M/S Chapter 45 upper GI
After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? -"I need to chew my food slowly and thoroughly." -"I need to drink 8 oz of water before eating." -"A total serving should amount to be less than 1 cup." -"I should pick cereals with less than 2 g of fiber per serving."
"I need to drink 8 oz of water before eating."
A client, who has occasional gastric symptoms, is receiving teaching on how to prevent GERD. Which statement indicates the client understands the teaching? -"Eating two large meals a day, instead of three." -"Eliminating bothersome foods will help." -"Sleeping flat without pillows is beneficial." -"Taking a nap after meals, when possible."
"Eliminating bothersome foods will help."
11. An elderly client presents with a complaint of 10-lb weight loss over the past month. Which assessment finding is most important in determining the care of this client? -History of seasonal allergies -History gallbladder removal -History of COPD -History of osteoarthritis
History of COPD
The nurse is checking the residual content for a client who is receiving intermittent feedings. Which residual content, if obtained, would lead the nurse to delay the feeding?
120 mL
The nurse fills a tube feeding bag with two 8-oz cans of commercially prepared formula. The client is to receive the formula at 80 mL/hour via continuous gastrostomy feeding tube and pump. How many hours will this bag of formula run before becoming empty?
6 hours
The nurse is caring for a young woman who is struggling with weight loss issues, without apparent physical cause. Which is the most likely nursing assessment for this nutritional disorder in which normal body weight is not maintained?
Anorexia nervosa
A client is being evaluated for an esophageal tumor. Which nursing assessment finding presents the greatest concern?
Back pain
The nurse is holding a teaching workshop on managing the symptoms of hiatal hernia in the elderly. Which lifestyle modification should be included in the presentation?
Eliminating tobacco use
An elderly client seeks medical attention for a vague complaint of difficulty swallowing. Which of the following assessment findings is most significant as related to this symptom? -Hiatal hernia -Gastroesophageal reflux disease -Gastritis -Esophageal tumor
Esophageal tumor
A client has a gastrointestinal tube that enters the stomach through a surgically created opening in the abdominal wall. The nurse documents this as which of the following?
Gastrostomy tube
A client with esophageal cancer has difficulty in swallowing. Which of the following would be appropriate to help the client achieve improved nutrition?
Give high-protein, semi-liquid foods.
A client, who is recovering from bariatric surgery, is returning from the postanesthesia care unit. Which nursing assessment is of greatest concern in the immediate postoperative period for this client?
Impaired Gas Exchange
Which of the following interventions would be most appropriate for a client with a hiatal hernia and nursing diagnosis of Acute Pain related to reflux of gastric secretions?
Inform the client to remain upright for at least 2 hours after meals.
A client who is recovering from anesthesia following oral surgery for lip cancer is experiencing difficulty breathing deeply and coughing up secretions. Which of the following measures will help ease the client's discomfort?
Keeping the head of the bed elevated
Which nursing action provides the most reliable means to assess placement of a client's nasogastric tube, prior to each medication administration?
Measure pH of aspirates
In caring for a client immediately following gastric cancer surgery, which nursing assessment finding would require priority attention? -NG tube set to high continuous suction -Moderate amount of dark red drainage in the suction container -Urine output at 40 mL/hour -Abdomen soft with sluggish bowel sounds
NG tube set to high continuous suction
The nurse is evaluating the medication list of a client with acute gastritis. Which medication would create the most concern? -Cardiac glycoside -Loop diuretic -Nonsteroidal anti-inflammatory -Antihistamine
Nonsteroidal anti-inflammatory
A client with a history of peptic ulcer disease is admitted for hematemesis associated with gastric bleeding. Which is the most appropriate action of the nurse?
Prepare for nasogastric irrigations.
A client with nausea and vomiting is to receive an antiemetic that inhibits the vomiting center in the brain. Which of the following would the nurse expect the physician to order most likely?
Prochlorperazine
A client with peptic ulcer disease is scheduled for a partial gastrectomy and vagotomy. The nurse understands the surgery will accomplish which physiologic effect?
Remove source of acid secretion.
A client is preparing for discharge to home, following a partial gastrectomy and vagotomy. What is the best rationale for the client being taught to lie down for 30 minutes after each meal?
Slows gastric emptying
A client has undergone a total gastrectomy for refractory ulcers. The nurse would explain the need for lifelong treatment with which of the following?
Vitamin B12 replacement
A client is prescribed a magnesium and aluminum hydroxide antacid to treat GERD. The nurse cautions this client to do which of the following?
Watch for possible antacid-related diarrhea.
Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client? -Abdominal distention, elevated temperature, weakness before eating -Constipation, rectal bleeding following bowel movements -Persistent loose stools, chills, hiccups after eating -Weakness, diaphoresis, diarrhea 90 minutes after eating
Weakness, diaphoresis, diarrhea 90 minutes after eating
A client with anorexia complains of constipation. Which of the following nursing measures would be most effective in helping the client reduce constipation?
Assist client to increase dietary fiber.
