Final Exam: Upper GI Disorders

Question 1

Nausea is?

Answer 1

feeling or discomfort with the desire to vomit

Question 2

Vomiting is?

Answer 2

the forceful ejection of partially digested food and secretions from the upper GI tract

Question 3

What does the presence of fecal odor and bile after prolonged vomiting suggest?

Answer 3

intestinal obstruction below the level of the pylorus

Question 4

If someone is vomiting a lot, it can cause an issue with? What is the priority assessment for this patient?

Answer 4

• Aspiration

- Assessing ABCs (airway, breathing, circulation) - patient may need an NG tube

Question 5

What is another way to get patients fluid if they are experiencing nausea/vomiting?

Answer 5

TPN (total parenteral nutrition) can carry fluids, nutrients, medications (eg: insulin)

Question 6

A nurse is caring for a patient treated with IV fluid therapy for severe vomiting. As the patient recovers and begins to tolerate oral intake, the nurse understands which of the following food choices would be most appropriate?

Answer 6

Dry toast (dry foods can alleviate feelings of nausea)

Question 7

When assessing the patient’s abdomen, what would be the most appropriate for the nurse to do?

Answer 7

Auscultate the abdomen before palpitation (palpitations can alter bowel sounds)

Question 8

Why is oral care important?

Answer 8

Oral infections can predispose patients to other body system infections (eg: endocarditis)

Question 9

Interprofessional care for patients with GERD? (2)

Answer 9

• avoid foods that affect acid secretion (chocolate, peppermint, fatty foods, coffee, tea)
• patient must be sitting up when eating (HOB should be elevated at least 30 degrees)

Question 10

In a patient with esophageal varices, vomiting bright red blood can indicate?

Answer 10

A rupture

Question 11

What can NG tubes do to the stomach that can benefit patients with gastritis and GERD?

Answer 11

Decrease the amount of acidity in the stomach

Question 12

What is the cause of peptic ulcer disease? (2)

Answer 12

• increased acid production

- H. pylori bacteria

Question 13

Which patient may be predisposed to peptic ulcer disease?

Answer 13

White man who is very STRESSED and SMOKES regularly

Question 14

What is the main concern for patients with peptic ulcer disease?

Answer 14

GI bleed

Question 15

When does pain associated with gastric peptic ulcer disease usually occur? What role does food play?

Answer 15

Pain occurs 1-2 hrs AFTER meals (food aggravates s/s)

Question 16

When does pain associated with duodenal ulcers occur? What role does food play?

Answer 16

• duodenal pain usually occurs 2-5 hrs AFTER a meal

- food helps to alleviate the pain acting as a buffer for the excessive acid

Question 17

Patient with hx of peptic ulcer disease has presented to the emergency department with complaints of severe abdominal pain and rigid, board-like abdomen, promoting the health care provider to suspect a perforated ulcer. What is the action to anticipate? (2)

Answer 17

Providing IV fluids and inserting an NG tube

• (Board-like abdomen: indicates bleeding in the ABD)
• (Perforated ulcer: indicates leakage of bleeding)

Question 18

The results of a patient’s recent endoscopy indicate the presence of peptic ulcer disease. Which of the following teaching points should the nurse provide the patient in light of their new diagnosis?

Answer 18

“It would be beneficial for you to eliminate drinking alcohol”

Question 19

What should be expected to see in a patient with an upper GI bleed?

Answer 19

Red blood in vomitus

Question 20

Interprofessional care for a patient with an upper GI bleed?

Answer 20

Monitor vitals

Question 21

What vitals indicate that the patient may be going into hypovolemic shock?

Answer 21

Tachycardic (high HR) with hypotension (low BP)

Question 22

The nurse is teaching a group of high school students about the prevention of food poisoning. Which comment by the student shows an understanding of foodborne illness protection?

Answer 22

“When they gave me a pink burger, I sent it back and got a new bun and clean plate.”

Question 23

Risk factors for diverticulitis that are most common? (2)

Answer 23

• lack of dietary fiber

- history of hemorrhoids (constant constipation and straining)