxatives Consistency of stools Use of opioid medications Frequency of bowel movements

A student nurse is performing an abdominal examination after receiving instructions from the registered nurse. Which action performed by the student nurse indicates the need for further teaching?

Uses cool hands while performing the patient's examination

A patient reports a two-month history of dark tarry stools and occasional blood on the toilet paper after wiping. The patient experiences generalized weakness and tires easily. The patient denies a history of taking iron pills or blueberry consumption. The nurse anticipates that which diagnostic tests will be prescribed to determine the cause of the blood? Select all that apply.

Virtual colonoscopy Guaiac stool test for occult blood Video capsule endoscopy (VCE) Magnetic resonance imaging (MRI)

While assessing the abdomen, the nurse uses the bell of the stethoscope to auscultate below the diaphragm to assess for lower-pitched bowel sounds. What measure should the nurse take to prevent abdominal contraction while auscultating?

Warm the bell of the stethoscope with the hands