GI MEDSURG 1
The nurse cares for a 34-yr-old woman after bariatric surgery. The nurse determines that discharge teaching related to diet is successful if the patient makes which statement?
"A high-protein diet that is low in carbohydrates and fat will prevent diarrhea."
The family of a patient newly diagnosed with hepatitis A asks the nurse what they can do to prevent becoming ill. Which response by the nurse is most appropriate?
"An immunoglobulin injection will be given to prevent infection or limit symptoms."
The nurse provides discharge instructions for a 64-yr-old woman with ascites and peripheral edema related to cirrhosis. Which patient statement indicates teaching was effective?
"Herbs and other spices should be used to season my foods instead of salt."
When evaluating the patient's understanding about the care of the ileostomy, which statement by the patient indicates the patient needs more teaching?
"I will be able to regulate when I have stools."
When teaching the patient with acute hepatitis C (HCV), which statement demonstrates understanding of the disease process?
"I will need to be monitored for chronic HCV and other liver problems."
The patient with cirrhosis is being taught self-care. Which statement indicates the patient needs more teaching?
"If I notice a fast heart rate or irregular beats, this is normal for cirrhosis."
At the first visit to the clinic, the female patient with a BMI of 29 kg/m2 tells the nurse that she does not want to become obese. Which question used for assessing weight issues would be most effective?
"In what ways are you interested in managing your weight differently?"
The nurse is preparing to administer a dose of bisacodyl to a patient with constipation and the patient asks how it will work. What is the best response by the nurse?
"It will increase peristalsis by stimulating nerves in the colon wall."
The nurse is preparing to administer famotidine to a postoperative patient with a colostomy. The patient states they do not have heartburn. What response by the nurse would be the most appropriate?
"It will reduce the amount of acid in the stomach."
The results of a patient's recent endoscopy indicate the presence of peptic ulcer disease (PUD). Which teaching point should the nurse provide to the patient based on this new diagnosis?
"It would be beneficial for you to eliminate drinking alcohol."
The nurse instructs an obese 22-yr-old man with a sedentary job about the health benefits of an exercise program. The nurse evaluates that teaching is effective when the patient makes which statement?
"The goal is to walk at least 10,000 steps every day of the week."
The nurse instructs a 50-yr-old woman about cholestyramine to reduce pruritus caused by gallbladder disease. Which patient statement indicates understanding of the instructions?
"The medication is a powder and needs to be mixed with milk or juice."
The nurse is preparing to insert a nasogastric (NG) tube into a patient with a suspected small intestinal obstruction that is vomiting. The patient asks the nurse why this procedure is necessary. What response by the nurse is most appropriate?
"The tube will help to drain the stomach contents and prevent further vomiting."
The severely obese patient has elected to have the Roux-en-Y gastric bypass (RYGB) procedure. The nurse will know the patient understands the preoperative teaching when the patient makes which statement?
"This surgery decreases how much I can eat and how many calories I can absorb."
Health risks associated with obesity include
- colorectal cancer - polycystic ovary syndrome - nonalcoholic steatohepatitis
A patient is given a bisacodyl suppository and asks the nurse how long it will take to work. What is the best response by the nurse?
15-60 minutes
In developing a weight reduction program with a 45-yr-old female patient who weighs 197 lb, the nurse encourages the patient to set a weight loss goal of how many pounds in 4 weeks?
4 to 8
Which patient would be at highest risk for developing oral candidiasis?
A 32-yr-old patient who is receiving ciprofloxacin for 3 weeks
The nurse identifies that which patient is at highest risk for developing colon cancer?
A 32-yr-old woman with a 12-year history of ulcerative colitis
Which patient is at risk for developing metabolic syndrome?
A 38-yr-old Native American man who has diabetes mellitus and elevated hemoglobin A1C
The nurse is caring for a group of patients. Which patient has the highest risk for developing pancreatic cancer?
A 72-yr-old African American man who has smoked cigarettes for 50 years
Which statement best describes obesity?
A complex interaction between genetic and environmental factors
The pernicious anemia that may accompany gastritis is due to
A lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa
When providing discharge teaching for a patient after a laparoscopic cholecystectomy, what information should the nurse include?
A lower-fat diet may be better tolerated for several weeks.
When caring for a patient with a biliary obstruction, the nurse will anticipate administering which vitamin supplements (select all that apply.)?
A, D, E, K
A patient with cholelithiasis is being prepared for surgery. Which patient assessment represents a contraindication for a cholecystectomy?
Activated partial thromboplastin time (aPTT) of 54 seconds
This bariatric surgical procedure involves creating a gastric pouch that is reversible and no malabsorption occurs. What surgical procedure is this?
Adjustable gastric band
A colectomy is scheduled for a patient with ulcerative colitis. The nurse should plan to include which prescribed measure in the preoperative preparation of this patient?
Administration of a cleansing enema
What patient is at the greatest risk for developing a peptic ulcer?
An 80 yr old woman who takes aspirin daily for atrial fibrillation
A nurse is caring for a client who has a new diagnosis of GERD. The nurse should anticipate prescriptions for which of the following medications?
Antacids, H2 receptor blockers, PPI
The patient with chronic gastritis is being put on a combination of medications to eradicate Helicobacter pylori. Which drugs does the nurse know will probably be used?
Antibiotic(s), proton pump inhibitor, and bismuth
A nursing intervention that is most appropriate to decrease postoperative edema and pain after an inguinal herniorrhaphy is...
Applying a scrotal support with an ice bag
A nurse is having difficulty arousing a client following an EGD. Which of the following is the priority action by the nurse?
Assess the client's airway
A nurse is completing discharge teaching with a client who has IBS. Which of the following instructions should the nurse include in the teaching?
Avoid foods that trigger exacerbations
The teaching plan for the patient being discharged after an acute episode of upper GI bleeding includes information concerning the importance of
Avoiding taking aspirin and drugs containing aspirin, only taking drugs prescribed by the health care provider
The nurse teaching young adults about behaviors that put them at risk for oral cancer
Avoiding use of smokeless tobacco
A community health nurse is conducting an initial assessment of a new patient. Which assessments should the nurse include when screening the patient for metabolic syndrome (select all that apply.)?
Blood pressure, fasting blood glucose, waist circumference
Which clinical manifestations of inflammatory bowel disease does the nurse determine are common to both patients with ulcerative colitis (UC) and Crohn's disease (select all that apply.)?
Bloody, diarrhea stools, cramping abdominal pain
What color should drainage from a NG tube be in the first 8 to 12 hours?
Bright red
A nurse is reviewing nutrition teaching for a client who has cholecystitis. The nurse should identify that which of the following food choices triggers cholecystitis?
Brownie with nuts
The patient with suspected pancreatic cancer is having many diagnostic studies done. Which one can be used to establish the diagnosis of pancreatic adenocarcinoma and for monitoring the response to treatment?
Cancer-associated antigen 19-9
A nurse is assessing a client who has advanced cirrhosis. The nurse should identify which of the following findings as indicators of hepatic encephalopathy?
Change in orientation, asterixis, fetor hepaticus
The nurse is preparing to administer a scheduled dose of docusate sodium when the patient reports an episode of loose stool and does not want to take the medication. What is the appropriate action by the nurse?
Chart the dose as not given on the medical record and explain in the nursing progress notes.
A nurse is reviewing bowel prep using polyethylene glycol with a client scheduled for a colonoscopy. Which of the following instructions should the nurse include in the teaching?
Check with the provider about taking current medications when consuming bowel prep
Nursing management of the patient with acute pancreatitis includes...
Checking for signs of hypocalcemia, monitoring for infection particularly respiratory tract infection
What are characteristics of a healthy stoma?
Cherry-red/dark pink in color, moist
A nurse is providing discharge teaching for a client who is post-op following open cholecystectomy with T-tube placement. Which of the following instructions should the nurse include in the teaching?
Clamp t-tube 1 hr before and after meals, keep the drainage system above the level of the abdomen
A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following findings should the nurse expect?
Client reports a sensation of bloating, client states that pain occurs 30 min to 1 hr after a meal, client experiences pain upon palpation of the epigastric region
What nutritional needs are used for ulcerative colitis?
Continuous eternal feeding
A nurse in a clinic is reviewing lab reports of a client who has suspected cholelithiasis. Which of the following is an expected finding?
Direct bilirubin 2.1 mg/dL
A nurse is caring for a client who has cirrhosis. Which of the following medications can the nurse expect to administer to this client?
Diuretic, beta-blocking agent, lactulose
A nurse is planning care for a client who has a small bowel obstruction and a NG tube in place. Which of the following interventions should the nurse include in the plan of care?
Document the NG drainage with the client's output, assess bowel sounds, provide oral hygiene every 2 hrs, monitor NG tube placement
When teaching the patient about the diet for diverticular disease, which foods should the nurse recommend?
Dried beans, All Bran (100%) cereal, and raspberries
A patient who had a gastroduodenostomy (Billroth I operation) for stomach cancer reports generalized weakness, sweating, palpitations, and dizziness 15 to 30 minutes after eating. What long-term complication does the nurse suspect is occurring?
Dumping syndrome
A nurse is caring for a client who has a small bowel obstruction from adhesions. Which of the following findings are consistent with the diagnosis?
Emesis greater than 500 mL with a fecal odor, report of spasmodic abdominal pain, high-pitched bowel sounds
A patient is seeking emergency care after choking on a piece of steak. The nursing assessment reveals a history of alcoholism, cigarette smoking, and hemoptysis. Which diagnostic study is most likely to be performed on this patient?
Endoscopic biopsy
Diagnostic testing is planned for a patient with a suspected peptic ulcer. The nurse explains to the patient that the most reliable test for determining the presence and location of an ulcer is...
Endoscopy
The nurse determines a patient has experienced the beneficial effects of therapy with famotidine when which symptom is relieved?
Epigastric pain
A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following findings should the nurse expect?
Epigastric pain radiating to the left shoulder
A nurse is planning care for a client who has acute gastritis. Which of the following nursing interventions should the nurse include in the plan of care?
Evaluate intake and output, monitor lab reports of electrolytes, observe stool characteristics
A nurse is teaching about pernicious anemia with a client who has chronic gastritis. Which of the following information should the nurse include in the teaching?
Expect a monthly injection of vitamin B12
A patient is refusing to eat anything on her meal tray. What instructions will the nurse give to the nursing assistant who is attempting to feed the client?
Feed her the soft food because she has no teeth, sit at her level so that she can feel more comfortable, the your time feeding her and don't rush her, ask the client what foods she likes and dislikes
Which patient has the morbidity risk?
Female 5 ft, 10 in. tall; obesity class III
What is the highest priority for a nurse to assess post-op?
Fluid and electrolyte balance
In planning care for a patient with metastatic liver cancer, the nurse should include interventions that...
Focus primarily on symptomatic and comfort measures
A patient with stage 1 colorectal cancer is scheduled for surgery. Patient teaching for this patient would include an explanation that...
Follow-up colonoscopies will be needed to ensure that the cancer does not recur
The best nutritional therapy plan for a person who is obese is
Foods from the basic food groups
A nurse is reviewing the health record of a client who has a suspected tumor of jejunum. The nurse should anticipate an order for which of the following tests?
GI x-ray with contrast, small bowel capsule endoscopy
A 35-year old female patient is admitted to the emergency department with acute abdominal pain. Which medical diagnosis should you consider as possible causes of her pain?
Gastroenteritis, ectopic pregnancy, gastrointestinal bleeding, IBS, inflammatory bowel disease
A nurse is completing the admission assessment of a client who has acute pancreatitis. Which of the following findings is the priority to report?
Hand spasms present when blood pressure is checked
A patient has a sliding hiatal hernia. What nursing intervention will reduce the symptoms of heartburn and dyspepsia?
Having the patient eat 4 to 6 smaller meals each day
The condition of a patient who has cirrhosis of the liver has deteriorated. Which diagnostic study would help determine if the patient has developed liver cancer?
Hepatic structure ultrasound
The nurse is caring for a patient admitted with a suspected bowel obstruction. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient's clinical picture?
High-pitched and hyperactive above the area of obstruction
The nurse is developing a plan of care for a patient with an abdominal mass and suspected bowel obstruction. Which factor in the patient's history does the nurse recognize as increasing the patient's risk for colorectal cancer?
History of colorectal polyps
A patient with hepatitis B surface antigen (HBsAg) present in the serum is being discharged with pain medication after knee surgery. Which medication order should the nurse question?
Hydrocodone with acetaminophen
Which criteria must be met for a diagnosis of metabolic syndrome?
Hypertension, Elevated triglycerides, elevated plasma glucose, increased waist circumference
What is a complication of ulcerative colitis?
Hypokalemia
After the nurse teaches a patient with GERD about recommended dietary modifications, which statement by the patient indicates that the teaching has been effective?
I need to avoid caffeinated drinks
A home health nurse is teaching a client about the care of a new colostomy. Which client statement demonstrates correct understanding of the instructions?
I need to check for leakage underneath my colostomy
A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following statements by the client indicates an understanding of the teaching?
I plan to eat small frequent meals, I will eat easy-to-digest foods with limited spice, I will use skim milk when cooking
The nurse determines that teaching regarding a weight loss program has been effective when the patient says...
I plan to join a behavior-modification group to make permanent changes necessary for weight loss
The nurse determines a patient undergoing ileostomy surgery understands the procedure when the patient states...
I should only have to change the pouch every 4-7 days
The nurse teaches the client with GERD about ways to minimize symptoms. Which of the following statements made by the client indicates that more teaching is needed?
I will be sure to drink tea instead of coffee
A nurse is completing discharge teaching to a client who is post-op following fundoplication. Which of the following statements by the client indicates understanding of the teaching?
I will elevate the head of my bed on blocks
A nurse is completing discharge teaching for a client who has an infection due to H. pylori. Which of the following statements by the client indicates understanding of the teaching?
I will take a combination of medications for treatment
The most appropriate therapy for a patient with acute diarrhea caused by a viral infection is to
Increase fluid intake
A nurse is teaching a client who has a new diagnosis of dumping syndrome following gastric surgery. Which of the following information should the nurse include in the teaching?
Increase protein in the diet
Pancreatitis lab values
Increased amylase and lipase levels
A nurse is completing preprocedure teaching for a client who will undergo a sigmoidoscopy. Which of the following information should the nurse include in the teaching?
Increased flatulence can occur following the procedure, NPO status should be maintained preprocedure
A patient with sudden pain in the left upper quadrant radiating to the back and vomiting was diagnosed with acute pancreatitis. Which intervention should the nurse include in the patient's plan of care?
Insert an NG and maintain NPO status to allow pancreas to rest.
A nurse is assessing a client who has pancreatitis. Which of the following actions should the nurse take to assess the presence of Cullen's sign?
Inspect the skin around the umbilicus
What is the preferred treatment for symptomatic gallbladder disease?
Laparoscopic cholecystectomy
The nursing management of the patient with cholecystitis associated with cholelithiasis is based on the knowledge that...
Laparoscopic cholecystectomy is the treatment of choice in most patients who are symptomatic
A patient who has undergone an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea when a full liquid diet is started postoperatively. The nurse recognizes that these symptoms are most indicative of...
Leakage of fluids into the mediastinum
The nurse is caring for a 55-yr-old man patient with acute pancreatitis resulting from gallstones. Which clinical manifestation would the nurse expect?
Left upper abdominal pain
A nurse is teaching a client who has hep B about home care. Which of the following instructions should the nurse include in the teaching?
Limit physical activity, avoid alcohol, eat small frequent meals
A nurse is completing an assessment of a client who has GERD. Which of the following is an expected finding?
Loss of tooth enamel
The nurse is administering a cathartic agent to a patient with renal insufficiency. Which order will the nurse question?
Magnesium hydroxide
What does pancreatic enzyme replacement therapy work to treat?
Malnutrition and malabsorption
A patient with extreme obesity has undergone Roux-en-Y gastric bypass surgery. In planning postoperative care, the nurse anticipates that the patient
May have only liquids orally, and in very limited amounts during the early postoperative period
Several patients are seen at an urgent care center with symptoms of nausea, vomiting, and diarrhea that began 2 hours ago while attending a large family reunion potluck dinner. You question the patients specifically about foods they ingested containing
Meat and milk
A patient with type 2 diabetes and cirrhosis asks the nurse if it would be acceptable to take silymarin (milk thistle) to help minimize liver damage. The nurse responds based on what knowledge?
Milk thistle may affect liver enzymes and thus alter drug metabolism.
Despite her symptoms, A.J. has a mild case of acute pancreatitis. Her care is primarily supportive. Which of the following interventions are appropriately included in your plan of care for her?
Monitor vital signs frequently, deep breathing techniques, intake and output, monitor electrolytes, monitor blood glucose level
The patient is having an esophagoenterostomy with anastomosis of a segment of the colon to replace the resected portion. What initial postoperative care should the nurse expect when this patient returns to the nursing unit?
NG will have bloody drainage and it should not be repositioned.
The nurse explains to a patient with an episode of acute pancreatitis that the most effective means of relieving pain by suppressing pancreatic secretions is the use of...
NPO status
The nurse should administer an as-needed dose of magnesium hydroxide after noting what information when reviewing a patient's medical record?
No bowel movement for 3 days
Appendectomy post-op initial care
Noting the first bowel movement after surgery
A nurse is planning care for a client who has a new prescription for TPN. Which of the following interventions should be included in the plan of care?
Obtain a capillary blood glucose four times daily, monitor vital signs three times during the 12-hr shift, change the TPN IV tubing every 24 hours
A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the following actions should the nurse take?
Offer a glass of water following medication administration
In contrast to diverticulitis, the patient with diverticulosis..
Often has no symptoms
In planning care for a client with Crohn's disease, the nurse recognizes that a major difference between ulcerative colitis and Crohn's disease is that Crohn's disease...
Often recurs after surgery, whereas ulcerative colitis is curable with a colestomy
A 50-yr-old African American woman has a body mass index (BMI) of 35 kg/m2, type 2 diabetes mellitus, hypercholesterolemia, and irritable bowel syndrome (IBS). She is seeking assistance in losing weight because, "I have trouble stopping eating when I should, but I do not want to have bariatric surgery." Which drug therapy should the nurse question if it is prescribed for this patient?
Orlistat (Xenical)- blocks fat breakdown and absorption in the intestine NOT for IBS
A patient with cirrhosis has increased abdominal girth from ascites. Which items identify the pathophysiology related to ascites (select all that apply.)?
Osmoreceptors in the hypothalamus stimulate thirst, Portal hypertension causes leaking of protein and water into the peritoneal cavity, Aldosterone is released to stabilize intravascular volume by saving salt and water, Inability of the liver to synthesize albumin reducing intravascular oncotic pressure.
You recall what you know about the pathophysiology of acute pancreatitis. Which of the following best described acute pancreatitis?
Pancreatic enzymes attack pancreatic cells and causes tissue damage
A nurse is teaching a client who has a hiatal hernia. Which of the following client statements indicates an understanding of the teaching?
Peppermint tea will increase my indigestion
The nurse performs a detailed assessment of the abdomen of a patient with a possible bowel obstruction, knowing that manifestations of an obstruction in the large intestines are...
Persistent abdominal pain, marked abdominal distention
The patient with advanced cirrhosis asks why his abdomen is so swollen. The nurses response is based on the knowledge that...
Portal hypertension and hypoalbuminemia cause a fluid into the peritoneal space
A nurse is caring for a client who has a new diagnosis of hep C. Which of the following lab findings should the nurse expect?
Positive EIA test
The nurse is teaching the patient and family that peptic ulcers are
Promoted by a combination of factors that may result in erosion of the gastric mucosa, including certain drugs and alcohol
A nurse on a medical-surgical unit is admitting a client who has hep B with ascites. Which of the following actions should the nurse include in the plan of care?
Provide a high-calorie, high-carb diet
A patient with a history of peptic ulcer disease has presented to the emergency department with severe abdominal pain and a rigid, boardlike abdomen. The health care provider suspects a perforated ulcer. Which interventions should the nurse anticipate?
Providing IV fluids and inserting a nasogastric (NG) tube
Which interventions would promote oral nutritional intake?
Providing mouth care before each meal, assisting the patient to sit up in a chair, ordering foods that the patient likes to eat, having a UAP feed the patient
A patient with Hep A is in the acute phase. The nurse plans care for the patient based on the knowledge that...
Pruritus is a common problem with jaundice in this phase
Assessment findings suggestive of peritonitis include
Rebound tenderness, observing that the patient is lying still
A patient has been told that she has elevated liver enzymes caused by nonalcoholic fatty liver disease. The nursing teaching plan should include...
Recommended by a heart-healthy diet
After administration of a dose of metoclopramide, which patient assessment finding would show the medication was effective?
Relief of nausea and vomiting
A patient with pancreatic cancer is admitted to the hospital for evaluation of possible treatment options. The patient asks the nurse to explain the Whipple procedure that the surgeon has described. The explanation includes the information that a Whipple procedure involves...
Removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum
A nurse is caring for a client who is receiving TPN solution. The current bag of solution was hung 24 hrs ago, and 400 mL of fluid remains to infuse. Which of the following is the appropriate action for the nurse to take?
Remove the current bag and hang a new bag
Teaching in relation to home management after a laparoscopic cholecystectomy should include...
Reporting any bile-colored drainage or pus from any incisions
A patient with an intestinal obstruction has a nasogastric (NG) tube to suction but complains of nausea and abdominal distention. The nurse irrigates the tube as necessary as ordered, but the irrigating fluid does not return. What should be the priority action by the nurse?
Reposition the tube and check for placement.
Which assessment variable requires immediate intervention post esophagectomy?
Respiratory rate of 36
A patient was admitted with epigastric pain because of a gastric ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?
Rigid abdomen and vomiting following indigestion
A nurse in the emergency department is completing an assessment of a client who has suspected stomach perforation due to a peptic ulcer. Which of the following findings should the nurse expect?
Rigid abdomen, tachycardia, rebound tenderness
The nurse determines that the goals of dietary teaching have been met when the patient with celiac disease selects from the menu...
Scrambled eggs and sausage
The nurse incorporates what teaching for a patient with a duodenal ulcer?
Smoking cigarettes can make the PUD worse
A nurse is completing discharge teaching with a client who is 3 days post-op following a transverse colostomy. Which of the following should the nurse include in the teaching?
Stoma should be moist and pink
The nurse is preparing to administer a daily dose of docusate sodium to a patient that will continue taking it after discharge. What information should the nurse provide to the patient to optimize the outcome of the medication?
Take each dose with a full glass of water or other liquid.
A nurse is teaching a client who has a duodenal ulcer and a new prescription for esomeperazole. Which of the following information should the nurse include in the teaching?
Take the medication one hour before a meal, limit NSAIDs when taking this medication
The nurse is aware of potential complications related to cirrhosis. Which interventions would be included in a safe plan of care (select all that apply.)?
Teach the patient to use soft-bristle toothbrush and electric razor, Teach the patient to avoid vigorous blowing of nose and coughing, Use the smallest gauge needle possible when giving injections or drawing blood, Instruct the patient to avoid aspirin and nonsteroidal antiinflammatory (NSAIDs).
Which instructions would the nurse include in a teaching plan for a patient with mild GERD?
The best time to take an as-needed antacid is 1 to 3 hours after meals
A nurse is assessing an older adult client in an extended care facility. The nurse should recognize which of the following findings as an obstruction of the large intestine due to a fecal impaction?
The client is having small, frequent liquid stools
The wound, ostomy, and continence nurse (WOCN) selects the site where the ostomy will be placed. What should be included in site consideration?
The patient must be able to see the site.
A nurse in a clinic is instructing a client about a fecal occult blood test, which required mailing three specimens. Which of the following statements by the client indicates understanding of the teaching?
This is an easy way to screen for colon cancer
A nurse is reviewing a new prescription for ursodiol with a client who has cholelithiasis. Which of the following information should the nurse include in the teaching?
This medication dissolves gallstones gradually over a period of 2 years
The nurse explains to the patient with Vincent's infection that treatment will include...
Topical application of antibiotics
A nurse is completing an admission assessment for a client who has a small bowel obstruction. Which of the following findings should the nurse report to the provider?
Urine specific gravity 1.04, hematocrit 60%, serum potassium 3.0
A patient with acute Hep B is being discharged in 2 days. The discharge teaching pan should include instructions to...
Use a condom during sexual intercourses
What should a patient be taught after a hemorrhoidectomy?
Use prescribed pain medication before a bowel movement
Why are steroids used for ulcerative colitis?
Used in severe flare-ups to decrease inflammation and bleeding
A nurse is admitting a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications?
Vasopressin
A nurse is providing discharge teaching to a client who has a new prescription for aluminum hydroxide. Which of the following information should the nurse include in the teaching?
Wait 1 hr before taking other oral medications
An optimal teaching plan for an outpatient with stomach cancer receiving radiation therapy should include information about
Wound and skin care, nutrition, drugs and community resources
The nurse is caring for a patient after bariatric surgery. What should be included in the plan of care (select all that apply.)?
ambulation, assess for incisional pain versus anastomosis leak, maintain HOB elevation, monitor for vomiting
The obesity classification that is most often associated with cardiovascular health problems is
android fat distribution
A nurse is providing care to a client who is 1 day post-op following a paracentesis. The nurse observes clear, pale-yellow fluid leaking from the operative site. Which of the following is an appropriate nursing intervention?
apply a dry, sterile dressing
A client with a subtotal gastrectomy is scheduled for discharge. Which of these instructions should the nurse give the client to reduce the possibility of dumping syndrome?
avoid drinking fluids with your meal
John has the paracentesis and they remove 2L of fluid. Which assessment finding would alert the nurse that the paracentesis has been successful?
decrease in post-procedure weight
The health care provider orders lactulose for a patient with hepatic encephalopathy. Which finding indicates the medication has been effective?`
decreased ammonia levels
The nurse is caring for a client with an exacerbation of ulcerative colitis. Which lab finding for the client will the nurse expect?
decreased serum potassium
What is a symptom of dumping syndrome?
dizziness after eating a meal
A physician suspects a patient has a perforated appendix. What assessment findings will the nurse expect the client to have?
dizziness, distended abdomen, fever
After administering a dose of promethazine to a patient with nausea and vomiting, what medication side effect does the nurse explain is common and expected?
drowsiness
A patient after a stroke who primarily uses a wheelchair for mobility has developed diarrhea with fecal incontinence. What is a priority assessment by the nurse?
fecal impaction
A patient is admitted to the emergency department after a motor vehicle crash with suspected abdominal trauma. What assessment finding by the nurse is of highest priority?
firmly distended abdomen
The patient who is admitted with a diagnosis of diverticulitis and a history of irritable bowel disease and gastroesophageal reflux disease (GERD) has received a dose of Mylanta 30 mL PO. The nurse will determine the medication was effective when which symptom has been resolved?
heartburn
Which of the following comments made by the patient indicates that additional instruction about the care of a new ileostomy is needed?
i should change the appliance daily to prevent odors
A nurse is teaching a client who has a new prescription for famotidine. Which of the following statements by the client indicates understanding of the teaching?
i will take my pill 1 hour before meals
Two days after a colectomy for an abdominal mass, a patient reports gas pains and abdominal distention. The nurse plans care for the patient based on the knowledge that the symptoms are occurring as a result what event?
impaired peristalsis
In planning care, which intervention should be included to provide the nurse with the most accurate information regarding ongoing nutritional status?
instruct the home health aide to weigh the client once a week
Dumping syndrome prevention
lie down for 20-30 minutes after eating, avoid milk and other dairy products, decrease carb contents of meals
Which diagnostic results support the diagnosis of PUD?
low hemoglobin, low hematocrit, positive for h. pylori bacteria
A 74-yr-old female patient with osteoporosis is diagnosed with gastroesophageal reflux disease (GERD). Which over-the-counter medication to treat GERD should be used with caution?
omeprazole
The nurse is caring for a patient who complains of abdominal pain and hematemesis. Which new assessment finding(s) would indicate the patient is experiencing a decline in condition?
pallor and diaphoresis
A 54-yr-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. Which diagnosis does the nurse expect?
pancreatitis
A patient with advanced cirrhosis with ascites is shot of breath and has an increased respiratory rate. The nurse should...
place the patient in fowler's position to relieve pressure on the diaphragm
What is billroth II anastamosis?
removal of part of the stomach
T-tube maintenance interventions include...
routinely monitor drainage, provide teaching to the patient, monitor stool for color and consistency
Which assessment parameter requires immediate intervention in a patient with severe ascites?
shallow respirations, rate 32 bpm
As a patient prepares for discharge, the nurse provides education about behaviors that reduce symptoms and aggravate peptic ulcers. Which teaching does the nurse provide?
sit upright 30-60 minutes after meals, extreme vomiting should be reported to your physician, h. pylori can be a concern in patients with peptic ulcers, the goal of initial therapy is to control symptoms and prevent further complications
A nurse is caring for a client following a paracentesis. Which of the following findings indicate the bowel was perforated during the surgery?
temperature elevation
A charge nurse is teaching a group of unit nurses about a client who has chronic gastritis and is scheduled for a selective vagotomy. Which of the following statements by the unit nurse indicates understanding of the purpose of the procedure?
the client will have a reduction of gastric acid secretions
The client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?
this is a normal, expected event
A patient complaining of nausea receives a dose of metoclopramide. Which potential adverse effect should the nurse tell the patient to report?
tremors
A nurse is completing pre-op teaching for a client who is scheduled for a laparoscopic cholecystectomy. Which of the following should be included in the teaching?
you might have shoulder pain after surgery
