Chapter 10: Abdominal Disorders Flashcards
Your 70-year-old patient has gastroesophageal reflux disease (GERD). After a trial of lifestyle modifications and antacids, the patient continues to have occasional mild heartburn after occasional meals and at night. The most appropriate next action is:
H2 antagonists
An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD?
Midepigastric pain that is not reproducible with palpation
The nurse practitioner is examining a 62-year-old female who has been complaining of lower abdominal pain. Upon auscultation, bowel sounds are high pitched and tinkling. Which of the following terms describes this finding?
Borborygmi
In teaching an older adult female client with end-stage renal disease her medication regimen, the nurse practitioner must include which of the following pieces of information in the treatment plan?
Take iron supplement before meals and the calcium after meals
A 62-year-old client presents with a complaint of fever, pain, and burning on urination. Difficulty urinating with dribbling has been increasing in the past few days. He has a feeling of pressure in his groin. On examination, his prostate is tender, boggy, and warm. A stat urinalysis reveals the presence of leukocytes and bacteria. He is allergic to sulfa drugs. His weight is 70 kg and his last serum creatinine was 1.0. While awaiting the culture and sensitivity, the nurse practitioner begins empiric treatment with which of the following?
Ciprofloxacin 500 mg Q 12 hours for 14 days
A 62-year-old woman presents with a recurrent urinary tract infection. She now has a fever of 104°F and severe costovertebral tenderness with pyuria. What is the appropriate diagnosis and intervention for this patient?
Pyelonephritis and hospitalization is required
Which of the following drugs would be useful for the nurse practitioner to prescribe for an older adult to prevent gastric ulcers when a nonsteroidal anti-inflammatory drug is used for chronic pain management?
Misoprostol (Cytotec)
A 68-year-old male reports painless rectal bleeding occasionally noted with thin pencil-like stools, but no pain with defection. He has a history of colon polyp removal 10 years ago but was lost to follow-up. The nurse practitioner’s appropriate intervention is:
Immediate referral to gastroenterologist and colonoscopy
Asymptomatic 1+ bacteruria is found in a nursing home resident with an indwelling catheter. The nurse practitioner’s initial intervention includes:
Assessing resident’s cognitive status and last change of the catheter/bag
When counseling clients regarding the use of antidiarrheal drugs such as Imodium anti-diarrheal and Kaopectate, the nurse practitioner advises patients to:
Do not use for possible infectious diarrhea
When teaching a group of older adults regarding prevention of gastroesophageal reflux disease symptoms, the nurse practitioner will include which of the following instructions?
Avoid food intolerances, raise head of bed on blocks, and take a proton pump inhibitor before a meal
A clinical clue for suspected renal artery stenosis would be:
Development of resistant hypertension in a previously well-controlled patient
Helicobacter pylori is implicated as a causative agent in the development of duodenal or gastric ulcers. What teaching should the nurse practitioner plan for a patient who has a positive Helicobacter pylori test?
Treatment regimen is multiple medications taken daily for a few weeks.
An obese middle-aged client presents with a month of nonproductive irritating cough without fever. He also reports occasional morning hoarseness. What should the differential include?
Gastroesophageal reflux
Which of the following findings would indicate a need for another endoscopy in clients with peptic ulcer disease?
Symptoms persisting after 6-8 weeks of therapy
