Chapter 45 Quiz & Flashcards: GI Patient Care

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Questions and Answers

What medical management strategies can help prevent constipation in older adults? (Select all that apply)

Nutritional diet high in fiber (correct)

Increasing daily activity (correct)

Decreasing fluid intake

Decreasing strict daily routines

Decreasing physical activity

Increasing fluid intake (correct)

How often should flexible sigmoidoscopy be performed?

5 years

How often should colonoscopy be performed for those at high risk for colon cancer?

10 years

The end-products of carbohydrate and protein digestion are absorbed by the?

Blood vessels in the villi Signup and view all the answers

A 56-year-old patient with diverticulitis has been admitted to the medical unit. The nurse will most likely document which assessment in the charting?

Pain in the left lower quadrant Signup and view all the answers

An ileostomy was performed on a patient for the treatment of debilitating ulcerative colitis disease. A problem the nurse should watch for in patients after this surgery is?

Skin excoriation Signup and view all the answers

A patient with cancer of the esophagus has been receiving radiation therapy. The nurse realizes that this patient should be assessed for?

Aspiration from fistula formation Signup and view all the answers

During an esophagogastroduodenoscopy, the physician will?

View the esophagus, stomach, and upper small intestine Signup and view all the answers

Achalasia is characterized by?

Caused by the inability of a muscle to relax Signup and view all the answers

Following a gastrectomy, the nurse would anticipate that the patient would need to be assessed for?

Vitamin B12 deficiency Signup and view all the answers

A 63-year-old patient is admitted with acute diverticulitis. The most appropriate nursing intervention to lessen this patient's signs and symptoms would be to?

Encourage a diet high in fiber content Signup and view all the answers

After ileostomy surgery, this patient may be at risk for?

Disturbed body image Signup and view all the answers

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. A nursing measure to minimize dumping syndrome is to administer the feeding?

In six small daily meals high in protein and fat Signup and view all the answers

Which intervention is contraindicated for a patient with an acute inflammatory intestinal disorder being observed to rule out appendicitis?

Apply heat to the abdomen Signup and view all the answers

After barium swallow contrast studies are performed, the nurse should ensure that the patient?

Expels all barium rectally Signup and view all the answers

When obtaining a stool specimen to be examined for ova and parasites, the nurse should instruct the patient to?

Obtain three different stool specimens on subsequent days Signup and view all the answers

After being evaluated with possible appendicitis, it is appropriate for the nurse to administer?

Fluid and electrolyte replacement Signup and view all the answers

A serious complication of a hernia in which the blood supply to the tissue becomes occluded is called a(n)?

Strangulated hernia Signup and view all the answers

The purpose of a transverse loop colostomy after a ruptured diverticulum is?

A temporary colostomy to allow healing of the bowel by diverting feces Signup and view all the answers

When a patient complains about adjusting to his colostomy, the nurse should best?

Encourage him to express his concern Signup and view all the answers

The most important nursing intervention to assure the patency of a nasogastric tube (NG) is to?

Monitor NG for patency and irrigate with sterile normal saline PRN as ordered Signup and view all the answers

A progressive wavelike movement that occurs involuntarily in hollow tubes of the body is called?

Peristalsis Signup and view all the answers

A NANDA-accepted nursing diagnosis for a patient with an abdominoperineal resection and a permanent colostomy would include?

Disturbed body image Signup and view all the answers

Bowel sound assessment is especially important for a postoperative patient who has had abdominal surgery as it can determine the?

Return of peristalsis Signup and view all the answers

A NANDA-accepted nursing diagnosis for a patient who is hemorrhaging and in hypovolemic shock from a bleeding peptic ulcer would include?

Ineffective tissue perfusion (gastrointestinal) Signup and view all the answers

The goals of diet management in a patient with inflammatory bowel disease are?

Correct and prevent malnutrition Signup and view all the answers

What nursing interventions would be appropriate for inflammatory bowel disease diagnoses of Imbalanced Nutrition?

Provide at least six small frequent meals per day Signup and view all the answers

Which nursing intervention would be the highest priority in evaluating a patient with peritonitis from a ruptured appendix?

Assessment of severity, location, and duration of pain Signup and view all the answers

Sulfasalazine is the recommended medication for treatment of Crohn's disease. Patient teaching should include?

Ensuring adequate hydration to prevent crystallization in kidneys Signup and view all the answers

The most lethal complication of a peptic ulcer is?

Perforation Signup and view all the answers

Symptoms of GERD can be modified or eliminated by which nursing interventions?

Remain upright for 1 to 2 hours post meals Signup and view all the answers

The purpose of antibiotic therapy in treating stomach disorders is that it?

Eradicates H. pylori Signup and view all the answers

Peptic ulcers are often common in the aging population. Which medications should be taken with caution to help prevent this problem?

NSAIDs Signup and view all the answers

After administering the medication GoLYTELY to a patient in preparation for diagnostic tests, which is most appropriate?

Available bedside commode for possible weakness Signup and view all the answers

A patient with Crohn's disease should have which nursing interventions?

Monitor I & O every shift Signup and view all the answers

A patient diagnosed with colorectal cancer asks, 'What prevents colon cancer?' The nurse's answer should include?

Familial predisposition of a cancer-causing gene Signup and view all the answers

Study Notes

Gastrointestinal Disorders

Villi Function: End-products of carbohydrate and protein digestion are absorbed into the bloodstream through the blood vessels in villi, tiny projections of the small intestine.
Diverticulitis Pain: Characteristic pain for diverticulitis is typically located in the left lower quadrant of the abdomen.
Ileostomy Concerns: Following an ileostomy, monitor for skin excoriation around the stoma due to potential impairment of skin integrity.
Esophageal Cancer & Radiation: Patients receiving radiation therapy for esophageal cancer should be assessed for aspiration resulting from the formation of an esophagotracheal fistula.
Esophagogastroduodenoscopy Procedure: This diagnostic procedure allows visualization of the esophagus, stomach, and duodenum using a flexible fiberoptic scope.
Achalasia Definition: Achalasia is a condition where a muscle is unable to relax, affecting digestive function.
Gastrectomy Monitoring: Post-gastrectomy, assess for vitamin B12 deficiency due to impaired absorption.
Diverticulitis Management: Encourage a high-fiber diet to help alleviate symptoms of gas and constipation commonly associated with acute diverticulitis.
Ileostomy Body Image: Patients undergoing an ileostomy are at risk of disturbed body image and low self-esteem, necessitating emotional support.
Dumping Syndrome Prevention: To prevent dumping syndrome post-Billroth II procedure, suggest eating six small meals high in protein and fat.
Appendicitis Care: Applying heat to the abdomen is contraindicated in suspected appendicitis as it may exacerbate symptoms.
Post-Barium Swallow Care: After barium swallow studies, instruct patients to ensure complete expulsion of barium to avoid constipation.
Stool Specimen for Parasites: For diagnosing parasites, obtain three stool specimens on separate days.
Fluid Resuscitation in Appendicitis: In cases of suspected appendicitis, fluid and electrolyte replacement is a key intervention.
Strangulated Hernia: A hernia with occluded blood supply is termed a strangulated hernia, posing serious health risks.
Transverse Loop Colostomy Purpose: This type of colostomy is temporary, intended to allow healing of the bowel by diverting feces.
Colostomy Adjustment Support: Encourage patients to express concerns regarding their colostomy to aid in coping and adjustment.
NG Tube Patency: The most important intervention to ensure the patency of a nasogastric tube is monitoring and irrigating it as needed.
Peristalsis Function: Refers to involuntary, progressive wavelike movements in the gastrointestinal tract that facilitate the movement of food and digestive substances.
Disturbed Body Image Diagnosis: Patients with an abdominoperineal resection and permanent colostomy may have a nursing diagnosis of disturbed body image.
Postoperative Bowel Sounds: Monitoring bowel sounds is critical after abdominal surgery to assess the return of peristalsis.
Ineffective Tissue Perfusion Diagnosis: This diagnosis can be applied to patients in hypovolemic shock due to hemorrhaging from a bleeding peptic ulcer.
Diet Management Goals in IBD: Goals include preventing weight loss, correcting malnutrition, replacing fluid losses, and providing adequate nutrition.
Nutrition Interventions in IBD: Suggest six small frequent meals to cater to decreased appetite and tolerance for larger meals.
Pain Management Priority in Peritonitis: When assessing a patient with peritonitis, evaluating pain severity is the highest nursing priority.
Hydration Importance for Sulfasalazine: Patients should be educated on the necessity of staying hydrated while taking sulfasalazine to avoid kidney problems.
Complications of Peptic Ulcers: Perforation is the most lethal complication, indicating a serious breach in the stomach or duodenum wall.
GERD Management Strategies: Advise patients to remain upright after meals to help manage gastroesophageal reflux symptoms.
Antibiotics for Stomach Disorders: Antibiotic therapy’s primary goal is to eradicate H. pylori bacteria.
NSAID Use and Peptic Ulcers: NSAIDs should be taken cautiously in older adults to prevent the development of peptic ulcers.
Care Essentials Post-GoLYTELY: For patients administered GoLYTELY, provide a bedside commode due to the likelihood of rapid bowel clearance.
Monitoring in Crohn’s Disease: Important nursing interventions include daily weight monitoring, I&O assessment, and ensuring access to a commode.
Colon Cancer Prevention: A high-fiber diet, regular checkups, and awareness of familial cancer predispositions can help prevent colon cancer.
Constipation Management in Older Adults: To prevent constipation, recommend a high-fiber diet, adequate hydration, and increased physical activity.
Flexible Sigmoidoscopy Frequency: Should be performed every five years for baseline gastrointestinal health assessment.
Colonoscopy Frequency for High-Risk Patients: Recommended every ten years for individuals with a history of colon cancer or a family history of colorectal cancer.

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Test your knowledge on the care of patients with gastrointestinal disorders through these flashcards. This quiz focuses on the absorption processes and the roles of the small intestine's villi in digestion. Perfect for nursing students and healthcare professionals.

Ch 45: Patient Care in GI Disorders