GI cancers

a patient with oral cancer has a history of heavy smoking, excessive alcohol intake, and personal neglect. during the patient's early postoperative course, what does the nurse anticipate that the patient may need? A. oral nutritional supplements B. drug therapy to prevent substance withdrawal symptoms C. counseling about lifestyle changes to prevent recurrence of the tumor D. less pain meds because of cross-tolerance with CNS depressants

B. drug therapy to prevent substance withdrawal symptoms

a patient with esophageal cancer is scheduled for a partial esophagectomy. which nursing intervention is likely to be of highest priority preoperatively? A. practice turning and deep breathing B. encourage a high calorie, high-protein diet C. brush teeth and mouth well each day D. teach about postop tubes and care

B. encourage a high calorie, high-protein diet

a patient with cancer of the stomach at the lesser curvature undergoes a total gastrectomy with an esophagojejunostomy. postop, what would the nurse teach the patient to expect? A. rapid healing of the surgical wound B. lifelong administration of cobalamin C. to be able to return to normal dietary habits D. close follow-up for development of peptic ulcers in the jejunum

B. lifelong administration of cobalamin a total gastrectomy removes the parietal cells responsible for secreting intrinsic factor necessary for absorption of cobalamin

following a patient's esophagogastrostomy for cancer of the esophagus, what is most important for the nurse to do? A. report any blood drainage from the NG tube B. maintain the patient in a semi-fowlers or fowlers position C. monitor for abdominal distention that may disrupt the surgical site D. expect to find decreased breath sounds bilaterally because of surgical approach.

B. maintain the patient in a semi-fowlers or fowlers position

as a result of a gastric resection, the client is at risk for development of dumping syndrome. the nurse should prepare a plan of care for this client based on knowledge that this problem stems primarily from which of the following GI changes? A. excess secretions of digestive enzymes in the intestines B. rapid emptying of the stomach contents into the small intestine C. excess glycogen production by the liver D. loss of gastric enzymes

B. rapid emptying of the stomach contents into the small intestine

a client has been diagnosed with adenocarcinoma of the the stomach and is scheduled to undergo a subtotal gastrectomy (Billroth II procedure). during the preoperative teaching, the nurse is reinforcing information about the surgical procedure. which of the following explanations is most accurate? A. the procedure will result in enlargement of the pyloric sphincter B. the procedure will result in anastomosis of the gastric stump to the jejunum C. the procedure will result in removal of the duodenum D. the procedure will result in repositioning of the vagus nerve

B. the procedure will result in anastomosis of the gastric stump to the jejunum

after a subtotal gastrectomy, the nurse should anticipate that NG tube drainage will be what color for about 12-24 hours after surgery? A. dark brown B. bile green C. bright red D. cloudy white

A. dark brown

which statement by a patient with dumping syndrome should lead the nurse to determine that further dietary teaching is needed? A. i should eat bread and jam with every meal B. i should avoid drinking fluids with my meals C. i should eat smaller meals about 6 times a day D. i need to lie down for 30-60 minutes after my meals

A. i should eat bread and jam with every meal

after surgery for gastric cancer, a client is scheduled to undergo radiation therapy. it will be most important for the nurse to include information about which of the following in the client's teaching plan? A. nutritional intake B. management of alopecia C. exercise and activity levels D. access to community resources

A. nutritional intake

a nurse is assessing a client who has been admitted with a diagnosis of upper GI bleeding. which of the following S/S should the nurse expect to find? (select all that apply) A. dry, flushed skin B. decreased urine output C. tachycardia D. widening pulse pressure E. rapid resp F. thirst

B. decreased urine output C. tachycardia E. rapid resp F. thirst

which of the following S/S would be indicative of the dumping syndrome? A. hunger B. vomiting C. diaphoresis D. heartburn

C. diaphoresis

the client tells the nurse that since his diagnosis of stomach cancer, he has been having trouble sleeping and is frequently preoccupied with thoughts about how his life will change. he sayd, "i wish my life could stay the same". based on this information, which one of the following nursing diagnosis would be appropriate at this time? A. ineffective coping related to the diagnosis of cancer B. insomnia related to fear of the unknown C. grieving related to the diagnosis of cancer D. anxiety related to the need for gastric surgery

C. grieving related to the diagnosis of cancer

the nurse understands that the best position for the client who has undergone a gastrectomy is: A. prone B. supine C. low fowler's D. right or left sims

C. low fowler's

after a subtotal gastrectomy, care of the client's NG tube and drainage system should include which of the following nursing interventions? A. irrigate the tube with 30 mL of sterile water every hour, if needed B. reposition the tube if it is not drainage well C. monitor the client for nausea, vomiting, and abdominal distention D. turn the machine to high suction if the drainage is sluggish on low suction

C. monitor the client for nausea, vomiting, and abdominal distention

a client with a suspected gastric cancer undergoes an endoscopy of the stomach. which of the following assessments made after the procedure would indicate the development of a potential complications? A. the client complains of sore throat B. the client displays signs of sedation C. the client experiences a sudden increase in temp D. the client demonstrates a lack of appetite

C. the client experiences a sudden increase in temp

A patient is scheduled for biopsy of a painful tongue ulcer. based on your knowledge of risk factors for oral cancer, what should the nurse specifically ask the patient about during a history A. excessive exposure to sunlight B. recurrent herpes simplex infections C. use of any type of tobacco products D. difficulty swallowing and pain in the ear

C. use of any type of tobacco products

which of the following would be a expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer? the client will: A. regain weight loss within 1 month after surgery B. resume normal dietary intake of 3 meals a day C. control nausea and vomiting through regular use of antiemetics D. achieve optimal nutritional status through oral or parenteral feedings

D. achieve optimal nutritional status through oral or parenteral feedings

to reduce the risk of dumping syndrome, the nurse should teach the client which of the following interventions? A. sit upright for 30 minutes after meals B. drink liquids with meals, avoiding caffeine C. avoid milk and other dairy products D. decrease the carbohydrate contents of meals

D. decrease the carbohydrate contents of meals

a client who is recovering from a subtotal gastrectomy experiencing dumping syndrome. the client asks the nurse, "when will i be able to eat 3 meals a day again". which of the following responses by the nurse is most appropriate? A. eating 6 meals a day is time-consuming, isnt it? B. you will have 6 small meals a day for the rest of your life C. you will be able to tolerate 3 meals a day before you are discharged D. most clients can resume their normal meal patterns in about 6-12 months

D. most clients can resume their normal meal patterns in about 6-12 months

following a billroth II procedure, a patient develops dumping syndrome. the nurse should explain that the symptoms associated with this problem are caused by? A. distention of the smaller stomach by too much food and fluid intake B. hyperglycemia caused by uncontrolled gastric emptying into the small intestines C. irritation of the stomach lining by reflux of bile salts because the pylorus has been removed D. movement of fluid into the small bowel because concentrated food and fluids move rapidly into the intestine

D. movement of fluid into the small bowel because concentrated food and fluids move rapidly into the intestine

while caring for a patient with a subtotal gastrectomy with a gastroduodenostomy anastomosis, the nurse determines that the NG tube is obstructed. which action should the nurse take first? A. replace the tube with a new one B. irrigate the tube until return can be aspirated C. reposition the tube and then attempt irrigation D. notify the surgeon to reposition or replace the tube

D. notify the surgeon to reposition or replace the tube