Gastrointestinal Disorders: Nursing and Pathophysiology

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Questions and Answers

Which of the following best describes the primary focus of nursing interventions related to disturbances in the gastrointestinal tract?

To strictly adhere to the physician’s orders without considering the patient's individual needs or preferences.
To address the underlying causes of the gastrointestinal disorder through surgical intervention.
To solely alleviate the physical symptoms experienced by the patient.
To promote optimal nutritional intake, manage symptoms, and prevent complications, while addressing the patient’s overall well-being. (correct)

A patient is diagnosed with Achalasia. Which physiological process is most directly affected by this condition?

The chemical breakdown of food in the stomach.
The peristaltic movement of food through the esophagus. (correct)
The absorption of nutrients in the small intestine.
The production of bile by the liver.

How would the nursing assessment for a client with a suspected disturbance in the gastrointestinal tract be best executed?

Relying solely on laboratory results, neglecting the subjective data provided by the patient.
Thoroughly evaluating the patient's nutritional status, abdominal assessment, bowel habits, and associated symptoms, to establish a comprehensive understanding of the issue. (correct)
Focusing primarily on the patient's medical history, disregarding current symptoms.
Administering diagnostic tests without obtaining a detailed history or performing a physical examination.

What is the most important reason for a nurse to educate a patient about their gastrointestinal disorder?

To ensure the patient adheres to medical advice, empowers them to actively participate in their care, and improves the overall outcome. (B) Signup and view all the answers

A client has undergone treatment for a gastrointestinal disorder. What is the most effective way to evaluate the outcome of care?

Comparing the patient's current status with the goals established during the planning phase, and adjusting the plan as necessary. (C) Signup and view all the answers

A nurse is caring for a patient with a newly diagnosed hiatal hernia. What dietary modification recommendation reflects the best understanding of the condition's management?

Consume small, frequent meals and avoid lying down immediately after eating to minimize reflux. (A) Signup and view all the answers

A client presents with symptoms indicative of a peptic ulcer. Which statement accurately reflects the pathophysiology of peptic ulcer disease?

It involves the erosion of the mucosal lining of the stomach or duodenum, often due to Helicobacter pylori infection or NSAID use. (B) Signup and view all the answers

A patient with Celiac disease is consulting with a nurse about managing their diet. Which of the following instructions would be most appropriate?

Adhere to a strict gluten-free diet, avoiding all products containing wheat, barley, and rye, to prevent intestinal damage. (D) Signup and view all the answers

What is the primary physiological defect that leads to achalasia?

Decreased or absent peristalsis in the distal esophagus combined with failure of the LES to relax properly. (C) Signup and view all the answers

A patient is diagnosed with achalasia. Which of the following lifestyle modifications is MOST appropriate for managing their dysphagia?

Chewing food thoroughly, eating slowly, and drinking plenty of fluids with meals. (C) Signup and view all the answers

Which diagnostic procedure is considered the definitive method for confirming a diagnosis of achalasia?

Esophageal manometry to assess esophageal motor function. (C) Signup and view all the answers

A patient with achalasia reports persistent chest discomfort despite pharmacological interventions. Which surgical treatment option addresses the underlying cause of achalasia?

Laparoscopic Heller myotomy, often followed by fundoplication, to surgically disrupt the LES muscle fibers. (C) Signup and view all the answers

A patient presents with dysphagia, regurgitation, and chest discomfort. Esophageal manometry reveals aperistalsis in the distal esophagus and incomplete LES relaxation. Which esophageal motility disorder is MOST likely?

Type III achalasia (B) Signup and view all the answers

What is the MOST important teaching point for a patient recently diagnosed with achalasia who is starting treatment with Isosorbide Dinitrate?

Monitor blood pressure regularly due to the risk of hypotension. (D) Signup and view all the answers

A patient with achalasia is scheduled for pneumatic balloon dilation. What key information should the nurse include in the pre-procedure teaching?

The procedure involves inflating a balloon in the esophagus to stretch the LES, which may need to be repeated over time. (A) Signup and view all the answers

How does a hiatal hernia contribute to symptoms that may mimic or exacerbate achalasia related discomfort?

By allowing the stomach to push through the diaphragm, which can lead to acid reflux and chest pain. (D) Signup and view all the answers

A patient is admitted with a suspected bowel obstruction. Which assessment finding would most strongly suggest a complete obstruction rather than a partial obstruction?

Absence of flatus and reported obstipation despite laxative use. (C) Signup and view all the answers

A client presents with suspected bowel obstruction. The physician orders an abdominal CT scan with contrast. Which information is most critical for the nurse to assess before the contrast administration?

The client's allergy history, particularly to iodine or shellfish. (A) Signup and view all the answers

A patient with a partial small bowel obstruction is being treated with nasogastric (NG) tube decompression. Which finding indicates the NG tube is effectively decompressing the bowel?

The patient's abdominal girth has decreased, and the amount of drainage in the NG tube canister is increasing. (B) Signup and view all the answers

A patient is diagnosed with Inflammatory Bowel Disease (IBD). What key aspect in their history differentiates Crohn's disease from Ulcerative Colitis?

History of smoking or non-smoking. (B) Signup and view all the answers

Beyond gastrointestinal distress, which of the following neurological manifestations might suggest the presence of undiagnosed celiac disease?

Chronic Migraine Headaches (D) Signup and view all the answers

An individual is suspected of having celiac disease. While awaiting endoscopy results, which serological test would be most appropriate to initially screen for this condition?

Immunoglobulin A (IgA) and Anti-tissue Transglutaminase (TTG) (C) Signup and view all the answers

A patient with a long history of Crohn’s disease is admitted with an acute exacerbation. Which of the following lab values would the nurse anticipate to be most affected by the disease process?

Decreased hemoglobin and hematocrit. (B) Signup and view all the answers

A patient newly diagnosed with celiac disease expresses frustration about the lack of a pharmacological cure. What is the most accurate and helpful response a nurse can provide regarding the current medical management of celiac disease?

Research is underway for medications to induce remission, but currently, a strict gluten-free diet is the only proven treatment. (D) Signup and view all the answers

Which pathophysiological process is most directly responsible for the abdominal distension observed in patients with intestinal obstruction?

Accumulation of Intestinal Contents, Fluid, and Gas Proximal to the Obstruction (B) Signup and view all the answers

In a patient with a complete small bowel obstruction, which sequence of events accurately describes the progression of pathophysiological changes if the obstruction is not relieved?

Decreased venous and arteriolar pressure → increased intestinal lumen → decreased circulating fluid volume → ischemia (C) Signup and view all the answers

A patient is admitted with a suspected small bowel obstruction. Which assessment finding would be most indicative of a mechanical obstruction rather than a paralytic ileus?

High-pitched bowel sounds proximal to the obstruction and absent bowel sounds distally (C) Signup and view all the answers

A patient with a history of Crohn's disease is admitted with symptoms of a small bowel obstruction. What underlying cause is most likely contributing to this patient's current condition?

Adhesions from Previous Surgeries (C) Signup and view all the answers

Which of the following conditions involves the telescoping of one part of the intestine into another, leading to intestinal obstruction?

Intussusception (A) Signup and view all the answers

In distinguishing between Crohn's disease and ulcerative colitis, which characteristic is most indicative of Crohn's disease?

The presence of transmural inflammation and granulomas. (B) Signup and view all the answers

A patient presents with symptoms suggestive of inflammatory bowel disease. Which diagnostic finding would strongly suggest ulcerative colitis over Crohn’s disease?

Diffuse and continuous inflammation from the rectum proximally. (C) Signup and view all the answers

Why do Crohn's disease patients frequently experience small bowel obstructions, a complication less commonly seen in ulcerative colitis?

Crohn's disease involves transmural thickening and potential strictures. (C) Signup and view all the answers

Which systemic complication is more frequently associated with ulcerative colitis due to its inflammatory and ulcerative nature?

Toxic megacolon, characterized by extreme dilation and potential rupture of the colon. (D) Signup and view all the answers

A patient with Crohn's disease develops a fistula near the anus. What aspect of Crohn's disease pathology contributes most directly to this complication?

The transmural inflammation. (D) Signup and view all the answers

A patient is undergoing diagnostic testing for suspected inflammatory bowel disease. A colonoscopy reveals friable mucosa with pseudopolyps. Which condition is most likely?

Ulcerative colitis. (C) Signup and view all the answers

In managing inflammatory bowel disease, why are immunomodulators often prescribed, especially in cases of Crohn's disease and ulcerative colitis?

To modulate the immune system and decrease the chronic inflammatory response. (A) Signup and view all the answers

A patient with long-standing ulcerative colitis is undergoing surveillance colonoscopies. What is the primary rationale for this regular monitoring?

To assess for the development of colon cancer. (A) Signup and view all the answers

Which of the following steps in the nursing process directly involves collecting subjective and objective data related to a patient's gastrointestinal health?

Assessment (A) Signup and view all the answers

A patient is diagnosed with a hiatal hernia. Which category of gastrointestinal disturbances does this condition fall under?

Disturbances in ingestion (C) Signup and view all the answers

Which of the following factors differentiates stress-related gastritis from gastritis caused by H. pylori?

Stress-related gastritis is often associated with major physiological trauma or burns. (C) Signup and view all the answers

What is the primary mechanism by which NSAIDs contribute to the development of gastritis?

Disrupting the protective mucosal barrier in the stomach. (C) Signup and view all the answers

A patient with gastritis reports experiencing pyrosis. What specific symptom is the patient describing?

Heartburn (A) Signup and view all the answers

Melena and hematochezia are potential symptoms of gastritis. What distinction differentiates these two conditions?

Melena presents as dark, tarry stools, while hematochezia presents as bright red blood in the stool. (A) Signup and view all the answers

A patient who has ingested a strong alkali is being treated for acute gastritis. What is the immediate priority in managing this patient's condition?

Protecting the airway and managing potential esophageal or gastric perforation. (B) Signup and view all the answers

Given that the gastric mucosa is capable of repairing itself, what is the primary focus of medical management in cases of mild to moderate gastritis?

Identifying and removing the causative factors while supporting the healing process. (D) Signup and view all the answers

Flashcards

Ingestion

The process of taking food into the body.

Digestion

The breakdown of food into smaller molecules that the body can absorb.