Chapter 32
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Questions and Answers

A 30-year-olad patient with ulcerative colitis is scheduled for a proctosigmoidoscopy. Which finding should cause the nurse to clarify routine preparation order with the physician.

  • The patient's age
  • Presence of severe diarrhea (correct)
  • Complaints of abdominal cramping
  • patient's weight is 10% below ideal body weight

The nurse is providing care for a patient whose nasogastric(NG) tube is attached to low intermittent suction for decompression of a bowel obstruction. The nurse notes the NG tube is not draining. What action should the nurse take?

  • Advance the NG tube 2 inches
  • Change the suction setting to high
  • Reinsert the NG tube into the other nares
  • Confirm placement with x-ray imaging (correct)

The nurse is inspecting the skin of a patient's abdomen. Which finding is consistent with gallbladder disease?

  • Jaundice (correct)
  • Caput medusae
  • Visible mound
  • Silver-colored lines

The nurse is auscultating the bowel sounds of a patient who is severely constipated and exhibits a swollen abdomen and pain. Which bowl sounds are consistent with a bowel obstruction?

<p>A high-pitched tinkling sound (C)</p> Signup and view all the answers

The nurse is providing care for a patient who has just undergone a percutaneous needle biopsy to rule out liver disease. Which priority action should the nurse take after the procedure?

<p>Position the patient on the right side for 2 hours (C)</p> Signup and view all the answers

A patient is being prepared for an upper gastrointestinal(GI) series involving a barium swallow. Which statement by the patient indicates an understanding of the instructions?

<p>I can't have anything to eat or drink for 8 hours before the procedure (D)</p> Signup and view all the answers

The nurse is ready to begin a tube feeding via an NG feeding tube for a patient who is comatose. What action should the nurse take before starting the feeding?

<p>Raise the head of the bed 30 degrees (B)</p> Signup and view all the answers

The nurse reviews the results of patient's stool occult blood test, which test positive. What question should the nurse ask the patient?

<p>Have you eaten turnips, fish or horseradish prior to testing? (D)</p> Signup and view all the answers

The nurse is caring for a patient who has an NG tube that is not vented. Which suction setting should the nurse select?

<p>Low intermittent suction (C)</p> Signup and view all the answers

The nurse is planning care for an older adult patient with disorders of the GI tract. What should the nurse consider?

<p>Peristalsis diminishes and slows motility, causing constipation (C)</p> Signup and view all the answers

The nurse is evaluating the understanding of a new graduate licensed practical nurse/licensed vocational nurse(LPN/LVN) about the topic of enteral feedings. What information by the new nurse requires correction?

<p>Measurement of residual volumes reflect gastric emptying and aspiration risk (B)</p> Signup and view all the answers

The nurse is providing care for a client who requires gastric irrigation for a medication overdose. The nurse understands the use of an orogastric tube requires which intervention?

<p>The tube is temporary and is removed following treatment (D)</p> Signup and view all the answers

The nurse is palpating the abdomen of a patient reporting mild abdominal pain in the lower region. How deep should the nurse depress this patient's abdomen

<p>1 inch (A)</p> Signup and view all the answers

The nurse is gathering data from a client in a clinic after hospitalization for an infection. The client reports having diarrhea, nausea, and abdominal pain since discharge. What action should the nurse take?

<p>Notify the HCP promptly (C)</p> Signup and view all the answers

The nurse is performing and abdominal examination and performing auscultation before palpation and percussion. Why did the nurse make this dicision?

<p>Palpation will alter or stimulate bowel sounds (A)</p> Signup and view all the answers

The nurse is providing care for a client 1 day after major surgery. The client's abdomen is distended, bowel sounds are absent, and the patient is nauseated. What action should the nurse consider?

<p>Request placement of an NG tube (C)</p> Signup and view all the answers

The nurse is caring for a patient admitted with malnutrition and placed on parenteral nutrition(PN). Which information should the nurse consider regarding insulin therapy for this patient?

<p>Insulin coverage may be added to the PN solution (D)</p> Signup and view all the answers

A patient is being scheduled for a barium swallow test to rule out esophageal strictures and gastric ulcer. Which pretesting information will the nurse provide for the patient?

<p>Do not smoke on the morning of the testing (C)</p> Signup and view all the answers

The nurse is providing care for a client with gallstones who is preparing for an endoscopic retrograde cholangiopancreatography(ERCP). What should the nurse include with teaching?

<p>You throat will be sore with hoarseness (C)</p> Signup and view all the answers

The nurse is providing care for a client with gallbladder disease. The client states "What good is a gallbladder anyway?" The nurse is aware that which digestive processes are a function of the gall bladder?

<p>Bile causes emulsification of large globules of fats into small globules (A), Bile carries bilirubin and excess cholesterol through the intestines (B), Bile secretion by the gallbladder is stimulated by the hormone secretin (C)</p> Signup and view all the answers

Which patients does the nurse recommend as benefiting form PN? (select all that apply)

<p>A patient who has esophageal cancer (A), A patient who is NPO for esophageal varices (C), A patient with sever burns across the face and chest (D)</p> Signup and view all the answers

The nurse is providing care for an older adult client. The client states, "I don't eat much anymore and I have terrible problems with my bowels" Which information does the nurse share with the patient to explain the changes as related to age?" (Select all that apply)

<p>Decreased GI peristalsis contributes to constipation (A), Constipation requires and increased intake of fluids and roughage (B), Decreased sense of taste can cause a loss of desire to eat (C), Periodontal disease can interfere with eating and healthy nutrition (D)</p> Signup and view all the answers

The nurse is providing care for a patient with an NG tube for PN, and IV line for fluids and medications, and a nasal cannula for oxygen therapy. Which safety interventions does the nurse implement during care for this patient?(Select all that apply)

<p>Label or color-code feeding tubes and connectors (A), Write &quot;Alert! For enteral use only &quot; on all tube feeding bags (C), During the handoff process, check tube origins and connections (D)</p> Signup and view all the answers

A patient is admitted to the skilled nursing unit and only has lower dentures and several broken teeth on the upper gums. What actions should the nurse take? (Select all that apply)

<p>Gather mores data to determine if the dentures are loose (B), Consult a dietitian (C), Determine if the teeth are loose (D)</p> Signup and view all the answers

A patient returns from an esophagogastroduodenoscopy(EGD) and reports a dry, scratchy throat. The unlicensed assistive personnel (UAP)fills the water pitcher and starts to give the patient a drink. What actions should the nurse take? (Select all that apply)

<p>Evaluate if a gag reflex is present (A), Stop the patient from drinking (C), Speak with the UAP in a private location (D)</p> Signup and view all the answers

The nurse reinforces teaching a patient with cirrhosis functions of the liver. Which of these would the nurse include as functions of the liver? Select all that apply

<p>Amino acid metabolism (A), Lipid metabolism (B), Synthesis of plasma proteins (C), Phagocytosis by Kupffer cells (D)</p> Signup and view all the answers

Following an endoscopic retrograde cholangiopancreatography, which nursing intervention is the priority?

<p>Maintain NPO (A)</p> Signup and view all the answers

The nurse would evaluate the patient as understanding teaching for gastrointestinal changes that occur with aging if the patient included which of these? Select all that apply.

<p>Decreased taste sensation (B), Esophagus motility lessens (C), Weaker gag reflex (D)</p> Signup and view all the answers

Which intervention is appropriate following a barium enema?

<p>Encourage fluids (C)</p> Signup and view all the answers

Which of these converting functions does the pancreatic enzyme trypsin have?

<p>Polypeptides to peptides (D)</p> Signup and view all the answers

Prior to administering medications via a percutaneous endoscopic gastrostomy (PEG) tube, which of these actions does the nurse take? Select all that apply

<p>Check placement (A), Check allergies. (B), Observe for abdominal distention. (C), Verify tube length. (D)</p> Signup and view all the answers

Flashcards

Ulcerative Colitis + Diarrhea

Severe diarrhea in a patient with ulcerative colitis requires clarifying the proctosigmoidoscopy preparation with the physician.

Non-draining NG tube

If an NG tube attached to low intermittent suction for bowel obstruction isn't draining, confirm placement with x-ray.

Gallbladder Disease Sign

Jaundice can indicate gallbladder issues.

Bowel Obstruction Sounds

High-pitched tinkling sounds, often accompanied by a swollen abdomen and pain, suggest bowel obstruction.

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Post-Liver Biopsy Position

After a percutaneous liver biopsy, position the patient on their right side for 2 hours to control bleeding.

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Barium Swallow Prep

A patient understanding the 8-hour fasting requirement for an upper GI series (barium swallow) with no food or drink.

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Proctosigmoidoscopy Prep Issue

Significant diarrhea in a patient with ulcerative colitis scheduled for proctosigmoidoscopy demands a physician clarification of the preparation.

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NG Tube Placement Check

When an NG tube connected to low intermittent suction for bowel decompression isn't draining, confirmation of placement via X-ray is necessary.

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Gallbladder Disease Indicator

Jaundice observed on the patient's abdomen may suggest gallbladder problems.

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Bowel Obstruction Symptoms

Severe abdominal pain, swelling, and intermittent high-pitched tinkling bowel sounds indicate a bowel obstruction.

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Post-Biopsy Positioning

After a percutaneous liver biopsy, position the patient on their right side for 2 hours to apply pressure and prevent internal bleeding.

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Upper GI Series Fasting

A patient's understanding of required fasting (no food or drink for 8 hours) for a barium swallow is essential for the procedure's safety and accuracy.

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Severe Diarrhea in Colitis

Severe diarrhea, in patients preparing for a proctosigmoidoscopy and experiencing ulcerative colitis, may be a cause for investigation and clarification in prep plan with a doctor

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