digestive system
Your patient, Christopher, has a diagnosis of ulcerative colitis and has severe abdominal pain aggravated by movement, rebound tenderness, fever, nausea, and decreased urine output. This may indicate which complication? A. Fistula. B. Bowel perforation. C. Bowel obstruction. D. Abscess.
B. Bowel perforation. patients with UC are at risk for Bowel perforation, toxic megacolon, hemorrhage, cancer and other anorectal and systemic complications.
Brenda, a 36 y.o. patient is on your floor with acute pancreatitis. Treatment for her includes: a Continuous peritoneal lavage. b Regular diet with increased fat. c Nutritional support with TPN. d Insertion of a T tube to drain the pancreas.
c Nutritional support with TPN. With acute pancreatitis, you need to rest the GI tract by TPN as nutritional support.
Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which observation best indicates the treatment is effective? a There is no skin breakdown. b Her appetite improves. c She loses more than 10 lbs. d Stools are less fatty and decreased in frequency.
d Stools are less fatty and decreased in frequency. Pancrelipase provides the exocrine pancreatic enzyme necessary for proper protein, fat, and carb digestion. With increased fat digestion and absorption, stools become less frequent and normal in appearance.
Develop a teaching care plan for Angie who is about to undergo a liver biopsy. which points do you include? you'll need to lie on your right side after the test. you'll need to lie on your stomach after the test.
you'll need to lie on your right side after the test. ( to compress the liver and to reduce the risk of bleeding or bile leakage).
Matt is a 49 y.o. with a hiatal hernia that you are about to counsel. Health care counselling for Matt should include which instructions?
Increase fluid intake with meals. increasing fluids helps empty the stomach. A high carb diet isn't restricted and fat intake shouldn't be increased.
which of the following definitions best describes diverticulosis? an inflamed outpouching of the intestine. a noninflamed outpouching of the intestine
a noninflamed outpouching of the intestine diverticulosis involves a noninflamed outpouching of the intestine
You have to teach ostomy self care to a patient with a colostomy. You tell the patient to measure and cut the wafer: A-To the exact size of the stoma B-About 1/16" larger than the stoma C-About 1/8" larger than the stoma D-About 1/4″ larger than the stoma
about 1/16" larger than the stoma. a proper fit protects the skin doesn't impair circulation. a 1/16" should be cut.
Before bowel surgery, Lee is to administer enemas until clear. During administration, he complains of intestinal cramps. what do you do next? discontinue the procedure. lower the ht of the enema container.
lower the ht of the enema container.
which of the following symptoms indicate diverticulosis? no symptoms exist change in bowel habits anorexia with low-grade fever
no symptoms exist diverticulosis is an asymptomatic condition. the other choices are s/s of diverticulitis
A patient with Crohn's disease is admitted after 4 days of diarrhea. which of the following urine specific gravity values do you expect to find in him? 1.005 1.030
1.030. the normal range is 1.010 to 1.025. a value of 1.030 is seen with dehydration.
Your teaching Anthony how to use his new colostomy. How much skin should be exposed between the stoma and ring of the appliance?
1/16" more than that allows the excretement to irritate the skin
you're caring for Carin who has just had ileostomy surgery. During the first 24 hours post-op, how much drainage can you expect from the ileostomy?
1500 mL. The large intestine absorbs large amounts of water so the initial output from the ileostomy may be as much as 1500 to 2000 mL / 24 hrs. Gradually, the small intestine absorbs more fluid and the output decreases.
Stephanie, a 28 y.o. accident victim, requires TPN. The rationale for TPN is to provide: 1. Necessary fluids and electrolytes to the body. 2. Complete nutrition by the I.V. route. 3. Tube feedings for nutritional supplementation. 4. Dietary supplementation with liquid protein given between meals.
2. Complete nutrition by the I.V. route. TPN is given I.V. to provide all the nutrients. it isn't a tube feeding nor is it a liquid dietary supplement.
You're patient is complaining of abdominal pain during assessment. What is your priority? 1. Auscultate to determine changes in bowel sounds. 2. Observe the contour of the abdomen. 3. Palpate the abdomen for a mass. 4. Percuss the abdomen to determine if fluid is present.
2. Observe the contour of the abdomen. the first step is to observe the contour of the abdomen
After an abdominal resection for colon cancer, the client returns to his room with a Jackson-Pratt drain in place. The client's spouse asks the nurse about the purpose of the drain. The best response would be for the nurse to say: 1) It irrigates the incision with a saline solution 2) It helps prevent bacterial infection of the incision 3) It measures the amount of fluid lost after surgery 4) It helps prevent the accumulation of drainage in the wound.
4) It helps prevent the accumulation of drainage in the wound. a jackson-pratt drain promotes wound healing by allowing fluid to escape from the wound.
Christina is receiving an enteral feeding that requires a concentration of 80 mL of supplement mixed with 20 mL of water. how much water do you mix with an 8 oz (240mL) can of feeding? 60 70 80 90
60 mL 80/20=240/X
Gail is scheduled for a cholecystectomy. After completion of preoperative teaching, Gail states,"If I lie still and avoid turning after the operation, I'll avoid pain. Do you think this is a good idea?" What is the best response? A) "You'll need to turn from side to side every 2 hours." B) "It's always a good idea to rest quietly after surgery." C) "The doctor will probably order you to lie flat for 24 hours." D) "Why don't you decide about activity after you return from the recovery room?
A) "You'll need to turn from side to side every 2 hours." To prevent venous stasis and improve muscle tone, circulation, and respiratory function, encourage her to move.
Jerod is experiencing an acute episode of ulcerative colitis. Which is priority for this patient? A. Replace lost fluid and sodium. B. Monitor for increased serum glucose level from steroid therapy. C. Restrict the dietary intake of foods high in potassium. D. Note any change in the color and consistency of stools.
A. Replace lost fluid and sodium.
You're caring for Betty with liver cirrhosis. Which of the following assessment findings leads you to suspect hepatic encephalopathy in her? a Asterixis b Chvostek's sign c Trousseau's sign d Hepatojugular reflex
Asterixis Asterixis is an early neurologic sign of hepatic encephalopathy elicited by asking the pt. to hold her arms stretched out. Asterixis is present if the hands rapidly extend and flex.
Annabelle is being discharged with a colostomy, and you're teaching about colostomy care. which statement describes healthy stoma? At first, the stoma may bleed slightly when touched. The stoma should appear dark and have a bluish hue.
At first, the stoma may bleed slightly when touched.
Regina is a 46 y.o. woman with ulcerative colitis. You expect her stools to look like: A. Watery and frothy. B. Bloody and mucous. C. Firm and well-formed. D. Alternating constipation and diarrhea.
B. Bloody and mucous. stools from ulcerative colitis are often bloody and contain mucus.
Findings during an endoscopic exam include a cobblestone appearance of the colon in your patient. The findings are characteristic of which disorder? A. Ulcer B. Crohn's disease C. Chronic gastritis D. Ulcerative colitis
B. Crohn's disease Crohn's disease penetrates the mucosa of the colon through all layers and destroys the colon in patches.
Claire, a 33 y.o. is on your floor with a possible bowel obstruction. Which intervention is priority for her? A. Obtain daily weights. B. Measure abdominal girth. C. Keep strict intake and output. D. Encourage her to increase fluids.
B. Measure abdominal girth.
In a client with Crohn's disease, which of the following symptoms should not be a direct result from antibiotic therapy? A. Decrease in bleeding B. Decrease in temperature C. Decrease in body weight D. Decrease in the number of stools
C. Decrease in body weight Decrease in body weight may occur during therapy due to inadequate dietary intake,
Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate? A. He has fresh, active upper GI bleeding. B. He needs immediate saline gastric lavage. C. His gastric bleeding occurred 2 hours earlier. D. He needs a transfusion of packed RBC's.
C. His gastric bleeding occurred 2 hours earlier. for blood to appear as coffee ground emesis, it would have to be digested approximately 2 hrs ago
after abdominal surgery, your patient has a severe coughing episode that causes wound evisceration. in addition to calling a doctor, which intervention is most appropriate?
Cover the wound with a saline-soaked sterile dressing.
You're discharging Nathaniel with hepatitis B. Which statement suggests understanding by the patient? A) "Now I can never get hepatitis again." B) "I can safely give blood after 3 months." C) "I'll never have a problem with my liver again, even if I drink alcohol." D) "My family knows that if I get tired and start vomiting, I may be getting sick again."
D) "My family knows that if I get tired and start vomiting, I may be getting sick again." hep B can recur. Pts who hav had heps are permanently barred from donating blood. Alcohol is metabolized by the liver and should be avoided by them.
Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He's jaundiced and reports weakness. Which intervention will you include in his care? A) Regular exercise B) A low-protein diet. C) Allow patient to select his meals. D) Rest period after small, frequent meals.
D) Rest period after small, frequent meals. Rest period after small, frequent meals are indicated during the acute phase of hep B.
If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if the diagnosis is Crohn's disease or ulcerative colitis? A. Abdominal computed tomography (CT) scan B. Abdominal x-ray C. Barium swallow D. Colonoscopy with biopsy
D. Colonoscopy with biopsy a Colonoscopy with biopsy can be performed to determine the state of the colon's mucosal layers,
You promote hemodynamic stability in a patient with upper GI bleeding by: A. Encouraging oral fluid intake. B. Monitoring central venous pressure. C. Monitoring laboratory test results and vital signs. D. Giving blood, electrolyte and fluid replacement.
D. Giving blood, electrolyte and fluid replacement. to stabilise a pt with acute bleeding, NS or LR solution is given IV until bp rises and urine output returns to 30 mL/hr.
Anna is 45 y.o. and has a bleeding ulcer. Despite multiple blood transfusions, her HGB is 7.5g/dl and HCT is 27%. Her doctor determines that surgical intervention is necessary and she undergoes partial gastrectomy. Postoperative nursing care includes: A. Giving pain medication Q6H. B. Flushing the NG tube with sterile water. C. Positioning her in high Fowler's position. D. Keeping her NPO until the return of peristalsis.
D. Keeping her NPO until the return of peristalsis. this decreases the risk for abdominal distention and obstruction
Which area of the alimentary canal is the most common location for Crohn's disease? A. Ascending colon B. Descending colon C. Sigmoid colon D. Terminal ileum
D. Terminal ileum studies have shown that the D. Terminal ileum is the most common site
You're caring for Jane, a 57 y.o. patient with liver cirrhosis who develops ascites and requires paracentesis. Before her paracentesis, you instruct her to: 1 Empty her bladder. 2 Lie supine in bed. 3 Remain NPO for 4 hours. 4 Clean her bowels with an enema
Empty her bladder. a full bladder can interfere with paracentesis and be punctured inadvertently.
You're caring for a 28 y.o. woman with hep B. She's concerned about the duration of her recovery. Which response isn't appropriate? Encourage her not to worry about the future. Encourage her to express her feelings about the illness.
Encourage her not to worry about the future. it minimizes her feelings.
Elmer is scheduled for a proctosopy and has an I.V. The doctor wrote an order for 5mg of I.V. diazepam (Valium). which order is correct regarding diazepam? Give diazepam in the I.V. port closest to the vein Mix diazepam with 50 mL of dextrose 5% in water and give over 15 min.
Give diazepam in the I.V. port closest to the vein Diazepam is absorbed by the plastic I.V. tubing and should be given in the port closest to the vein.
Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated? a Calcium b Glucose c Magnesium d Potassium
Glucose Glucose level increases and dm may result d/t the pancreatic damage to the islets of Langerhans.
A patient who underwent abdominal surgery now has a gaping incision due to delayed wound healing. which method is correct when irrigating a gaping abdominal incision with sterile normal saline solution, using a piston syringe? Apply a wet-to-dry dressing to the wound after the irrigation. Irrigate continuously until the solution becomes clear or all the solution is used.
Irrigate continuously until the solution becomes clear or all the solution is used. To wash away tissue debris and drainage effectively, irrigate the wound until the solution becomes clear or all the solution is used.
Your patient has a G.I. tract that is functioning, but has the inability to swallow foods. which is the preferred method of feeding for the patient
NG tubing because the GI tract is functioning, feeding methods involve the enteral route which bypasses the mouth but allows the major portion of the GI tract to be used.
which of the following substances is most likely to cause gastritis? milk bicarbonate of soda NSAIDS
NSAIDS they are a common cause of gastritis because they inhibit prostaglandin synthesis.
You're performing an abdominal assessment on Brent who is 52 y.o. In which order do you proceed? 1. Observation, percussion, palpation, auscultation 2. Observation, auscultation, percussion, palpation 3. Percussion, palpation, auscultation, observation 4. Palpation, percussion, observation, auscultation
Observation, auscultation, percussion, palpation
Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings do you expect to be abnormal for this patient? a Serum creatinine and BUN b Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) c Serum amylase and lipase d Cardiac enzymes
Serum amylase and lipase pancreatitis involves activation of pancreatic enzymes, such as amylase and lipase. these levels are elevated in a pt with acute pancreatitis.
You're doing preoperative teaching with Gertrude who has ulcerative colitis who needs surgery to create an ileoanal reservoir. Which information do you include? a. A reservoir is created that exits through the abdominal wall. b. A second surgery is required 12 months after the first surgery. c. A permanent ileostomy is created. d. The surgery occurs in two stages.
The surgery occurs in two stages. an ileoanal reservoir is created in two stages. the two surgeries are about 2 to 3 months apart. first, diseased intestines are removed and a temporary loop ileostomy is created. second, the loop ileostomy is closed and stool goes to the reservoir and out through the anus.
Anthony, a 60 y.o. pt., has just undergone a bowel resection with a colostomy. During the first 24 hrs, which of the following observations of stoma should you report?
Trickles of bright red blood.
Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to patient. Which of the following is a most accurate explanation? a "It empties the stomach of fluids and gas." b "It prevents spasms at the sphincter of Oddi." c "It prevents air from forming in the small intestine and large intestine." d "It removes bile from the gallbladder."
a "It empties the stomach of fluids and gas."
Stephen is a 62 y.o. patient that has had a liver biopsy. Which of the following groups of signs alert you to a possible pneumothorax? a Dyspnea and reduced or absent breath sounds over the right lung b Tachycardia, hypotension, and cool, clammy skin c Fever, rebound tenderness, and abdominal rigidity d Redness, warmth, and drainage at the biopsy site
a Dyspnea and reduced or absent breath sounds over the right lung s/s of pneumothorax include dyspnea and absent breath sounds over the affected lungs.
Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort? a Give tepid baths. b Avoid lotions and creams. c Use hot water to increase vasodilation. d Use cold water to decrease the itching.
a Give tepid baths. For pruritus, care should include tepid sponge baths and use of emollient creams and lotions.
Glenda has cholelithiasis (gallstones). You expect her to complain of: a Pain in the right upper quadrant, radiating to the shoulder. b Pain in the right lower quadrant, with rebound tenderness. c Pain in the left upper quadrant, with shortness of breath. d Pain in the left lower quadrant, with mild cramping.
a Pain in the right upper quadrant, radiating to the shoulder.
Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity? a Restrict fluids b Encourage ambulation c Increase sodium in the diet d Give antacids as prescribed
a Restrict fluids decreases amount of fluid and accumulation of fluid in peritoneal space.
which of the following complications is thought to be the most common cause of appendicitis? a fecalith bowel kinking
a fecalith a fecalith is a fecal calculus, that occludes the lumen of the appendix and is the most common cause of appendicitis.
Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you immediately do after inserting an NG tube for liquid enteral feedings? a. Aspirate for gastric secretions with a syringe. b. Begin feeding slowly to prevent cramping. c. Get an X-ray of the tip of the tube within 24 hours. d. Clamp off the tube until the feedings begin.
a. Aspirate for gastric secretions with a syringe. aspirating the stomach contents confirms correct placement. if an X-ray is ordered, it must be done immediately, not in 24 hrs.
you are developing a care plan on Sally, a 67 y.o. pt with hepatic encephalopathy. which of the following do you include? administering a lactulose enema as ordered. encouraging a protein-rich diet.
administering a lactulose enema as ordered. you may administer the laxative lactulose to reduce ammonia levels in the colon.
medical management of a client with diverticulitis will include which treatments? reduced fluid intake increased fiber in diet administration of antibiotics
administration of antibiotics antibiotics are to reduce inflammation. the client isn't typically allowed anything orally until the acute episode subsides. Parenteral fluids are given until the client feels better then its recommended to drink 8 oz of water
which of the following factors is believed to cause UC? acidic diet altered immunity
altered immunity several theories exist regarding the cause. one suggests altered immunity as the cause based on extraintestinal characteristics of the disease.
hepatic encephalopathy develops when the blood level of which substance increases? ammonia amylase calcium
ammonia ammonia levels increase d/t improper shunting of blood, causing ammonia to enter systemic circulation, which carries to the brain.
which of the following areas is the most common site of fistulas in client's with crohn's disease? anorectal ileum rectovaginal transverse colon
anorectal fistulas occur in all these areas,
which of the following nursing interventions should be implemented to manage a client with appendicitis? assessing for pain assessing for symptoms of peritonitis
assessing for symptoms of peritonitis
George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage? a "If there is any drainage, notify the surgeon immediately." b "The drainage will decrease daily until the bile duct heals." c "First, the drainage is dark green; then it becomes dark yellow." d "If the drainage stops, milk the tube toward the puncture wound."
b "The drainage will decrease daily until the bile duct heals." as healing occurs, bile drains from the tube, the amt of bile should decrease. teach the pt to expect dark green drainage and to notify if drainage stops
which of the following tests should be administered to a client suspected of having diverticulosis? abdominal ultrasound barium enema
barium enema a barium enema will cause diverticula to fill with barium and be easily seen on x-ray.
surgical management of ulcerative colitis may be performed to treat which of the following complications? gastritis bowel herniation bowel outpouching bowel perforation
bowel perforation perforation, obstruction, hemorrhage and toxic megacolon are common complications of UC.
Eleanor, a 62 y.o. woman with diverticulosis is your patient. Which interventions would you expect to include in her care? a. Low-fiber diet and fluid restrictions. b. Total parenteral nutrition and bed rest. c. High-fiber diet and administration of psyllium. d. Administration of analgesics and antacids.
c. High-fiber diet and administration of psyllium.
Type A chronic gastritis can be distinguished from type B by its ability to
cause atrophy of the parietal cells. Type A causes changes in parietal cells.q
A patient has severe exacerbation of ulcerative colitis. Lon-term meds will include
corticosteroids to control inflammation, they are used for longterm
Fistulas are most common with which of the bowel disorders? crohn's diseae diverticulitis
crohn's disease the lesions of crohn's disease are transmural that is they involve the thickness of the bowel.
Sitty, a 66 y.o. patient underwent a colostomy for ruptured diverticulum. She did well during the surgery and returned to your med-surg floor in stable condition. You assess her colostomy 2 days after surgery. Which finding do you report to the doctor? a. Blanched stoma b. Edematous stoma c. Reddish-pink stoma d. Brownish-black stoma
d. Brownish-black stoma indicates lack of blood flow and maybe necrosis.
Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by: a. Periodic rectal hemorrhage. b. Hypertension and tachycardia. c. Vomiting and elevated temperature. d. Crampy and lower left quadrant pain and low-grade fever.
d. Crampy and lower left quadrant pain and low-grade fever. one sign of acute diverticulitis is crampy lower left quadrant pain. a low-grade fever is another common sign.
Katrina is diagnosed with lactose intolerance. To avoid complications with lack of calcium in the diet, which food should be included in the diet? a. Fruit b. Whole grains c. Milk and cheese products d. Dark green, leafy vegetables
d. Dark green, leafy vegetables they are rich in calcium.
You're preparing a patient with a malignant tumor for colorectal surgery and subsequent colostomy. the patient tells you he's anxious. what should the initial step be?
determine what the pt already knows about colostomies initially you should assess his knowledge and how it will affect his lifestyle
you're caring for Beth who underwent a Billroth 11 procedure (surgical removal of the pylorus and duodenum) for treatment of peptic ulcer. which findings suggest that the pt is developing syndrome, a complication associated with this procedure?
dizziness and sweating. after billroth 11, a large amount of hypertonic fluid enters the intestine. this causes extracellular fluid to move rapidly into the bowel, reducing circulating blood volume and producing vasomotor symptoms. Vasomotor symptoms include dizziness and sweating, tachycardia, syncope, pallor, and palpitations.
You're caring for Lewis, a 67 y.o. patient with liver cirrhosis who develops ascites and requires paracentesis. Relief of which symptom indicated that the paracentesis was effective? 1. Pruritus 2 Dyspnea 3 Jaundice 4 Peripheral Neuropathy
dyspnea. ascites puts pressure on the diaphragm. Paracentesis is done to remove fluid and reducing pressure on the diaphragm. the goal is to improve pt's breathing. the other are signs of cirrhosis that cannot be improved by paracentesis.
you're preparing a teaching plan for a 27 y.o. named Jeff who underwent surgery to close a temporary ileostomy. Which nutritional guideline do you include in this plan?
eat 6 small meals a day.
the student nurse is preparing a teaching care plan to help improve nutrition in a patient with achalasia. you include what? swallow foods while leaning forward. eat meals sitting upright.
eat meals sitting upright.
which of the following diagnostic tests should be performed annually over age 50 to screen for colon cancer? abdominal CT scan abdominal xray fecal occult blood test
fecal occult blood test surface blood vessels of polyps and cancers are fragile and often bleed with the passage of stools.
you're caring for a pt with sigmoid colostomy. the stool from colostomy is
formed.
your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. which factor increases as a result of vagotomy? peristalsis gastric acidity gastric motility gastric pH.
gastric pH. if the vagus nerve is cut as it enters the stomach, gastric acid secretion is decreased, but gastric emptying is delayed. bec gastric acid is decreased, gastric pH increases.
you're patient, post-op drainage of a pelvic abscess secondary to diverticulitis, begins to cough violently after drinking water. his wound has ruptured and a small segment of the bowel is protruding. what's ur priority? ask the pt wat happened, call the doctor, and cover the area with water soaked bedsheet. obtain vs, call the doctor and obtain emergency orders. have the doctor called while you remain with the patient, flex the pt's knees, and cover the wound with sterile towels soaked in sterile saline solution.
have the doctor called while you remain with the patient, flex the pt's knees, and cover the wound with sterile towels soaked in sterile saline solution.
which of the following factors is believed to be linked to crohn's disease? consipation diarrhea hereditary
hereditary although the definite cause is unknown, its thought to be associated with infectious, immune, or psychological factors.
the student nurse is participating in colorectal cancer-screening program. which pt has the fewest risk factors for colon cancer? janice, a 45 y.o with 25 yr history of UC George, a 50 y.o. whose father died of colon cancer. herman, a 60 y.o. who follows a low-fat, high-fiber diet
herman, a 60 y.o. who follows a low-fat, high-fiber diet
1. A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the pt's blood pressure because of which change that is associated with the liver failure?
hypoalbuminemia. bp decreases as the body is unable to maintain normal oncotic pressure with liver failure, so pts with liver failure require close bp monitoring.
which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green or brown? ileostomy ascending colostomy transverse colostomy descending colostomy
ileostomy
which of the following definitions best describes gastritis? erosion of the gastric mucosa inflammation of the diverticulum inflammation of gastric mucosa reflux of stomach acid into the esophagus
inflammation of gastric mucosa
you have a patient with achalasia (incomplete muscle relaxation of the GI tract, especially sphincter muscles) . which medications do you anticipate to administer?
isosorbide dinitrate( isordil) achalasia is characterized by incomplete relaxation of the LES, dilation of the lower esophagus, and a lack of esophageal peristalsis. because nitrates relax the lower esophageal sphincter, expect to give Isordil orally or sublingually.
Janice is waiting for discharge instructions after her herniorrhaphy. which instructions should you include?
lose weight, if obese because obesity weakens the abdominal muscles.
which of the following diets is implicated in the development of diverticulosis? low-fiber diet high- fiber diet
low-fiber diet
which of the following diets is most commonly associated with colon cancer? low-fiber high fat low fat high fiber
low-fiber high fat the metabolic end products are carcinogenic
which of the following associated disorders may the client with crohn's disease exhibit? ankylosing spondylitis malabsorption
malabsorption bec of the transmural nature of the crohn's disease lesions, malabsorption may occur with it.
The student nurse is teaching the family of a patient with liver failure. which diet should be limited? meats and beans butter and gravies.
meats and beans meats and beans are high-protein foods.in liver failure, liver is unable to metabolize proteins adequately.
your patient maria takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. which drug is useful in preventing NSAIDS induced peptic ulcer disease? calcium carbonate (TUMS) misoprostol(cytotec)
misoprostol(cytotec) misoprostol(cytotec) restores prostaglandins that protect stomach from NSAIDS, which diminish prostaglandins
you're developing the plan of care for a patient experiencing dumping syndrome after a Billroth 11 procedure. which dietary instructions do you include?
omit fluids with meals. gastric emptying time can be delayed by omitting fluids from your patient's meals.
during the first few days of recovery from ostomy surgery for uc, which aspects should be the first priority of client care? body image ostomy care sexual concerns skin care
ostomy care although all concerns are imp, ostomy care is crucial
your patient with peritonitis is NPO and complaining of thirst.what should be your priority?
provide frequent mouth care. helps relieve dry mouth.
which of the following symptoms is associated with UC? dumping syndrome rectal bleeding
rectal bleeding in UC, rectal bleeding is the predominant symptom. soft stools are more common with crohn's disease.
A 53 y.o. pt has undergone a partial gastrectomy for adenocarcinoma of the stomach. an ng tube is in place and is connected to low continuous suction. during the immediate postop period, you expect the gastric secretions to be which color? brown red clear yellow
red normally, drainage is bloody for the first 24 hrs.
you're assessing the stoma of a patient with a healthy, well-healed colostomy. you expect the stoma to appear
red and moist.
A 29 y.o. patient has an acute episode of ulcerative colitis. what diagnostic test confirms this diagnosis?
sigmoidoscopy. it allows direct observation of the colon mucosa for changes, and if needed, biopsy.
your goal is to minimize David's risk of complication after herniorrhaphy. you instruct the pt to
splint the incision if he can't avoid sneezing or coughing.
which of the following terms best describes the pain associated with appendicitis? aching fleeting intermittent steady
steady
which of the following symptoms may be exhibited by a client with crohns' disease? bloody diarhhea narrow stools n/v steatorrhea
steatorrhea steatorrhea from malabsorption may occur with crohn's disease.
Your patient recently had abdominal surgery and tells you he feels a popping sensation in his incision during a coughing spell, followed by severe pain. you anticipate an evisceration. which supplies do you take to his room? a suture kit. sterile water and suture kit. sterile saline solution and sterile dressings.
sterile saline solution and sterile dressings. saline solution is isotonic, or close to body fluids in content, and is used along with sterile dressings to cover an eviscerated wound and keep it moist.
which of the following medications is most effective for treating the pain associated with IBS? acetaminophin steroids stool softeners
steroids ibs is caused by inflammation which steroids can reduce
what information is correct about stomach cancer? stomach pain is often a late symptom surgery is often a successful treatment. chemotherapy and radiation are often successful treatment.
stomach pain is often a late symptom outcomes are particularly poor when cancer reaches that point. surgery, chemotherapy and radiation have minimal positive effects.
an intubated patient is receiving continuous enteral feedings through a salem pump at a rate of 60 mL/hr. Gastric residuals have been 30-40 mL when monitored Q4h. you check the residuals and aspirate 220 mL. first response?
stop the feeding and clamp the ng tube. allow time for the stomach to empty before additional feeding is added.
Crohn's disease can be described as a chronic relapsing disease. which of the areas in the GI system may be involved with this disease? the entire length of the large colon only the sigmoid area the small intestine and colon: affecting the entire thickness of the bowel the entire large colon through the layers of mucosa and submucosa
the small intestine and colon: affecting the entire thickness of the bowel crohn's disease can affect any segment of the small intestine, the colon, or both, affecting entire thickness of the bowel.
which of the following associated disorders may a client with UC exhibit? gallstones hydronephrosis nephrolithiasis toxic megacolon
toxic megacolon toxic megacolon is an extreme dilation of segment of the diseased colon caused by paralysis of the colon,
A patient has an acute upper GI hemorrhage. your interventions include treating hypovolemia treating hypervolemia
treating hypovolemia a pt with acute upper GI hemorrhage must be treated with hypovolemia and hemorrhagic shock. you as a nurse can't diagnose the problem.
Colon cancer is most closely associated with which of the following conditions? a. appendicitis b. hemorroids c. hiatal hernia d. ulcerative colitis
uc chronic uc, granulomas, and familial polyposis seem to increase a person's chance of developing colon cancer
which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis? treating constipation with chronic laxative use, leading to dependence on laxatives chronic constipation causing an obstruction, reducing forward flow of intestinal contents undigested food blocking the diverticulum, predisposing the area to bacterial invasion.
undigested food blocking the diverticulum, predisposing the area to bacterial invasion. undigested food can block the diverticulum, decreasing blood supply to the area and predisposing area to bacterial invasion. chronic laxative use is a common problem in elderly but doesnt' cause diverticulitis.
dark, tarry stools indicate bleeding in which location of the G.I. tract? upper colon lower colon upper G.I. tract small intestine.
upper G.I. tract. melena is a passage of dark, tarry stools that contain a large amount of digested blood. it occurs with bleeding from the GI tract.
which of the following interventions should be included in the medical management of crohn's disease? increasing oral intake of fiber administering laxatives using longterm steroid therapy
using longterm steroid therapy to reduce inflammation associated with deeper layersof the bowel wall. other managment focuses on bowel rest
You're advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend? a. Peas b. Cabbage c. Broccoli d. Yogurt
yogurt. high-fiber foods stimulate peristalsis, and as a result, flatus. yogurt reduces gas formation.
Arthur has a family history of colon cancer and is scheduled to have a sigmoidoscopy. He is crying as he tells you, "I know that I have colon cancer, too." Which response is most therapeutic? 1 "I know just how you feel." 2 "You seem upset." 3 "Oh, don't worry about it, everything will be just fine." 4"Why do you think you have cancer?"
you seem upset.