GI
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
A nurse is caring for a client newly diagnosed with hepatitis A. Which statement by the client indicates the need for further teaching?
"How did this happen? I've been faithful my entire marriage."
A nurse is aware that insulin secretion increases 3 to 5 minutes after a meal and then returns to baseline. If a patient ate breakfast at 7:30 AM, the nurse would expect a baseline level by:
10:30 AM
A client diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which statement indicates that the client understands his condition and how to control it?
"I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual."
A diabetic educator is discussing "sick day rules" with a newly diagnosed type 1 diabetic. The educator is aware that the client will require further teaching when the client states what?
"I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours."
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."
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."
A nurse is taking health history data from a client. Use of which of the following medications would especially alert the nurse to an increased risk of hepatic dysfunction and disease in this client? Select all that apply.
Acetaminophen Ketoconazole Valproic acid
A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate?
Administering 1 ampule of 50% dextrose solution, per physician's order
A client has been admitted to the critical care unit with a diagnosis of thyroid storm. What interventions should the nurse include in this client's immediate care? Select all that apply.
Administering beta blockers to reduce heart rate Applying interventions to reduce the client's temperature
A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis?
Assess the client's breath odor
A nurse is caring for an older adult client who has type 2 diabetes mellitus. She suspects that the patient is exhibiting symptoms of diabetic ketoacidosis (DKA) instead of hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Which of the following are indicators of a diagnosis of DKA? Select all that apply.
Blood glucose level of 280 mg/dL Arterial pH of 7 Plasma bicarbonate level of 13 mEq/L
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
Which of the following is an age-related change that may affect diabetes? Select all that apply.
Decreased renal function Taste changes Decreased vision
Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes melitus. Which of the following explains the cause of this secondary diabetes?
Dysfunction of the pancreatic islet cells
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
A client is given a diagnosis of hepatic cirrhosis. The client asks the nurse what findings led to this determination. Which of the following clinical manifestations would the nurse correctly identify? Select all that apply.
Enlarged liver size Ascites Hemorrhoids
The nurse is educating the patient with diabetes about the importance of increasing dietary fiber. What should the nurse explain is the rationale for the increase? Select all that apply.
Help reduce cholesterol levels Decrease the need for exogenous insulin May improve blood glucose levels
Exercise lowers blood glucose levels. Which of the following are the physiologic reasons that explain this statement. Select all that apply.
Increases lean muscle mass Increases resting metabolic rate as muscle size increases Decreases total cholesterol Increases glucose uptake by body muscles
A client with a long-standing diagnosis of type 1 diabetes has a history of poor glycemic control. The nurse recognizes the need to assess the client for signs and symptoms of peripheral neuropathy. Peripheral neuropathy constitutes a risk for what nursing diagnosis?
Infection
A mother brings her teenage son to the clinic, where tests show that he has hepatitis A virus (HAV). They ask the nurse how this could have happened. Which of the following explanations would the nurse correctly identify as possible causes? Select all that apply.
Infection at school Suboptimal sanitary habits Consumption of sewage-contaminated water or shellfish Sexual activity
The nurse is assessing a patient with nonproliferative (background) retinopathy. When examining the retina, what would the nurse expect to assess? Select all that apply.
Leakage of fluid or serum (exudates) Microaneurysms Focal capillary single closure
A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? Select all that apply.
Little endogenous insulin Ketosis-prone Younger than 30 years of age
The nurse is caring for a client with an abnormally low blood glucose concentration. What glucose level will the nurse observe when assessing laboratory results?
Lower than 50 to 60 mg/dL (2.77 to 3.33 mmol/L)
A client with a history of type 1 diabetes has just been admitted to the critical care unit (CCU) for diabetic ketoacidosis. The CCU nurse should prioritize what assessment during the client's initial phase of treatment?
Maintaining and monitoring the client's fluid balance
The nurse is educating the patient with diabetes about the importance of increasing dietary fiber. What should the nurse explain is the rationale for the increase? Select all that apply.
May improve blood glucose levels Decrease the need for exogenous insulin Help reduce cholesterol levels
A hospitalized, insulin-dependent patient with diabetes has been experiencing morning hyperglycemia. The patient will be awakened once or twice during the night to test blood glucose levels. The health care provider suspects that the cause is related to the Somogyi effect. Which of the following indicators support this diagnosis? Select all that apply.
Normal bedtime blood glucose Increase in blood glucose from 3:00 AM until breakfast Decrease in blood sugar to a hypoglycemic level between 2:00 to 3:00 AM
While conducting a physical examination of a client, which of the following skin findings would alert the nurse to the possibility of liver problems? Select all that apply.
Petechiae Jaundice Ecchymoses
The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?
Reflects the amount of glucose stored in hemoglobin over past several months.
A client with type 2 diabetes has been managing his blood glucose levels using diet and metformin. Following an ordered increase in the client's daily dose of metformin, the nurse should prioritize which of the following assessments?
Reviewing the client's creatinine and BUN levels
A client is being discharged after a liver transplant and the nurse is performing discharge education. When planning this client's continuing care, the nurse should prioritize what risk diagnosis?
Risk for Infection Related to Immunosuppressant Use
A client is prescribed corticosteroid therapy. What would be priority information for the nurse to give the client who is prescribed long-term corticosteroid therapy?
The client is at an increased risk for developing infection.
A nurse practitioner treating a patient who is diagnosed with hepatitis A should provide health care information. Which of the following statements are correct for this disorder? Select all that apply.
There is a 70% chance that jaundice will occur. Transmission of the virus is possible with oral-anal contact during sex. Typically there is a spontaneous recovery.
Hep B route
blood saliva semen vagina (incubation period 1-6 month)
Hep C
blood, sex (15-160 day)
Hep A, E route of transmission
fecal-oral, ingestion of foods/fluids infected w virus, sexual oral-anal, (A: incubation period 4-6wks)(E: 15-65)
A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer?
if it's used within 1 month
A client has received a diagnosis of type 2 diabetes. The diabetes nurse has made contact with the client and will implement a program of health education. What is the nurse's priority action?
readiness to learn
A client presents at the walk-in clinic reporting diarrhea and vomiting. The client has a documented history of adrenal insufficiency. Considering the client's history and current symptoms, the nurse should anticipate that the client will be instructed to increase intake of:
sodium
The nurse is caring for a patient with hyperparathyroidism and observes a calcium level of 16.2 mg/dL. What interventions does the nurse prepare to provide to reduce the calcium level? Select all that apply.
Administration of calcitonin Intravenous isotonic saline solution in large quantities Monitoring the patient for fluid overload
The nurse is planning the care of a client with hyperthyroidism. What should the nurse specify in the client's meal plan?
Small, frequent meals, high in protein and calories
