Lower GI Exam

Hernia

Bulging of abdominal contents through abdominal wall

A nurse is caring for a client who has acute pancreatitis. After the client's pain has been addressed, which of the following is the next intervention to include in the plan of care?

Maintain NPO status

A nurse is caring for a client who has an acute exacerbation of ulcerative colitis. The nurse should recognize that which of the following is the most important nursing action for this client?

Maintaining fluid and electrolyte balance

A nurse is inserting a nasogastric tube for a client who had a colectomy. The client ask the nurse why he needs the tube. Which of the following statements by the nurse is appropriate?

The tube will decompress your stomach of the gas and fluid

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following should the nurse implement? (select all that apply)

-Administration of furosemide (Lasix) -Implement a low sodium diet -Measure the abdominal girth

Signs of Cirrhosis

-Anorexia -Nausea -Weight loss -Ascites -Bruising -Muscle cramping, weakness, fatigue -Dull right upper quadrant pain -GI bleeding -Itching -Jaundice -Spider angioma

Signs of Hepatic Encephalopathy

-Behavior changes -Flapping tremor -Confusion -Fetor hepaticus -Gradual progression to coma

Causes of Cirrhosis

-Chronic alcohol use -Chronic hep B and C -Non-alcoholic steatohepatitis (NASH) - Fatty liver

A nurse is reviewing the laboratory findings of a client who has an acute exacerbation of Crohn's disease. Which of the following laboratory findings should the nurse expect to be increased with Crohn's disease? (select all that apply)

-Erythrocyte sedimentation rate (ESR) -WBC

Which of the following drugs would the nurse expect to be prescribed for a woman with irritable bowel syndrome and constipation? Select all apply

-Fluoxetine/Prozac -Paroxetine/Paxil

What medication is ordered to reduce ammonia levels?

-Osmotic disaccharide laxative lactulose -NG tube -Enema -Antibiotics

Which of the following foods might a patient with diverticulitis have been instructed to avoid, even though this has not been proven to prevent diverticulitis? Select all that apply

-Peanuts -Raspberries

which of these differentiates diverticulitis from diverticulosis? Select all apply

-Presence of inflammation and infection -Lack of symptoms

A patient is wondering about ileostomy odor and is provided information by the nurse. Which of the following responses by the patient would indicate that teaching has been effective? Select all that apply

-The plastic in the pouch is odor-proof, so there is no odor as long as there is no leak -Effluent from an ileostomy can have an odor

The nurse is counseling a patient with frequent anal fissures and a history of constipation. Which of the following patient statements indicates that further teaching is required?

-There isn't much I can do except seek pain relief whenever I have a fissure -Decreasing the amount of fluids I drink each day will reduce stool frequency and subsequent irritation -Opioid analgesics are probably needed to help with this condition

The nurse is caring for a patient who has normal saline infusing. The patient suddenly requests assistance to the bedside commode and has bright red liquid stools and reports feeling weak and having visual disturbances. Which actions should the nurse take immediately? Rank nursing actions in order.

1) Perform rapid head to toe assessment 2) Identify level of consciousness 3) Check patency of IV site and infusion 4) Obtain vital signs 5) Notify health care provider 6) Measure output 7) Assist patient into bed 8) Cover with warm blankets

Melena

Blood in stool

A nurse who is planning care for a client who has ulcerative colitis is reinforcing teaching about the common link with Crohn's disease. Which of the following conditions should the nurse include in the client education?

Both are inflammatory

A nurse is reinforcing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following should the nurse reinforce in the teaching plan?

A low fat diet

A patient is diagnosed with acute diverticulitis. Which of the following collected data does the nurse recognize may have placed the patient at risk for developing diverticulitis

A low-fiber diet

A nurse is caring for a client who is diagnosed with paralytic ileus. When auscultating the abdomen, the nurse expects the bowel sounds to be

Absent

A nurse is developing a plan of care for a client who was admitted for an acute exacerbation of ulcerative colitis. Which of the following actions should the nurse contribute to the plan of care?

Administer antidiarrheal medication

A nurse is caring for a client with decreased liver function due to cirrhosis. When selecting a snack, which of the following selections indicates the client understands dietary requirements?

Banana

Liver Flap

Asterixis

A nurse is reinforcing teaching on a preventive care conference to clients who are at risk for acquiring viral hepatitis. Which of the following is appropriate educational information presented by the nurse?

Avoid food prepared with tap water

A client with a long history of ulcerative colitis has anemia. The nurse should explain to the client that which of the following manifestations of colitis is likely to result in anemia?

Chronic blood loss

Progressive, irreversible replacement of liver tissue with scar tissue

Cirrhosis

A nurse is contributing to the plan of care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse recommend for inclusion in the plan of care?

Decrease the client's fluid intake

A nurse is administering morphine 2 mg IV every 2 to 4 hours to a client who has an abdominal incision. Which of the following side effects should the nurse monitor?

Constipation

A nurse notes a small section of bowel protruding from the abdominal incision of a postoperative client. Which of the following actions should the nurse perform first?

Cover the client's wound with a moist sterile dressing

A nurse has administered an intramuscular injection to a patient with hepatitis C. Before placing in a puncture-resistant container, which of the following nursing actions display the safety precautions?

Dispose of the needle uncapped

Colostomy

Diversion of large bowel through abdominal wall

Ileostomy

Diversion of small bowel through abdominal wall

A nurse in a clinic is preparing information on a low fiber diet restrictions for a client who has ulcerative colitis. Which of the following foods should be eliminated in the client's diet?

Dried apricots

Which of the following dietary instructions is most important to include in the plan of care to prevent complications for a patient with an ileostomy?

Drink adequate fluids to prevent dehydration

Confusion and coma are symptoms

Encephalopathy

A nurse is providing care for a client who had a laparoscopic cholecystectomy. Which of the following is an appropriate nursing action?

Encourage ambulation on the day of surgery

A nurse is implementing a plan of care for a client who has hepatitis B. Which of the following should the nurse implement?

Encourage short periods of ambulation

A nurse is developing a plan of care for a client who has ileostomy and application of stoma bag care. Based on the nurse's understanding, which of the following are appropriate concepts?

Facilitate ring adhesion with pectin flange

A nurse is assessing a client who has obstruction of the common bile duct due to cholelithiasis. Which of the following is an expected finding?

Fatty stools

Steatorrhea

Fatty, foul-smelling stools

Ascites

Fluid in abdominal cavity from decreased albumin level

Fetor Hepaticus

Foul breath

A nurse is collecting data on a client who has acute pancreatitis. Which of the following factors should the nurse anticipate in the client's history?

Gallstones

Abbreviation for serum hepatitis

HBV

Abbreviation for infectious hepatitis

HCV

A nurse is caring for a client who has cirrhosis. When delivering the client's lunch tray, which of the following items requires intervention?

Ham sandwich

A nurse is caring for a client who had a cholecystectomy and has a T-tube drain. Which of the following are appropriate nursing actions?

Hang the bag to gravity drainage

A client who has hepatitis A asks the nurse how he might have contacted the virus. Which of the following is an appropriate question by the nurse?

Have you been to a third world country in the past?

A nurse is caring for an older adult client diagnosed with colon cancer. The client asks the nurse several questions about his treatment plan. Which of the following nursing actions is appropriate?

Help the client write down questions to ask his provider

This syndrome causes oliguria

Hepatorenal syndrome

A nurse is reinforcing teaching about ileostomy care to a client. Which of the following statements by the client indicates a need for further teaching?

I will be certain to take enteric-coated medications

A nurse is providing information on pain control or a client who has acute pain following a subtotal gastric resection. Which of the following client statements indicates an understanding of pain control?

I will call for pain medication before the previous dose wears off

A nurse is reinforcing discharge instructions with a client who has hepatitis A. The nurse determines that the teaching is effective when the client makes which of the following statements?

I will not donate blood

A nurse is providing teaching to a client who is scheduled for a bowel resection. Which of the following statements by the client indicates to the nurse a need for further teaching?

I will take my docusate (Colace) with a glass of water the morning of surgery

What serum lab value is elevated which contributes to hepatic encephalopathy (HE)?

Increased ammonia production - excess protein intake/infection

Portal Hypertension

Increased pressure in the portal circulation

Appendicitis

Inflamed appendix

Colitis

Inflammation of colon

Hepatitis

Inflammation of liver cells

Peritonitis

Inflammation/infection of peritoneum

A nurse is anticipating the provider's orders for a client who has a paralytic ileus following an appendectomy. Which of the following are expected nursing actions?

Insert nasogastric tube

A nurse is reviewing the medical record of a client who has pancreatitis. The physical exam report by the provider indicates the presence of Cullen's sign. Which of the following is an appropriate action by the nurse to identify this finding?

Inspect the skin around the umbilicus

A pattern of alternating constipation and diarrhea is most characteristic of which of the following gastrointestinal tract disorders?

Irritable bowel syndrome

A nurse is caring for a client who has returned to the ambulatory surgery unit following a laparoscopic cholecystectomy and reports severe pain in his right shoulder under the clavicle. The nurse explains that the client's pain

Is due to carbon dioxide instilled into the abdomen

Blood pressure decreases

Kidney is the first to shut down

Abbreviation for location of liver

LUQ

Asterixis

Liver flap

A nurse is gathering a health history on a client who may be at risk for contracting hepatitis C (HCV). Which of the following should the nurse recognize as placing the client at possible risk?

Multiple tattoos on arms

Encephalopathy

Neurological changes from excess ammonia

Hepatorenal Syndrome

Oliguria and sodium retention without kidney detects

Diverticulosis

Outpouchings in colon

The nurse is caring for a client on the third day following abdominal surgery and assesses the absence of bowel sounds, abdominal distention, and the client passing no flatus. These findings indicate the client is experiencing which of the following postoperative complications?

Paralytic ileus

A patient who has ulcerative colitis is taken to the emergency department with severe rectal bleeding. Which of the following is the best option for maintaining nutritional status for this patient with ulcerative colitis who must be nil os (NPO) for an extended period of time?

Parenteral nutrition

A nurse is creating a plan of care for a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect to find?

Petechiae

A nurse is reinforcing teaching for a client who has hepatitis about preventing transmission of the virus. The nurse should emphasize which of the following strategies?

Practicing effective hand hygiene

Cirrhosis

Progressive replacement of healthy liver tissue with scar tissue

A nurse is planning care for a client who has viral hepatitis. Which of the following should the nurse include in the plan of care?

Provide high carbohydrate

A nurse in the post anesthesia care unit is collecting data on a client who has a colostomy after a colectomy. Which of the following conditions should the nurse report to the provider?

Purplish colored stoma

Pancreatectomy

Removal of all or part of the pancreas

Colectomy

Removal of large bowel

Which of the following nursing diagnoses is most appropriate for the nurse to contribute to the plan of care for a patient with symptoms of a bowel obstruction?

Risk for Deficient Fluid Volume related to nausea and vomiting

Cirrhosis 1

Scarring and hardening of the liver from inflammation

A nurse is caring for an older adult client in an extended care facility. Which of the following findings indicates the client has a stool impaction causing a large intestine obstruction?

Small, frequent liquid stools

Abbreviation for liver shunt

TIPS

A nurse is organizing at the beginning of her shift the plan of care for 2 clients. The first client who is one day post-operative from a partial bowel resection requires a complete dressing change, total parental nutrition administration, and is reporting pain at a level 6 on a 10-point scale. The second client who has a newly inserted percutaneous gastrostomy tube requires tube feeding, dressing change, and daily weight. Which of the following nursing actions should the nurse plan to complete first?

Take vital signs on both clients

Intussusception

Telescoping of bowel

A nurse is talking with a client who has cholelithiasis and is about to have an oral cholangiogram. Which client statement indicates to the nurse that he understands the purpose of this procedure?

They are going to examine my gallbladder and ducts

A nurse is reviewing a new prescription for ursodiol (ursodeoxycholic acid) with a client who has cholelithiasis. Which of the following should be included in the teaching?

This medication dissolves gall stones

Fistula

Tunnel connection between bowel and another organ

Volvulus

Twisting of bowel

A client is about to undergo an abdominal paracentesis. How should the nurse position the client for this procedure?

Upright

A nurse is caring for a client following a total gastrectomy. The nurse should reinforce that the client will need to take which of the following vitamins for the rest of her life?

Vitamin B12

Varices

Weakened, swollen veins

Jaundice

Yellowing of the sclerae and skin from excess bilirubin

Which of the following explanations by the nurse to reinforce the patient's postoperative education for a loop ostomy would be correct?

You will have a loop of bowel on your abdomen that can be returned to your abdomen after your bowel has healed

Abdominal circulation

portal hypertension

Visible veins around umbilicus

caput medusae

Liver inflammation

hepatitis

Appendicitis Location

lower right quadrant between the umbilicus and the anterior iliac crest - McBurney's point