Gastrointestinal Problems

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention?

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply.

1. Diarrhea
2. Black, tarry stools
3. Hyperactive bowel sounds
4. Gray-blue color at the flank
5. Abdominal guarding and tenderness
6. Left upper quadrant pain with radiation to the back

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations support this diagnosis? Select all that apply.

1. Fever
2. Positive Cullen’s sign
3. Complaints of indigestion
4. Palpable mass in the left upper quadrant
5. Pain in the upper right quadrant after a fatty meal
6. Vague lower right quadrant abdominal discomfort

A client is diagnosed with viral hepatitis, complaining of “no appetite” and “losing my taste for food.” What instruction should the nurse give the client to provide adequate nutrition?

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding?

A client has just had a hemorrhoidectomy. Which nursing interventions are appropriate for this client? Select all that apply.

1. Administer stool softeners as prescribed.
2. Instruct the client to limit fluid intake to avoid urinary retention.
3. Encourage a high-fiber diet to promote bowel movements without straining.
4. Apply cold packs to the anal-rectal area over the dressing until the packing is removed.
5. Help the client to a Fowler’s position to place pressure on the rectal area and decrease bleeding.

The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items should the nurse include on this list? Select all that apply.

1. Coffee
2. Chocolate
3. Peppermint
4. Nonfat milk
5. Fried chicken
6. Scrambled eggs

A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client’s care plan?

The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs further information if the client makes which statement?

The primary health care provider has determined that a client has contracted hepatitis A based on flu-like symptoms and jaundice. Which statement made by the client supports this medical diagnosis?

The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is most appropriate?

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer?

The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which postoperative prescription should the nurse question and verify?

The nurse is providing discharge instructions to a client following gastrectomy and should instruct the client to take which measure to assist in preventing dumping syndrome?

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply.

1. Maintain NPO (nothing by mouth) status.
2. Encourage coughing and deep breathing.
3. Give small, frequent high-calorie feedings.
4. Maintain the client in a supine and flat position.
5. Give hydromorphone intravenously as prescribed for pain.
6. Maintain intravenous fluids at 10 mL/hr to keep the vein open.

The nurse is providing discharge teaching for a client with newly diagnosed Crohn’s disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction?

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence?

The nurse is reviewing the laboratory results for a client with cirrhosis and notes tha the ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to the client?

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which manifestation of duodenal ulcer?

A client with hiatal hernia chronically experiences heartburn following meals. The nurse should plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia?

The nurse is providing care for a client with a recent transverse colostomy. Which observation requires immediate notification of the primary health care provider?

A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?

A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery?

The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome (IBS). Which statement by the client indicates a need for further teaching?

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence?