What should the nurse do before infusing a brevity flow tube feeding using a large syringe you should?

Check for placement

 The nurse explains that the newest endoscopic procedure for examining the small intestine is?

   Video capsule – it is swallowed by the pt to provide a view of the small intestine

    What risk factors are involved that increase the chances of developing oral cancer?

   What is the initial care for a postoperative patient who has had lesions removed from his mouth and has just returned to the unit?

   Monitor respiratory status, use solution to keep oral mucosa moist and be alert for signs of infection.

   What could result for a client who has esophageal cancer tilts his head back while eating.

             Aspiration

  The nurse caring for a patient with esophageal surgery who has had stents placed in the esophagus instructs the patient how best to avoid regurgitation, your instruction should include?

Erect position, head tilted slightly forward, quiet relaxed environment, High calories/high protein diet, semisolid food.

    What precautionary implementations, after administering promethazine (Phenergan) for nausea should the nurse take because of the common side effect of antiemetics?

Monitor respiratory status, I&O, cardiac status and CBC –

use caution with asthma, glaucoma and prosthetic hypertrophy

  What instruction should be included in your teaching plan that would be used for a client with a hiatal hernia to help reduce complaints of heartburn, regurgitation, and eructation.

NPO (food or liquids) 2-3 hrs before bedtime, sleep with head elevated 6-12 inches**

Small frequent meals, avoid foods that are known to increase LES pressure, fatty foods, coffee, teas, caffeine and alcohol

The 40-year-old Client just been diagnosed with cancer of the stomach says, “I feel blank and numb.”  How would you respond?  (Hint: Psych question)

On assessment, what should be reported of an inguinal hernia immediately?

Signs and symptoms of strangulation – nausea, pain, abdominal distention, fever and tachycardia

  The goal for your client with gastritis who has experienced nausea, vomiting, and diarrhea is to have a return of normal elimination patterns. A goal that reflects a measurable amount?

Monitor I&O ratios  - combination of prolosec and antibiotics, corticordsteriods and b12 injections to prevent complications, a bland diet in 6 small feedings per day.  H2 receptor blockers, proton pump receptors

   The nurse is caring for a patient hemorrhaging from a peptic ulcer when the patient complains of sharp sudden pain, with a rapidly deteriorating condition. Initially you should

Suspect a perforation, notify the doctor, start gastric decompression and iv fluids and antibiotics. Monitor vitals.

What is the process when you collect several stool specimens that are to go to the laboratory?

Collect in a clean, dry container without any urine or toilet tissue in the container, deliver it to the laboratory immediately, instruct pt. not to eat red meat for 2-3 days before sample collection – if testing for occult blood, if visible blood or mucus is present in stool include it in specimen to be sent to the lab, have the container labeled with pt name and date.

Your 44-year-old client admitted with severe diarrhea and fatigue, which has been going on for several days, why would diarrhea cause chronic fatigue?

Because it interferes with absorption of nutrients and can lead to malnutrition and anemia

The client inquires if gastric analysis is going to require multiple withdrawals of gastric content for evaluation of the presence of hydrochloric acid throughout the day, your response?

   The most appropriate way to ensure effectiveness of Stool softeners to promote normal elimination of feces would be?

To only use for occasional constipation, if they are used regularly they will interfere with normal elimination.  Try high fiber foods, drinking at least 8 glass of water, and exercise first.

 The best indication that a client with intestinal obstruction has achieved normal hydration would be?  

Equal fluid input/output, b/p and pulse within pt’s norms, moist mucus membranes

The nurse caring for a patient with a 3-day postoperative bowel resection observes that the suction apparatus is not working and the patient is becoming distended. What is the initial implementation you would do?

Notify the physican immediately, digestive fluids may be leaking into the thoracic or abdominal cavity.

   How can you best achieve after abdominal surgery, your patients’ ability to cough and take deep breaths?

  A medication commonly used to treat IBD is? 

   What are risk factors in an older man that puts him at risk for developing diverticulosis?

What client teaching should be included about avoidance to promote self-care of Client with diverticulitis?

Avoid spicy foods, seeds and opiods.

 What complication would the nurse monitor for after a liver biopsy?

Hemorrhage and pneumothorax

 Pruritus in clients with hepatitis is related how?

It’s associated with jaundice, due to the high bilirubin levels which deposit the bile salts under the skin and cause itching

 What would your plan be to prevent complications in a hepatitis patient on bed rest?

Teach the pt to cough and deep breathe q2h to reduce risk of pneumonia, gentle leg exercises to promote circulation and discourage thrombi, discourage crossing of legs, keep records of bowel movements and I&O’s, asses skin for signs of pressure sores

What sign would be a contraindication for the need of increased fluid intake?

Edema or ascites increased abdominal girth

   The patient with jaundice has a nursing diagnosis for impaired skin integrity, what intervention can be used:

Measures to relieve pruritus that may accompany jaundice such as:  mild soap, application of moisturizing lotions, cotton gloves on hands.

  The Occupational Health and Safety Administration (OSHA) has a requirement that all health care providers have the vaccination for? 

Hepatitis B

  A dropping bilirubin level in a patient with hepatitis means?

What reason is promoting rest a goal of medical treatment for patients with cirrhosis which is to prevent complications and limit cell damage.

To limit deterioration of liver function and to prevent complications.

 What diet modification is used to combat the continued rise in ammonia levels in the cirrhotic Client?

Protein is restricted, supplements

     How would you assess the progress of ascites on a daily basis?

Asses respiratory status and Input and output ratio, check labs for electrolyte imbalances

 Why will a LeVeen peritoneal-venous shunt be done instead of a paracentesis for a client with ascites?

    High ammonia level contributes to hepatic encephalopathy. As this level increases, what nursing implementation must be considered?

Reduction of the ammonia levels with lactulose

Patients with hepatitis A should avoid sharing?

Water, food and medical equipment

The nursing measure that takes priority in relation to the care of a patient with an gastroesophageal balloon tube?

Risk for infection ??  bc of inserting a foreign object into the body?  Important to remove old blood from the stomach so it will not be digested, also gastric suctioning to reduce the risk of vomiting which would force the balloon out of place.

The instruction that should be given to the patient with portal hypertension to reduce the threat of hemorrhage?

   The nurse who has a client with hepatitis B should initiate what precaution?

Standard (gown, gloves, mask)

    The patient was positive for hepatitis B virus although she had the disease 4 years ago and now is symptom-free, can you explain this disease state? 

     The nurse sees a laboratory report showing an elevation that is diagnostic for acute pancreatitis, what test is this?

  In planning care for the patient with pancreatitis, the nurse assigns the highest priority to?

Signs of hypovolemic shock – restlessness, trachycardia, tachypnea, hypotension, decreased urinary output.

    The nurse reports the observation that would indicate blocked flow of bile from the liver to the intestine, which is?