Pancreatitis = recent weight loss & temperature elevation. elevation. Inflammation of the pancreas causes a response that elevates temperature and leads to abdominal pain that typically typically occurs with eating. NV may occur as a result of pancreatic pancreatic tissue damage that’s caused by activation of pancreatic enzymes. pancreatic enzymes. The client may experience weight loss because because of the loss of the desire to eat. The client typically experiences experiences tachycardia.
The nurse should instruct the client with Peptic Ulcer Disease to take aluminum-magnesium complex (Riopan) with water because it helps transport the the antacid in the stomach. The client should not take an antacid with fruit fruit juice or foods rich in vitamin C & D because antacids impair the absorption of nutrients in food and juice.
The LPN must have special training before initiating IV Therapy for a laparoscopy.
A client receiving tx for a gastric ulcer should be instructed instructed to take antacids even if their symptoms reside. reside. Antacids decrease gastric acidity. Antacids should not not be taken with other meds b/c they interefere. Clients with cardiac problems problems should not take antacids with sodium, switch to magnesium based. Antacids should be taken 1 hour before or 2 hours after meals
The predominant clinical feature for a patient with pancreatitis is abdominal pain and the primary nursing goal is relieving abdominal pain. Also Pancreatitis causes NV NV & the nurse should prevent fluid deficit. deficit.
The incorrect statement of a client following a barium enema is “I should limit my fiber intake for 1 to 2 weeks following the procedure”. Correct statements are the pt will not need a laxative after the procedure procedure because barium increases elimination; fluid intake should be increased to 2-3L/dy; and the pt should report a Bm.
Serum potassium of 3 mEq/L is below normal indicating hypokalemia which can cause cardiac arrhythmias and asystole.
Cholelithiasis pt w/ gallstone lodged lodged in the common bile duct the nurse should should expect to see yellow sclera. Yellow sclera is an early sign of jaundice which occurs when the common bile duct is obstructed. obstructed. Light amber urine is normal. Circumoral palor is a sign of hypoxia. hypoxia. Black tarry stools is a sign of GI GI bleeding.
Loss of 2.2lbs in 24hrs is the best finding to indicate a patient treated with spirinolactone for fluid retention is experiencing a therapeutic effect.
For a client w/ emphysema that has not been adhering to the medication regiment the nurse should collaborate with the resp therapist to make sure breathing treatments are administered as ordered and closely assess client’s respiratory status.
Liver failure patient exhibits subnormal subnormal serum glucose & elevated serum ammonia levels. levels. Ammonia levels increase b/c the liver cant adequately detoxify ammonia produced in the GI tract & glucose levels decline because the liver i sn’t capable of releasing stored glucose.
Risks for peptic ulcers include alcohol alcohol abuse & smoking. Also stress. Chronic renal failure , (not acute) is associated associated w/ duodenal ulcers.
Pt recovering from an ileostomy to treat inflammatory bowel disease the nurse should stress the importance of increasing fluid intake to prevent prevent dehydration. Ileostomy pts should should wear an appliance appliance at all times. No high fiber foods-irritates foods-irritates the intestines. No enteric coated meds.
Diverticulitis- “I should increase my intake of fresh fruits fruits & veggies during remission” During diverticulitis follow low low fiber diet to minimize bulk in stools. During diverticulosis follow follow high fiber diet.
Atrophy of gastric mucosa increases increases the risk of anemia. B12 absorption impaired. impaired.
After splenectomy nurse should prepare to admin Pneumovax 23.
You are turning patient after colon resection. resection. Wound dehiscence & evisceration occurs. occurs. First response response is to place saline soaked sterile dressings on wound before you call the Dr.
Hepatitis A pt nurse expects to see anorexia, nausea & vomiting. Eructation & constipation = gallbladder; ascites= hepatic disease.
For ostomy site gently wash stoma with a facecloth & mild soap.
For a client post gastric bypass surgery immediate intervention is required for a right lower leg red and swollen. A red swollen extremity is a sign of thromboembolism, a common complication after gastric surgery.
Dietary instructions for pancreatitis include high carbohydrate, low fat diet. A client with a hx of pancreatitis should avoid foods and beverages that stimulate the pancreas, such as fatty foods, caffeine, and gas-forming foods; should avoid eating large meals; and should eat plenty of carbohydrates, which are easily metabolized.
An alcohol abuse client w/ pancreatitis complains of pain worsening & radiating to his back. What is the priority intervention? Administering Morphine , AS ORDERED. Key words as ordered- priority is addressing clients pain issues. Maintaining NPO status is not a priority over giving a med that’s ordered.
Cullen’s sign is evidenced by discoloration at the preumbilical area. The sign may indicate an underlying subcutaneous intraperitonial hemorrhage.
Nurse who collects the stool specimen should collect the specimen in a sterile container. The specimen does’nt have to be taken to the laboratory immediately unless stool is being examined for ova & parasites.
IBS pt w/ Chron’s Disease can expect the following therapies: corticosteroid therapy & antidiahhreal meds. Corticosteroids ie prednisone, reduce the S&S of diarrhea, pain & bleeding by decreasing inflammation. Antidiarrheals ie diphenoxylate/ Lomotil, combat diarrhea by decreasing peristalsis. Lactulose treats constipation & would aggravate the symptoms. High fiber & milk products are contraindicated in client’s with chron’s because they promote diarrhea.
ED patient with severe ab pain & elevated wbc count is dx with appendicitis. The patient is a greatest risk for rupture of the appendix.
For a legally blind patient it is appropriate for the nurse to read an informed consent form and ask him if he has any questions before signing.
In the RUQ the nurse would expect to find the Liver. RUQ contains liver, gallbladder, duodenum, head of the pancreas, hepatic flexure of the colon, portions of the ascending & transverse colon, and a portion of the right kidney. LLQ= sigmoid. RLQ= appendix. LUQ=spleen.
Client with cirrhosis has a PT of 15 seconds compared to a control of 11 seconds. The nurse expects to administer phytonadione(Mephyton). Increased PT= increased clotting time = increased bleeding risk. Vitamin K is needed to promote prothrombin synthesis. Warafin is an anticoagulant that prolongs PT.
Nurse preparing a client with Chron’s disease for a barium enema. The day before the test the nurse should encourage plenty of fluids. Adequate fluid intake is necessary to avoid dehydration that may be caused by barium and to prevent fecal impaction after the procedure. Low residue diet 1-2 days before the procedure to reduce contents of th e GI tract. Fiber intake is limited in a low residue diet. Dairy products leave residue and are prohibited. Only clear liquids are allowed the evening before the test.
Pt complaining of RLQ pain in ED the nurse should report WBC count 22.8/mm3 (elevated). This is a sign of infection and indicates the client’s appendix may have ruptured.
Atropine decreases salivation and gastric secretions before surgery.
Complication of an EGD (esophagogastroduodenoscopy) is bloody secretions. Sore throat, drroling, and absent gag reflex are all expected after the procedure.
Teaching should be performed by the nurse not the nurse’s aide.
Initial position for a colonoscopy is on the left side with knees bent.
Garamycin/ gentamicin the nurse should monitor for hearing, urine output, and BUN & creatinine levels. Adverse rxns th
to gentamicin include ototoxicity (affects 8 cranial hearing nerve) and nephrotoxicity. Instruct him to report any hearing loss or tinnitus.
Pt w/ vancomycin resistant enterococci the nurse should wear gown, gloves, mask, and eye protection before entering the room. Vanco resistant enterococci requires contact precautions. When leaving the room gloves are most contaminated so they should be removed first.
A nurse should use an infusion pump to administer TPN. Complications of TPN include fluid overload, electrolyte imbalances, infection, hyperglycemia, air embolism, and pneumothorax.
Laxatives should not be used regularly to prevent constipation.
Exercise prevents constipation.
Pt w/ cholecystitis is given propantheline bromide. This medication: inhibits contraction of the bile duct & gall bladder. It is an anticholinergic and has an antispasmodic effect on the bile duct & gallbladder.
For a pt on TPN increased urine output (polyuria) suggests the client has developed hyperglycemia.
Constipation is a predisposing condition for hemorrhoids. Other risks include pregnancy, orthostatic hypotension, and other conditions associated with high intra abdominal pressure. Rectal bleeding is a symptom of hemorrhoids not a predisposing condition.
A dusky stoma indicates blood supply to the stoma has been interrupted.
Depth for inserting an enema to average sized adult is 3-4”
Pt w/ inhalation anesthetic is shivering severely after surgery. Nurse should provide O2 AS ORDERED. Hypothermia is a common effect of inhalation anesthetics and shivering is normal.
Hemovacs must be compressed to establish suction.
Blood in stools is one of the warning signs for colorectal cancer. Check for frank and occult blood.
Muscle wasting, decrease in chest & axillary hair, and increased bleeding tendencies are symptoms of cirrhosis. Also may have mild fever, edema, abdominal pain, and enlarged liver. Peptic ulcer pts complain of dull gnawing epigastric pain that is relieved by eating. Appendicitis is characterized by periumbilical pain that moves to the RLQ and rebound tenderness. Cholelithiaisis is characterized by severe abdominal pain that presents several hours after a large meal.
Most appropriate action for a client w/ cute pancreatitis is withholding alloral intake AS ORDERED to decrease pancreatic secretions. Pancreatitis causes considerable pain but it is treated with IM Demerol/ meripidine, not morphine. Morphine worsens the pain causing spasms of the pancreatic and biliary ducts.
Barium swallow: avoid eating or drinking anything 6-8 hrs before the test. No other preparation is needed. Before a lower GI series the pt should eat a low residue or clear liquid diet for 2 days and take a potent laxative or oral liquid preparation.
Enteric precautions for shigellosis must be maintained until 3 fecal cultures are negative.
Hypoprothrombinemia may result as a result of antibiotic therapy interfering with the synthesis of Vitamin K.
The part of the GI tract that mainly absorbs products of digestion is the small intestine.
Kaolin and pectate (Kaopectate) is given to decrease the amount of loose stools. Onset occurs within 30 minutes.
Gnawing epigastric pain is associated with duodenal ulcers. Pain occurs when the stomach is empty and is relieved by eating. Ulceritive colitis is characterized by exacerbations and remissions of severe bloody diarrhea. Appendicitis is
charactertized by epigastric or umbilical pain along with nausea, vomiting, and low grade fever. Diverticulitis is in the LLQ and has moderate onset accompanied by nausea, vomiting, fever, and chills.
Pt w/ gastric cancer nursing priority is correcting nutritional deficits. Gastric cancer pts usually have nutritional deficits and may have cachexia.
