Chapter 54: Care of Patients with Esophageal Problems
Ignatavicius: Medical-Surgical Nursing, 8th Edition
MULTIPLE CHOICE
1.A client has been
... [Show More] taught about alginic acid and sodium bicarbonate (Gaviscon). What statement by the client indicates that teaching has been effective?
a. “I can only take this medicine at night.”
b. “I should take this on a full stomach.”
c. “This drug decreases stomach acid.”
d. “This should be taken 1 hour before meals.”
ANS: B
Gaviscon should be taken with food in the stomach. It can be taken with meals at any time. Its mechanism of action is not to decrease stomach acid.
DIF:Evaluating/SynthesisREF:1113
KEY:Gastrointestinal disorders| antacids| patient education
MSC:Integrated Process: Nursing Process: Evaluation
NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies
2.A client has returned to the nursing unit after an open Nissen fundoplication. The client has an indwelling uri- nary catheter, a nasogastric (NG) tube to low continuous suction, and two IVs. The nurse notes bright red blood in the NG tube. What action should the nurse take first?
a. Document the findings in the chart.
b. Notify the surgeon immediately.
c. Reassess the drainage in 1 hour.
d. Take a full set of vital signs.
ANS: D
The drainage in the NG tube should initially be brown with old blood. The presence of bright red blood indi- cates bleeding. The nurse should take a set of vital signs to assess for shock and then notify the surgeon. Docu- mentation should occur but is not the first thing the nurse should do. The nurse should not wait an additional hour to reassess.
DIF:Applying/ApplicationREF:1116
KEY: Gastrointestinal disorders| postoperative nursing| nursing assessment
MSC:Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
3.A client is scheduled to have a fundoplication. What statement by the client indicates a need to review preop- erative teaching?
a. “After the operation I can eat anything I want.”
b. “I will have to eat smaller, more frequent meals.”
c. “I will take stool softeners for several weeks.”
d. “This surgery may not totally control my symptoms.”
ANS: A
Nutritional and lifestyle changes need to continue after surgery as the procedure does not offer a lifetime cure.
The other statements show good understanding.
DIF:Evaluating/SynthesisREF:1117
KEY:Gastrointestinal disorders| patient education
MSC:Integrated Process: Nursing Process: Evaluation
NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation
4.A client with an esophageal tumor has difficulty swallowing and has been working with a speech-language pathologist. What assessment finding by the nurse indicates that the priority goal for this problem is being met?
a. Choosing foods that are easy to swallow [Show Less]