Chapter 54: Concepts Of Care For Patients With Problems Of The Biliary System And Pancreas

Question 1

The nurse is planning care for a client who had a laparoscopic Whipple surgery. For which complications will the nurse assess? Select all that apply.
A. Bleeding
B. Wound infection
C. Intestinal obstruction
D. Diabetes mellitus
E. Abdominal abscess

Answer 1

Answers: A, B, C, D, E
Rationales: Clients having this complex surgery can develop any or all of the postoperative complications listed in the test item.

Question 2

The nurse is teaching a preoperative client who is scheduled for a laparoscopic cholecystectomy (“lap chole”). What statement by the client indicates a need for further teaching?
A. “I will likely need oral pain medications for the first few days after my surgery.”
B. “I should only be hospitalized for 2 to 3 days after my surgery.”
C. “I will probably not be at risk for complications from this surgery.”
D. “I should be able to go back to work in the next week or so.”

Answer 2

CORRECT: B
“I should only be hospitalized for 2 to 3 days after my surgery.”
A “lap chole” surgery has many advantages over the open traditional surgical method, including a short hospital stay, usually same-day surgery, minimal risk for complications, and the ability to achieve pain control by using oral analgesics.

Question 3

A client who had a Whipple surgical procedure develops an internal fistula between the pancreas and stomach. For which complication would the nurse monitor?
A. Cirrhosis
B. Crohn disease
C. Peritonitis
D. Peptic ulcer disease

Answer 3

CORRECT: C

Peritonitis
Leakage of pancreatic enzymes, bile, and/or gastric secretions into the abdomen (peritoneal cavity) often causes peritonitis, which requires IV antibiotic therapy to manage.

Question 4

The nurse is caring for a client who had a Whipple surgical procedure yesterday. For what serum laboratory test results would the nurse want to monitor frequently and carefully?
A. Blood glucose
B. Blood urea nitrogen
C. Phosphorus
D. Platelet count

Answer 4

CORRECT: A

Blood glucose
During a Whipple procedure, most or all of the pancreas is manipulated, stressed, and possibly removed. Therefore, the client is at risk for hyperglycemia or hypoglycemia and blood glucose would need careful monitoring with a possible need for treatment.

Question 5

A client has undergone the Whipple procedure (radical pancreaticoduodenectomy) for pancreatic cancer. Which nursing actions would the nurse implement to prevent potential complications? (Select all that apply.)
A. Ensure that drainage color is clear.
B. Check blood glucose often.
C. Place the client in the supine position.
D. Check bowel sounds and stools.
E. Monitor mental status.

Answer 5

CORRECT: B, D, E

Check blood glucose often.
To prevent potential complications after a Whipple procedure, the nurse would check the client’s glucose often to monitor for diabetes mellitus. Bowels sounds and stools would be checked to monitor for bowel obstruction. A change in mental status or level of consciousness could be indicative of hemorrhage.

Check bowel sounds and stools.
To prevent potential complications after a Whipple procedure, the nurse would check the client’s glucose often to monitor for diabetes mellitus. Bowels sounds and stools would be checked to monitor for bowel obstruction. A change in mental status or level of consciousness could be indicative of hemorrhage.

Monitor mental status.
To prevent potential complications after a Whipple procedure, the nurse would check the client’s glucose often to monitor for diabetes mellitus. Bowels sounds and stools would be checked to monitor for bowel obstruction. A change in mental status or level of consciousness could be indicative of hemorrhage.