Chapter 44 Med Surg
A nurse is employed as a gastroenterologists office nurse. When assessing the client, which objective data would provide useful information for diagnosis?
22 lb weight loss in 2 months
The nurse is instructing the client on frequent sensations experienced when a contrast agent is injected into the body during diagnostic studies. Which sensation is most common?
A warm sensation
The nurse is caring for a client recovering from an EGD (esophagogastroduodenoscopy) Which of the following client symptoms would require further nursing assessment?
Abdominal distention - could indicate complications such as perforation and bleeding
The nurse is reviewing the results of a hemoccult test with the client. Which question, asked by the nurse, is important to screen for the potential of a false-positive result. SATA
Are you prescribed regular strength aspirin daily? Can you tell me the amount of alcohol that you drink on an average week? When was the last time that you included red meat in your diet?
Then nurse is preparing to measure the clients abdominal girth as part of the physical examination. At which location would the nurse most likely measure?
At the umbilicus
When assisting with preparing a client scheduled for barium swallow, which of the following would be appropriate to include?
Avoid smoking for at least 12 to 24 hours before the procedure.
The nurse is accompanying the client to the diagnostic imaging unit for a MRI. Which action, by the nurse, is most important prior to the test?
Calculate drop per minute for IV fluids and infuse by gravity. Client will not be able to have an electrical pump operating during the MRI.
When examining the skin of a client who is dehydrated due to fluid losses from the gastrointestinal tract, which of the following would be most important?
Checking if the mucous membranes are dry
A client is schedule for an esophagogastroduodenoscopy (EGD) to detect lesions in the gastrointestinal tract. The nurse would observe for which of the following while assessing the client during the procedure?
Clients tolerance for pain and discomfort
The nurse is caring for a geriatric client at a long term care facility. When administering the clients medications, which age related changes of the client are anticipated? SATA
Decreased motility in the esophagus A weak gag reflex Decreased elasticity of the rectal wall
The nurse is working in a diagnostic testing unit focusing on GI studies. For which testing procedure is the nurse correct to assess the gag reflex before offering fluids?
Esophagogastroduodenoscopy
The nurse is providing community education at the mall. The nurse is instructing on the muscular tube that connects the mouth to the stomach. The nurse outlines this structure on a drawing and labels it which of the following?
Esophagus
The nurse is assessing a client who is stating gastrointestinal upset and feeling of bloating. Which type of meal would the nurse anticipate causing these types of symptoms?
Hamburger and French fries
The nurse is caring for a client following gastrointestinal diagnostic testing. The client verbalized being ashamed because he is having frequent gas. Which nursing suggestion is best?
Having gas following the procedure is normal. Expel the gas to decrease discomfort.
When preparing a client for MRI of the abdomen, which statement would indicate the need to notify the physician?
I really don't like to be in small, enclosed spaces.
The nurse is working on a general medical unit. A client is schedule for an upper gastrointestinal series. Upon return to the nursing unit, what does the nurse identify as the client goal.
Increase the amount of fluids
When examining the abdomen of a client with complaints of nausea and vomiting, which of the following would the nurse do first?
Inspection
The nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment?
Inspection, auscultation, percussion, palpating
The nurse is caring for a geriatric client and notices polypharmacy. Which diagnostic studies are anticipated?
Liver function studies
Which of the following would be most important to ensure that a client does not retain any barium after a barium swallow?
Monitoring the stool passage and its color
The nurse is working with clients with digestive tract disorders. Which of the following organs does the nurse realize has effects as an exocrine gland and an endocrine gland?
Pancreas
A client undergoing a diagnostic examination for gastrointestinal disorder was given polyethylene glycol/electrolyte solution as part of the test preparation. Which of the following measures should the nurse take once the solution is administered?
Permit the client to only drink clear liquids
The nurse is caring for a client who is scheduled for a percutaneous liver biopsy. Which diagnostic test is obtained prior?
Prothrombin time (PT)
The nurse is scheduling GI diagnostic testing for a client. Which GI tests should be schedule first?
Radiography of the gallbladder should be performed before other GI exams in which barium is used because residual barium tends to obscure the images of the gallbladder and its duct.
The nurse is instructing the client who was newly diagnosed with peptic ulcers. Which of the following diagnostic studies would the nurse anticipate reviewing with the client?
Serum antibodies for H. pylori
The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass. The nurse is most correct to state at which location?
Sigmoid colon
The nurse is providing care to a client who has had a percutaneous liver biopsy. The nurse would monitor the client for which of the following?
Signs and symptoms of bleeding
After teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders, the instructor determines that the teaching was successful when the students identify which of the following structures as possible being affected?
Stomach
The nurse is assisting the physician in a percutaneous liver biopsy. In which position would the nurse assist the client to assume?
Supine position, also the nurse places a rolled towel beneath the right lower ribs.
The nurse is teaching the client about the upcoming endoscopic retrograde cholangiopancreatography (ERCP). Although the nurse instructs on several pertinent points of care, which is emphasized?
The client will change positions frequently throughout the procedure. It is essential that the client understand that the cooperation is essential in changing positions throughout the procedure to prevent injury of the GI tract.
The nurse is assessing a client of color for jaundice. In which location would the nurse assess for discoloration? SATA
The sclera, the gums, the hard palate, the conjunctiva
The nurse is caring for a geriatric client experiencing diarrhea. When instructing on the body site where water and electrolytes are absorbed, the nurse is most correct to instruct on which location?
The small bowel
Which nursing instruction is correct to provide the client following a barium enema?
The stools may be white or clay colored
The nurse is instructing a client prior to a colonoscopy. The client states, "why do i have to drink this disgusting liquid?" The nurse is most correct to verbalize the goal of oral preparation as which of the following?
To cleanse the bowel to promote clear visualization of structures
The nurse is caring for a client following a colonoscopy. During the procedure, two medium-sized polyps were removed. Which nursing assessment in the recovery area is a priority.
Vital signs, vital signs of an increased pulse rate and falling blood pressure can indicate a perforation and bleeding.
