Iggy GI review

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A client has a routine sigmoidoscopy. What common complications is the nurse looking for in a post procedure assessment?

Heavy bleeding.

Which factors place the client at risk for GI problems?

Smoking a half-pack of cigarettes per day.
Socioeconomic status
Some herbal preparations.
Use of NSAIDs.

A client is scheduled for a colonoscopy. What does the nurse tell the client to do before the procedure is performed?

Begin a clear liquid diet 12-24 hours before the test.

A client with newly diagnosed irritable bowel syndrome reports having five to six loose stools daily. What is the common psychological client response to this GI health problem?

Embarrassment

What substance, produced in the stomach, facilitates the absorption of vitamin B12?

Intrinsic factor

What is a common GI problem that older adult clients experience more frequently as they age?

Decreased hydrochloric acid

A client is admitted to the hospital with severe RUQ abdominal pain. Which assessment technique does the nurse use for this client?

Examines the RUQ of the abdomen last.

A client is admitted to the hospital with elevated serum amylase and lipase levels and a decreased calcium level. Which GI health problem is indicated by these lab findings?

Acute pancreatitis

A nurse is assessing a client who had abdominal surgery yesterday. What method provides the most accurate data about resumption of peristalsis in the client?

Asking the client whether he or she has passed flatus

A nurse is educating a group of older adults about screening for colorectal cancer. Which statement by a group member indicates the need for further clarification about these guidelines?

I will need to have a routine colonoscopy every 5 years.

An outpatient clinic nurse is recovering a client who had a colonoscopy. The client asks for a drink. How does the nurse respond to the client's request?

When you are able to pass flatus, you can have a drink.

Which action does the nurse delegate to unlicensed UAP helping to care for a client with weight loss and anorexia?

Obtain a stool specimen.

A nurse is assessing a client who has come to the emergency department with acute abdominal pain. Which assessment finding is of greatest concern?

Bruising is noted around the client's umbilicus.

An older adult is scheduled for a double-contrast barium enema. What is the priority health teaching the nurse will provide?

Be sure to take the laxative as prescribed after the test.

Which food will the nurse instruct the client undergoing chemotherapy for oral cancer with secondary stomatitis to avoid?

Salted food

The nurse is providing instructions to a client who has a history of stomatitis. Which instructions will the nurse include in the client's teaching plan?

Rinse the mouth with warm saline or sodium bicarbonate.

When caring for a client with oral cancer who has developed stomatitis as a complication of radiation and chemotherapy, which nursing action will the nurse delegate to the home health aide?

Provide oral care using disposable foam swabs.

The nurse is assessing a client with gastroesophageal reflux disease (GERD). Which findings will the nurse expect to observe?

Dyspepsia
Flatulence
Regurgitation

The nurse and the dietitian are planning sample diet menus for the client who is experiencing dumping syndrome. Which sample meal is best for this client?

Chicken and rice

The client has a long-term history of Crohn's disease and has recently developed acute gastritis. The client asks the nurse whether Crohn's disease was a direct cause of the gastritis. What is the nurse's best response?

"We know that there can be an association between Crohn's disease and chronic gastritis, but Crohn's does not directly cause acute gastritis to develop."

The nurse is teaching the client how to prevent recurrent chronic gastritis symptoms before discharge. Which statement by the client demonstrates correct understanding of the nurse's instruction?

"Small meals should be eaten about six times a day."

The nurse is caring for an older adult male client who reports stomach pain and heartburn. Which syndrome is most significant in determining whether the client's ulceration is gastric or duodenal in origin?

Pain occurs 1 1/2 to 3 hours after a meal, usually at night.- Duodenal

The nurse reviews a medication history for a client newly diagnosed with peptic ulcer disease (PUD) who has a history of using ibuprofen (Advil, Motrin, others) frequently for chronic knee pain. The nurse anticipates that the health care provider will request which medication for this client?

Misoprostol (Cytotec)

A client with a recent diagnosis of acute gastritis needs health teaching about nutrition therapy. Which foods and beverages should the nurse teach the client to avoid?

Onions
Orange Juice
Tomato Juice

When taking a history of a client diagnosed with a duodenal ulcer, which assessment finding does the nurse expect?

Waking at night with pain

The nurse assesses a client for the risk for gastric cancer. Which of these factors would likely increase the client's risk?

Having a history of untreated gastroesophageal reflux disease
Eating a diet high in smoked and pickled foods
Eating a diet high in salt and adding salt to food

A home health nurse is teaching a client about the care of a new colostomy. Which client statement demonstrates correct understanding of the instructions?

"I need to check for leakage underneath my colostomy."

A client with irritable bowel syndrome (IBS) is constipated. The nurse instructs the client about a management plan. Which client statement shows an accurate understanding of the nurse's teaching?

"I need to go for a walk every evening."

A Certified Wound, Ostomy, Continence Nurse (CWOCN) is teaching a client with colorectal cancer how to care for a newly created colostomy. Which client statement reflects correct understanding of the necessary self-management skills?

"I will make certain that I always have an extra bag available."

A client with CRC had colostomy surgery performed yesterday. The client is very anxious about caring for the colostomy and states that the health care provider's instructions "seem to be overwhelming." What does the nurse do first for this client?

Encourages the client to look at and touch the colostomy stoma

A client is being evaluated in the emergency department (ED) for a possible small bowel obstruction. Which symptoms does the nurse expect to assess?

Upper abdominal distention, metabolic alkalosis, and great amount of vomiting

A client with a bowel obstruction is requested a nasogastric (NG) tube. After the nurse inserts the tube, which nursing intervention is the highest priority for this client?

Connecting the tube to low intermittent suction

A nurse is teaching a client with a newly created colostomy about foods to limit or avoid because of flatulence or odors. Which foods are included? Select all that apply.

Broccoli
Mushrooms
Onions
Peas

Situation: A 28-year-old comes to the clinic with a history of recurrent episodes of diarrhea or constipation and reports of abdominal pain and bloating. The client is diagnosed with irritable bowel syndrome (IBS). What OTC medications does a nurse suspect as a possible cause of the client's problem?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Situation: A 28-year-old comes to the clinic with a history of recurrent episodes of diarrhea or constipation and abdominal pain with bloating. The client is diagnosed with irritable bowel syndrome (IBS). What does the nurse advise the client to take during the periods of constipation?

Bulk-forming laxatives

A nurse is assigned to care for a client who had a partial colectomy and ascending colostomy yesterday. What assessment findings are expected for the client? Select all that apply.

The colostomy stoma is pinkish red and moist.
The client has pain that is controlled by analgesics.

A client who had surgery for inflammatory bowel disease (IBD) is being discharged. The case manager will arrange for home health care follow-up. The client tells the nurse that family members will also be helping with care. What information is critically important for the nurse to provide to these collaborating members?

Written and oral instructions regarding symptoms to report to the health care provider

A client is scheduled for discharge after surgery for inflammatory bowel disease (IBD). The client's spouse will be assisting home health services with the client's care. What is most important for the home health nurse to assess in the client and the spouse with regard to the client's home care?

Ability of the couple to perform incision care and dressing changes

A client with a recent, surgically created ileostomy refuses to look at the stoma and asks the nurse to perform all required stoma care. What does the nurse do next?

Has another client with a stoma—who performs self-care—come and talk with the client

A client with an exacerbation of ulcerative colitis (UC) has been prescribed a low-residue diet. Which meal does the nurse help the client select?

Scrambled eggs, white toast with margarine

A certified wound, ostomy, continence nurse (CWOCN) nurse is teaching a client about caring for a new ileostomy. What information is most important to include?

"Call the health care provider if your stoma has a bluish or pale look."

A client has vague symptoms that indicate an acute inflammatory bowel disorder (IBD). Which symptom is most indicative of Crohn's disease (CD)?

Chronic diarrhea, abdominal pain, and fever

Which is a correct statement differentiating Crohn's disease (CD) from ulcerative colitis (UC)?

Clients with UC may experience hemorrhage.

A nurse is teaching a client with Crohn's disease (CD) about managing the disease with the drug adalimumab (Humira). Which instruction does the nurse emphasize to the client?

"Avoid large crowds and anyone who is sick."

A nurse is teaching a client about dietary methods to help manage exacerbations ("flare-ups") of diverticulitis. What does the nurse advise the client?

"Consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet."

A client has newly diagnosed ulcerative colitis (UC). What does the nurse tell the client about diet and lifestyle choices?

"Lactose-containing foods should be reduced or eliminated from your diet."

A nurse is instructing a client with recently diagnosed diverticular disease about diet. What food does the nurse suggest the client include?

A slice of 5-grain bread

A home health client has had severe diarrhea for the past 24 hours. Which nursing action does the RN delegate to a home health aide (unlicensed assistive personnel [UAP]) who assists the client with self-care?

Checking and reporting the client's heart rate and blood pressure—in lying, sitting, and standing positions

Situation: A 21-year-old woman has abdominal pain, cramping, and diarrhea. She reports having 10 to 12 liquid, bloody stools per day. A stool sample for ova and parasites is negative. A diagnosis of ulcerative colitis (UC) is made, and she is started on sulfasalazine (Azulfidine). What does the nurse tell her about why she is receiving this therapy?

"Your intestinal inflammation will be reduced."

An older adult has a perforated appendix and is scheduled for emergent surgery. What assessment findings will the nurse expect the client to have before surgery? Select all that apply.

Dizziness
Distended Abdomen
Fever

The nurse is caring for a client with an exacerbation of ulcerative colitis. Which laboratory finding for the client will the nurse expect?

Decreased serum potassium

The health care provider prescribes sulfasalazine (Azulfidine) for a client with ulcerative colitis. What nursing action is most important before the client begins the medication?

Ask the client if he has any allergies to sulfa-type drugs.

Which statement by the client with cirrhosis indicates that further instruction is needed about the disease?

"My liver is scarred, but the cells can regenerate themselves and repair the damage."

In caring for the client who has undergone paracentesis, which changes in the client's status should be promptly reported to the provider?

Decreased blood pressure, increased heart rate- indicative of shock

When providing discharge teaching to the client with cirrhosis, it is essential for the nurse to emphasize avoidance of which of these?

Nonsteroidal anti-inflammatory drugs

Which activity by the nurse will best relieve symptoms associated with ascites?

Elevating the head of the bed

When assessing a client with hepatitis B, the nurse anticipates finding which of these?

Tea-colored urine
RUQ tenderness
Itching

When assessing a client for hepatic cancer, the nurse anticipates finding an elevation in which of these?

Alpha-fetoprotein- fetal hemoglobin

The nurse asks the client with liver disease to raise the arms to shoulder level and dorsiflex the hands. A few moments later, the hand begins to flap upward and downward. How does the nurse correctly document this in the medical record?

Asterixis

When caring for a client with advanced cirrhosis, what laboratory assessment findings will the nurse expect?

Increased alanine aminotransferase
Increased alkaline phosphatase
Decreased bilirubin in the stool

The nurse is attempting to position the client having an acute attack of pancreatitis in the most comfortable position possible. In which position will the nurse place this client?

Side-lying position, with knees drawn up to the chest

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