Gastrointestinal Flashcards
0
Q
Which statement is true about Barretts epithelium in the patient with GERD?
A
While the body heals, a different type of cell forms on the lower part of the esophagus
1
Q
Which physiologic factor contributes to GERD?
A
Irritation from refluxate
2
Q
Which statements about GERD are correct?
A
- Overweight and obese patients are at an increased risk
2. It is a common upper gastrointestinal disorder in the US
3
Q
Dyspepsia
A
Pain described as a substernal or retrosternal burning sensation that tends to move up and down the chest in a wavelike fashion
4
Q
Water brash
A
Reflex salivary hypersecretion in response to reflux
5
Q
Dysphagia
A
Difficulty swallowing
6
Q
Odynophagia
A
Painful swallowing
7
Q
Globus
A
Feeling of something in the back of the throat
8
Q
Eructation
A
Belching
9
Q
Pyrosis
A
Retrosternal burning
10
Q
A patient is scheduled to have several diagnostic tests to verify the medical diagnosis of GERD. Which diagnostic test is the most accurate method of diagnosing this disorder?
A
24 hour ambulatory pH monitoring
11
Q
The nurse has provided teaching to a patient with GERD. Which statement by the patient indicates the teaching has been effective.
A
I wont lift heavy objects
12
Q
A patient is on nizatidine therapy for the treatment of GERD. Which sign indicates that the patient may be having an adverse effect associated with this drug?
A
Dysrhythmia
13
Q
A patient who has been prescribed Reglan is being disharged home. Which statement by the patient indicates a need for further discharge teaching by the nurse?
A
I will take the drug after meals
14
Q
Which statement is true about the drug Aciphex for treatment of GERD?
A
PAtients who use this drug should be instructed to wear sunscreen
15
Q
A patient has returned to the unit after a stretta procedure for GERD. Which action by the student nurse requires the supervising nurse to intervene?
A
A nasogastric tube is prepared for insertion
16
Q
Which lifestyle adjustment may a patient have to make to best control GERD?
A
Attain and maintain ideal body weight
17
Q
WHich statements will the nurse include when providing health teaching for a patient with haitial hernia
A
- Elevate the head of the bed at least 6 inches for sleeping at night
- Remain in the upright position several hours after eating
- Avoid straining or excessive vigorous exercise
- avoid wearing clothing that is to tight
- Avoid eating in the late evening
18
Q
Hiatal hernias are also called………..hernias
A
Diagphramatic
19
Q
What diagnostic test best identifies a hiatal hernia?
A
Barium swallow study with fluoroscopy
20
Q
Barretts epithelium is considered ……. even though it is new epithelium
A
Premalignant
21
Q
The nurse has provided postoperative teaching for a patient who underwent a laparoscopic nissen fundoplication. Which statement by the patient indicates a need for additional teaching?
A
ill discontinue the antireflux drugs
22
Q
What is the primary focus of care after conventional surgery for hiatal hernia?
A
Prevention of respiratory complications
23
Q
GERD can be cause of which adult onset disorders?
A
- Dental caries
- Laryngitis
- Asthma
24
The nurse is assessing a patients nasogastric drainage following a fundoplication procedure. How does the nurse expect to find the drainage to appear the first 8 hours after surgery?
Dark brown
25
The nurse is giving discharge instructions to a patient after fundoplication procedure. Which activities is the patient instructed to avoid?
1. Drinking more than 8 oz of water at a time
2. Chewing gum
3. Drinking with a straw
4. Eating gas producing foods
26
A patient is prescribed Protonix. What does the nurse tell the patient is the major action of this medication?
It inhibits gastric acid secretion
27
A patient is undergoing a workup for squamous cell carcinoma of the esophagus. What are the two primary risk factors associated with the development of this carcinoma?
Tobacco use and heavy alcohol intake
28
The definitive diagnosis for esophageal cancer is made with which procedure?
Esophageal ultrasound with fine needle aspiration
29
Nonsurgical treatment options for cancer of the esophagus can include which therapies?
1. Swallowing therapy
2. Chemoradiation
3. Targeted therapies
4. Photodynamic therapy
5. Endoscopic therapies
30
Which are pathologic changes associated with acute gastritis?
Vascular congestion
Edema
Acute inflammatory cell infiltration
31
Which are possible complications of chronic gastritis?
Pernicious anemia
Gastric cancer
Decreased gastric acid secretion
Peptic ulcer disease
32
True or false
| the diagnosis of gastritis is made solely on clinical symptoms
False
33
True or false
| The onset of infection with H. pylori can result in acute gastritis
True
34
True or false
| Long-term use of acetaminophen creates a high risk for acute gastritis
False
35
True or false
| Atrophic gastritis is a type of chronic gastritis that is seen most often in older adults
True
36
The nurses teaching a patient about health promotion and maintenance to prevent gastritis. Which information does the nurse include?
1. A balanced diet can help prevent gastritis
2. If you stop smoking there is less of a chance that you will develop gastritis
3. Yoga has been found to be effective in preventing gastritis
37
The patient with chronic gastritis is being admitted. Which symptom does the nurse identifies being associated with this patient's condition?
Pernicious anemia
38
When teaching the patient about pernicious anemia which statement is the nurse include?
Pernicious anemia results in a deficiency of vitamin B 12
39
The patient comes to the emergency department reporting rapid onset of epigastric pain with nausea and vomiting. The patient says the pain is worse than any heartburn he has had, and that he has not had an appetite for the past day. What does the nurse suspect this patient has?
Acute gastritis
40
Which diagnostic test is the gold standard for diagnosing gastritis?
Esophagogastroduodenoscopy EGD
41
The nurses teaching a patient about Vantech prescriber gastritis. Which statement by the patient indicates effective teaching by the nurse?
This drug will block the secretions of my stomach
42
The patient with acute gastritis is receiving treatment of blocking buffer gastric acid secretions to relieve pain. Which drug does the nurse identify as an anti-secretory agent (proton pump inhibitor)
Omeprazole (Prilosec )
43
The nursing student caring for patient was the duodenal ulcer is about to administer proton pump inhibitor. Which statement about this medication is true?
These drugs should not be used for a prolonged period of time because they may contribute to osteoporotic related fractures
44
The nurses teaching a patient being discharged home about taking prescribed medications that include Carafate. Which statement by the patient indicates teaching has been affected?
Sulcralfate works to heal my ulcer
45
True or false
| peptic ulcer is a term used to describe all gastric and duodenal ulcers
True
46
True or false
| Prostaglandins increased stomachs resistance to ulceration
True
47
True or false
| Cushing's ulcer is a type of stress ulcer commonly seen in patients with expensive burn
False, curlings ulcer
48
True or false
| IV Pepcid or protonic's are often prescribed to prevent stress ulcers
True
49
True or false
| Hematemesis usually indicates bleeding at or below the duodenojejunal junction
False, at or above
50
True or false
| Cox 2 inhibitors such as Celebrex are less likely to cause mucosal damage to the stomach as compared to NSAIDs
True
51
Drug therapy for peptic ulcer disease is implemented for which purposes?
1. Pain relief
2. Eliminate H. pylori infection
3. Heal ulceration
4. Prevent reoccurrence
52
Magnesium hydroxide (Maalox)
Observe the patient for the side effect of diarrhea
53
Omeprazole (Prilosec )
Caution patients taking Plavix that this drug may reduce its effectiveness
54
Esomeprazole (nexium)
Assess the patient for hepatic problems because theyll need to take a lower dose of this drug
55
Misoprostol (cytotec)
Useful for patients to protect against NSAID induced ulcers
56
Which statement about the use of antacids in the treatment of gastric ulcers this true?
Avoid using antacids with phenytoin (Dilantin)
57
Patient with peptic ulcer disease is receiving Maalox . Which actions of the nurse take in regards to administering this medication?
1. Give the medication two hours after the patient meal
2. Do not give other drugs within 1 to 2 hours of antacid
3. Assess the patient for a history of renal disease before giving Maalox
4. Assess the patient for history of heart failure before giving Maalox
5. Observe the patient for the side effect of diarrhea
58
The nurses provided instructions for a patient prescribed Carafate to treat a gastric ulcer. Which statement by the patient indicated the teachings been effective?
I will take this drug on an empty stomach
59
A patient is admitted with an upper G.I. bleed. Which finding that the nurse expect to assessing the patient?
Syncope
60
The patient develops an active upper G.I. bleed. Which is a priority at the nurse takes and caring for the patient?
1. Provide oxygen
2. Start one or two large bore IV lines
3. Prepare to infuse 0.9% normal saline solution or lactated ringers solution
4. Prepare for NG tube insertion
61
When performing an assessment on a patient with an active upper GI bleed, which conditions does the nurse identify as common causes of upper GI bleeding?
1. Esophageal cancer and varices
2. Duodenal ulcer
3. Gastritis
4. Gastric cancer
62
The LPN is caring for a patient with an NG tube. The supervising nurse intervenes when the LPN attempts to perform which action?
Lubricate the tube with a petroleum based product
63
The student nurse is performing a gastric lavage on a patient with an active upper GI bleed. Which action by the student requires intervention by the supervising nurse?
Using an ice cold solution to lavage the stomach
64
Which drug is the drug of choice for aggressive acid suppression to prevent rebleeding in a patient with a gastric bleed?
Ocetreotide (sandostatin)
65
Which are findings in a patient who has Zollinger-Ellison syndrome?
1. Gastrinomas
2. Steatorrha
3. Increased amounts of gastric acid
66
The nurse is caring for several patients with gastric and duodenal ulcers. Which differential features of gastric ulcers compared to duodenal ulcers does the nurse identify?
Normal secretion or hyposecretion
| Hematemesis more common
67
The nurse is performing a physical assesment on a patient admitted to the unit with gastric cancer. Which findings indicate signs of distant metastasis?
1. Virchows nodes
2. Blumers self
3. Sister mary joseph nodes
4. Krukenberg tumor
68
The nurse is assessing a patient who has had a total gastrectomy and notes bright red blood in the NG and abdominal distention. What does the nurse do next?
Inform the surgeon of these findings
69
True or false
| Dumping syndrome is a term that refers to a group of vasometer symptoms that occur after eating
True
70
True or False
| Late dumping syndrome is caused by a release of an excessive amount of insulin
True
71
True or false
| To manage dumping syndrome, the patient needs to eliminate liquid ingested with meals
True
72
True or false
| Patients with dumping syndrome are instructed to eat a diet that is high in carbohydrates and low in fat and protein
False
73
True or false
After gastric resection, patients should be assessed for the development of atrophic glossitis which occurs secondary to vitamin B 12 deficiency
True
74
The nurse is teaching a patient with dumping syndrome about diet. Which statement by the patient indicates that teaching has been effective?
I will use sugar free gelatin with caution
75
Which statement about general principles of diet therapy for patients with dumping syndrome is true?
Patients with dumping syndrome should have liquids between meals only
76
True or false
irritable bowel syndrome is a functional G.I. disorder characterized by chronic recurrent diarrhea, constipation, and abdominal pain and bloating
True
77
True or false
| No actual pathophysiologic changes occur in IBS
True
78
True or false
| Symptoms of IBS typically begin in late adulthood
False, young adulthood
79
True or false
| IBS is the most common digestive disorder seen in clinical practice
True
80
True or false
| Most common symptom of IBS is pain in the right lower quadrant of the abdomen
False, left lower quad
81
True or false
| Hydrogen breath test maybe use in the diagnostic phase of the disease
True
82
True or false
A newer group of drugs used to manage IBS are the muscarinic receptor antagonist which act by inhibiting intestinal motility
True
83
Which drug is the drug of choice for the treatment of IBS when pain is the predominant symptom?
Amitiptyline ( Elavil)
84
The nurse is teaching a patient with IBS about complementary and alternative therapies for the disease. Which patient statments indicate that the teaching has been effective?
I should exercise regularly to help manage the disease
| Peppermint oil has been used to expel gas and relax spastic intestinal muscle
85
Reducible
Contents of the sac can be replaced in the abdominal cavity by gentle pressure
86
Femoral
A plug of fat in the femoral canal enlarges and eventually close the peritoneum and often the urinary bladder in sack
87
Umbilical
Acquired as a result of increased intra-abdominal pressure
88
Indirect inguinal
Sack forms from the peritoneum that contains a portion of the intestine I omentum. Hernia pushes downward at an angle into the inguinal canal
89
Incarcerated
Cannot be replaced back into the abdominal cavity
90
Strangulated
Blood supply to the herniated bowel segment is cut off
91
Incisional
Occurs at the site of the previous surgical incision
92
The nurses performing an abdominal assessment on a patient suspected of having an abdominal hernia. The nurse also takes the abdomen and determines the absence of bowel sounds. What does the nurse suspect in this patient?
Obstruction and strangulation
93
Which are true statements about caring for a patient with a truss?
The trusses only used after the hernia has been reduced by the physician and powder should be applied to the skin under the truss daily
94
Which activity does the nurse tell the patient to avoid after surgery for hernia repair?
Coughing
95
What do postoperative measures for a male patient who has had an inguinal herniorrhaphy include?
Elevating the scrotum on a pillow
