GI and MS
To prevent gastroesophageal reflux in a male client with hiatal hernia, the nurse should provide which discharge instruction?
"Avoid coffee and alcoholic beverages."
A male client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been "spitting up blood." A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client's wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is
"Has your husband recently fallen or injured his chest?"
A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response?
"You may have eaten contaminated restaurant food."
Classic signs of Liver Failure
1. Hyper ammonimia 2. Jaundice 3. Fluid Overload 4. Bleeding
Name factors that can damage the liver
1. Infection 2. Ischemia 3. Medications. 4. Toxins 5. Alcohol
Complications associated with paracentesis
1. Infection-peritonitis 2. Bleeding. 3. Bowel perforation.
Measures to lower ammonia levels?
1. Lactulose 2. Neomycin 3. Low Protein diet
Cause of ascites in a patient with liver failure.
1. portal hypertension 2. low plasma proteins
Treatment for osteomyelitis
2-3 months antibiotics wound care
Patient with liver cirrhosis is showing signs of neuro impairment which lab value will you check?
Ammonia levels
The physician orders a Bernstein test for a client who complains of chest pain. When teaching the client about this test, the nurse explains that it's done to:
Assess for acid perfusion of the esophageal mucosa.
When is the best time to give Sucralfate?
Before meals and at bedtime.
Definitive diagnostic procedure for osteoporosis
Bone density scan or DEXA
Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube?
Change the tube feeding solutions and tubing at least every 24 hours
A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond?
Check the tube for kinks
Which conditions make enema contraindicated?
Diverticulitis and Appendicitis
Most common cause of Colon Cancer in the younger groups
Familial adenomatous polyposis
Mode of transmission for Hepatitis A?
Fecal-oral
Priority management for ANY acute GI distress.
GI Rest, Fluid and electrolyte replacement
Priority in the management for patients with cholecystitis/cholelithiasis
GI rest, Pain control, Antibiotics, Nutritional management Long term: Stone dissolution, Surgery
Priority post procedure care for endoscopy.
Gag reflex assessment
Organ meat
Gouty arthritis
Condition that leads to recurrent peptic ulcer formation?
H. Pylori infection
Patient is having acute GI bleeding, what is your priority?
Hemodynamic Stability(VS and H+H)
Electrolyte imbalance common in pancreatitis?
Hypocalcemia
Nursing responsibility after barium swallow.
Increase fluid intake. Laxatives as ordered
Intervention to prevent diverticulitis for a patient with diverticulosis.
Increased fluid and fiber in the diet to have healthy and regular bowel habits.
The nurse provides health teachings about Sucralfate. Which of the following best describes sucralfate?
It promotes healing by adhering to ulcer surface.
While palpating a female client's right upper quadrant (RUQ), the nurse would expect to find which of the following structures?
Liver
Which dietary modification will you recommend for a patient with Gouty Arthritis?
Low uric acid/purine diet. Increased fluid intake
Patient has fresh bloody stool where is the possible cause of bleeding?
Lower GIT
A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?
Lying on left side with knees bent
Sodium Bicarbonate was prescribed to a patient to relieve heartburn. The nurse knows that the medication is contraindicated to which of the following conditions?
Metabolic alkalosis
Patient with dilaudid PCA. Which drug should be readily available?
Narcan
The nurse is caring for a female client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?
Nothing by mouth
Type of arthritis common for obese patients
Osteoarthritis
Why is pain medication contraindicated for a patient suspected with appendicitis?
Pain meds may mask signs of rupture.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
Pancreatitis
Diverticulitis ruptures what is the likely complication?
Peritonitis
The nurse caring for a client with small-bowel obstruction would plan to implement which nursing intervention first?
Preparing to insert a nasogastric (NG) tube
What differentiates Crohn's and Ulcerative Colitis
Presence of blood in the stool .
Priority in the management of liver cirrhosis
Preserve remaining liver function, End of life concerns
Fatal complication from a fractured long bone.
Pulmonary/fat embolismCompartment syndrome
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease?
Purpura and petechiae
Priority management for acute musculoskeletal injuries
Rest Immobilize Compress Elevate
Which type of heart failure can lead to liver failure?
Right sided heart failure.
Complication of arthroscopy
Septic Arthritis
Patient with unexplained anemia is suspected GI bleed but there are no obvious signs of bleeding, which test will be recommended?
Stool occult blood
Priority assessment for a patient after left femoral fracture repair
VS and Neurovascular assessment for affected extremity.
Patient with Chronic gastritis, which vitamin deficiency will be most evident?
Vitamin B 12 Deficiency, pernicious anemia
During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to hypoprothrombinemia?
Vitamin K
Which lab value will you review for a patient with Rheumatoid Arthritis?
WBC, ANA, ESR, CRP
Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:
alcohol abuse and smoking
A patient with gastroesophageal reflux disease asks which food will not aggravate his present condition. The nurse should instruct the patient to include which of the following?
baked chicken breast
When evaluating a male client for complications of acute pancreatitis, the nurse would observe for
decreased urine output
Which diagnostic test would be used first to evaluate a client with upper GI bleeding?
hgb and hct
When is the best time to give Calcium?
in the morning, Ca absorbed with activity.
Produced by the parietal cells to absorb Vitamin B12.
intrinsic factor
Weight bearing joints
osteoarthritis
A male client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse's first response is to:
place saline-soaked sterile dressings on the wound.
A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note first:
severe RUQ pain
Which lab value is the best indicator of liver function?
ALT and AST
A client is suspected to have appendicitis. He complains of severe RLQ pain, nausea and vomiting, temperature is at 102 F. Which of the following interventions will be most appropriate?
Administer NS at 100 ml/hr
What laboratory finding is the primary diagnostic indicator for pancreatitis?
Elevated serum lipase
The client who is on long-term NSAID therapy is also receiving Misoprostol. The medication exhibits its therapeutic effect if the client did not experience which of the following symptoms?
Epigastric pain
The electrolyte imbalance expected with patients having acute exacerbation of IBS and IBD?
Hypokalemia/Hyponatremia
Priority for a patient having diarrhea.
Identify and treat the cause Correct fluid and electrolyte imbalance.
A male client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of:
increasing fluid intake to prevent dehydration.