Med-Surg: Chapter 55, Care of Patients with Stomach Disorders
What statement about type A gastritis is most accurate?
-It is associated with pernicious anemia.
The laboratory report of a patient with acute gastritis states there are traces of blood in the stool. What term does the nurse use to document this finding?
-Melena
A patient who has peptic ulcer disease has developed pyloric obstruction. The nurse monitors the patient's laboratory values closely to assess for which complication?
-Metabolic alkalosis
The nurse is reviewing the medications prescribed for a patient with peptic ulcer disease (PUD). Which drug is the patient taking to treat Helicobacter pylori infection?
-Metronidazole
The nurse finds a patient vomiting coffee ground-type emesis. On assessment, the patient has blood pressure of 100/74 mm Hg, is acutely confused, and has a weak and thready pulse. Which intervention is the nurse's first priority?
-Administering intravenous (IV) fluids
Which statements should the nurse include when teaching patients and their families regarding prevention of gastritis? Select all that apply.
-"Eating a well-balanced diet is important." -"Alcoholic beverages in excessive amounts should be avoided." -"Excessive intake of coffee or even decaffeinated drinks should be avoided." -"Protection against exposure to toxic substances in the workplace should be practiced."
A patient with peptic ulcer disease (PUD) asks the nurse whether a maternal history of gastric cancer will cause the patient to develop gastric cancer. What is the nurse's best response?
-"If you are concerned that you are at high risk, I recommend speaking to your provider about the possibility of genetic testing."
A patient asks the nurse how an infection such as H. pylori can cause gastric ulcers. What does the nurse tell the patient about this organism?
-"It produces an enzyme that alters the pH of the gastric environment."
A patient with chronic gastritis who is ordered to take vitamin B 12 asks the nurse why this vitamin is necessary. What does the nurse tell the patient about vitamin B 12?
-"It will prevent a type of anemia."
The nurse is teaching a patient with peptic ulcer disease about the prescribed drug regimen. Which statement made by the patient indicates a need for further teaching before discharge?
-"Nizatidine needs to be taken three times a day to be effective."
The nurse has placed a nasogastric (NG) tube in a patient with upper gastrointestinal bleeding to administer gastric lavage. The patient asks the nurse about the purpose of the NG tube for the procedure. What is the nurse's best response?
-"Saline goes down the tube to help clean out your stomach."
A patient who currently takes phenytoin has been started on a multidrug regimen for treatment of peptic ulcer disease. What does the nurse tell this patient about taking these medications?
-"Take the phenytoin 1 to 2 hours before or after the antacid."
The nurse is teaching a patient about the use of ranitidine and sucralfate to treat gastritis. What does the nurse include in this teaching?
-"Take the ranitidine at bedtime."
A patient with peptic ulcer disease (PUD) asks the nurse whether licorice and slippery elm might be useful in managing the disease. What is the nurse's best response?
-"These herbs could be helpful. However, you should talk with your provider before adding them to your treatment regimen."
The nurse is teaching a patient about self-management of gastritis. Which piece of education is appropriate?
-"Use complementary and alternative therapies."
A patient has undergone an esophagogastroduodenoscopy (EGD) procedure. Which is a priority nursing assessment for this patient?
-Ability to swallow secretions
The endoscopy of a patient reveals a reddened and thick mucosal membrane around the stomach with prominent rugae. What condition does the patient have?
-Acute gastritis
The nurse is caring for a patient with peptic ulcer disease (PUD). What signs and symptoms in the patient suggest a surgical emergency? Select all that apply.
-Assuming the knee-chest position -Tender, rigid, board-like abdomen -Sudden, sharp pain in the mid-epigastrium
Which disorder in older adults may have a direct association with mucosa-associated lymphoid tissue (MALT) lymphoma?
-Atrophic gastritis
Which self-management measure will the nurse teach the patient with gastritis?
-Avoid exposure to lead
The nurse assesses that a patient experiences regular epigastric discomfort that usually goes away after eating. Which initial nursing action is correct?
-Contact the provider to report these symptoms
A patient with extensive burns reports severe abdominal pain and blood-tinged vomitus. Which ulcers might be the reason behind the patient's condition?
-Curling's ulcer
A patient with peptic ulcer disease has developed a pyloric obstruction, and the provider orders placement of a nasogastric (NG) tube. The NG tube is used for which purpose in this patient?
-Decompression of the stomach
The nurse is caring for a patient who has granular dark vomitus that resembles coffee grounds. Which type of ulcer does the nurse suspect in this patient?
-Gastric
A patient being evaluated for a gastric ulcer reports sharp, burning left-sided upper epigastric pain, which increases with food. The nurse notes epigastric tenderness, a soft abdomen, and normally active bowel sounds. Based on these findings, which condition does the nurse suspect?
-Gastric ulcer
Which ulcers usually develop due to H. pylori infection?
-Gastric ulcers and duodenal ulcers
A patient has been diagnosed with gastritis. What statement about this disorder is accurate?
-Gastritis is the inflammation of gastric mucosa.
The patient presents to the emergency department with acute gastritis. The nurse suspects which organism is most likely the culprit?
-Helicobacter pylori
Which is the most serious complication of peptic ulcer disease that a nurse should check for in an older patient?
-Hemorrhage
Which area of the body is a location for gastric ulcers?
-In the antrum of the stomach
The admission assessment for a patient with acute gastric bleeding indicates blood pressure 82/40 mm Hg, pulse 124/min, and respiratory rate 26/min. Which admission request does the nurse implement first?
-Infuse lactated Ringer's solution at 200 mL/hr
The nurse is caring for a patient and is monitoring the patient regularly for acute gastritis with bleeding. Which medication class most likely causes the nurse to believe the patient is at risk for this disorder?
-NSAIDS
A patient is admitted with chronic peptic ulcer disease (PUD). What sign or symptom is suggestive of a pyloric obstruction?
-Nausea and vomiting
The nurse caring for a patient with a duodenal ulcer finds the patient lying in the fetal position. The patient reports experiencing a sudden onset of sharp pain. Which action by the nurse is correct?
-Notify the provider immediately
The nurse is caring for an older adult male patient who reports stomach pain and heartburn. Which characteristic is most significant in determining whether the patient's ulceration is gastric or duodenal in origin?
-Pain occurs 1½ to 3 hours after a meal, usually at night.
A patient who has chronic gastritis is at increased risk for which condition?
-Pernicious anemia
What are the key features of chronic gastritis? Select all that apply.
-Pernicious anemia -Nausea and vomiting -Intolerance to fatty food
The nurse is reviewing orders for a patient admitted to the intensive care unit with perforation of a duodenal ulcer. Which order does the nurse implement first?
-Place a nasogastric (NG) tube, and connect to suction
A nutritionist is asked to assist in forming a plan for a patient with peptic ulcer disease (PUD). Which recommendation is most helpful for this patient?
-Reducing caffeine intake
Which nursing action is best for the charge nurse to delegate to an experienced LPN/LVN?
-Reinforce the teaching about avoiding alcohol and caffeine for a patient with chronic gastritis
The nurse is assessing a patient who reports episodes of pain in the abdomen. What feature suggests the possibility of a duodenal ulcer?
-The patient has type O blood. (Patients with duodenal ulcers most often have type O blood. They are usually 50 years or older and are often well-nourished. Another key feature of a duodenal ulcer is a high secretion of gastric acid; abdominal pain due to a duodenal ulcer is therefore relieved by the ingestion of food. Pain usually occurs again about 90 minutes to 3 hours after eating food.)
Which patient assessment data frequently correlates with a diagnosis of chronic gastritis?
-Treatment with radiation therapy
Which pathologic changes can occur in a patient with gastritis? Select all that apply.
-Vascular congestion -Acute inflammatory cell infiltration -Degenerative changes in the superficial epithelium of the stomach lining
