GI Review Spring 24

The nurse is caring for a client who is diagnosed with a complete small bowel obstruction. For what priority problem is this client most likely at risk?

• Nausea

• Electrolyte imbalance

• Obstipation

• Abdominal distenstion

Answer explanation

The client who has a small bowel obstruction is at the highest risk for fluid and electrolyte imbalances, especially dehydration and hypokalemia due to profuse vomiting. Nausea, abdominal distention, and obstipation are also usually present, but these problems are not as life threatening as the imbalances in electrolytes.

Esophagogastroduodenoscopy (EGD) with biopsy is the gold standard for diagnosing gastritis.

• True

• False

Which signs and symptoms would the nurse expect when assessing a client diagnosed with celiac disease? (Select all that apply.)

• Diarrhea

• Constipation

• Anorexia

• Abdominal pain

• Anal fistula

Answer explanation

Signs and symptoms of celiac disease include anorexia, constipation and/or diarrhea, and abdominal pain. Anal fistulas are not associated with celiac disease.

A nurse cares for a client who has a new colostomy. Which action would the nurse take?

• Change the ostomy pouch and barrier every morning.

• Allow the pouch to completely fill with stool prior to emptying it.

• Empty the pouch frequently to remove excess gas collection.

• Use surgical tape to secure the pouch and prevent leakage.

Answer explanation

The nurse would empty the new ostomy pouch frequently because of excess gas collection, and empty the pouch when it is one-third to one-half full of stool. The ostomy pouch does not need to be changed every morning. Ostomy barriers would be used to secure and seal the ostomy appliance; surgical tape would not be used.

The nurse is teaching a client how to avoid the formation of hemorrhoids. What lifestyle change would the nurse not include?

• Avoiding alcohol

• Quitting smoking

• Increasing dietary fiber

• Decreasing fluid intake

Answer explanation

The major cause of hemorrhoid formation is constipation. Therefore, the nurse teaches the client ways to prevent constipation, which include increasing dietary fiber, increasing exercise and fluid intake, and avoiding straining when have a stool.

Which actions would the nurse include in the plan of care of an older adult client diagnosed with complications of diverticulitis? (Select all that apply.)

• Evaluate stools for occult blood.

• Palpate the abdomen for distention.

• Provide the client with a low-fiber diet.

• Administer pain medications as prescribed.

• Assess for sudden changes in mental status.

Answer explanation

When caring for an older adult who has diverticulitis, the nurse would administer analgesics as prescribed, palpate the abdomen for distention and tenderness, assess for confusion and sudden changes in mental status, and check stools for occult or frank bleeding. A low-fiber/residue diet would be provided when symptoms are present and a high-fiber diet when inflammation resolves.

A common drug regimen to treat H. pylori infection is PPI-triple therapy, which includes _________ and __________ for 10 to 14 days.

Answer explanation

Triple therapy includes one proton-pump inhibitor and two antibiotics.

A nurse cares for a patient who has a chronic inflammatory bowel disease. Which actions would the nurse take to prevent skin excoriation? (Select all that apply.)

• Identify foods that increase diarrhea.

• Use medicated wipes instead of toliet paper.

• Gently pat perineum dry after cleansing.

• Apply a thin coat of aloe cream to the perineum.

• Cleanse the perineum with an antibacterial soap.

Answer explanation

To prevent skin excoriation from frequent bowel movements associated with inflammatory bowel disease, the nurse would encourage good skin care with a mild soap and water and gently patting the area dry after each bowel movement. Using medicated wipes instead of toilet paper and applying a thin coat of aloe cream are appropriate. The client should identify and avoid foods that increase diarrhea. Antibacterial soaps are harsh and should not be used.

Eliminating the causative factor(s) is the primary treatment approach for acute gastritis.

• True

• False

Which action will the nurse teach a client with GERD to minimize symptoms? (Select all that apply.)

• Restrict caffeinated or carbonated beverages.

• Eat slowly and chew food thoroughly.

• Consume 4 to 6 small meals each day.

• Do not eat for 3 hours before going to bed.

• Sleep on your side to prevent regurgitation.

Answer explanation

The client with GERD can benefit from restricting or avoiding carbonanted beverages which can irritate tissues. Eating slowly and chewing food thoroughly can assist with digestion, as can consuming small meals daily instead of large meals that can induce reflux. Avoidance of eating 3 hours before bed can minimize the incidence of GERD. The client must be taught to sleep propped up to promote gas exchange and prevent regurgitation rather than laying on the side. This can be done by placing blocks under the head of the bed or by using a large, wedge-style pillow instead of a standard pillow.