PrepU Ch. 45-Caring for Clients with Disorders of the Upper Gastrointestinal Tract
A client is admitted to the hospital with an exacerbation of his
... [Show More] chronic gastritis. When assessing his
nutritional status, the nurse should expect a deficiency in:
vitamin B12.
Explanation:
The nurse should expect vitamin B12 deficiency. Injury to the gastric mucosa causes gastric atrophy and
impaired function of the parietal cells. These changes result in reduced production of intrinsic factor,
which is necessary for the absorption of vitamin B12. Eventually, pernicious anemia will occur.
Deficiencies in vitamins A, B6, and C aren't expected in a client with chronic gastritis.
A client has received a diagnosis of oral cancer. During client education, the client expresses dismay at
not having recognized any early signs or symptoms of the disease. The nurse tells the client that in early
stages of this disease:
there are usually no symptoms.
Explanation:
The early stage of oral cancer is characteristically asymptomatic.
The nurse prepares to administer all of a client's medications via feeding tube. The nurse consults the
pharmacist and/or physician when the nurse notes which type of oral medication on the client's
medication administration record?
enteric-coated tablets
Explanation:
Enteric-coated tablets are meant to be digested in the intestinal tract and may be destroyed by stomach
acids. A change in the form of medication is necessary for clients with tube feedings. Simple compressed
tablets may be crushed and dissolved in water for clients receiving oral medications by feeding tube.
Buccal or sublingual tablets are absorbed by mucous membranes and may be given as intended to the
client undergoing tube feedings. The nurse may make an opening in the capsule and squeeze out
contents for administration by feeding tube.
The nurse is inserting a nasogastric tube for a patient with pancreatitis. What intervention can the nurse
provide to allow facilitation of the tube insertion?
Allow the patient to sip water as the tube is being inserted.
Explanation:
During insertion, the patient usually sits upright with a towel or other protective barrier spread in a
biblike fashion over the chest. The nostril may be swabbed or the oropharynx sprayed with an anesthetic
agent to numb the nasal passage and suppress the gag reflex. The tip of the patient’s nose is tilted
upward, and the tube is aligned to enter the nostril. When the tube reaches the nasopharynx, the
patient is instructed to lower the head slightly and, if able, to begin to swallow as the tube is advanced.
The patient may also be encouraged to sip water through a straw to facilitate advancement of the tube if
this action is not contraindicated.
A patient taking metronidazole (Flagyl) for the treatment of H. pylori states that the medication is
causing nausea. What suggestion can the nurse provide to the patient to alleviate this problem?
Take the medication with meals to decrease the nausea.
Explanation:
Metronidazole (Flagyl) should be administered with meals to decrease GI upset.
A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for
peptic ulcers, the nurse should mention:
alcohol abuse and smoking.
Explanation:
The nurse should mention that risk factors for peptic (gastric and duodenal) ulcers include alcohol abuse,
smoking, and stress. A sedentary lifestyle and a history of hemorrhoids aren't risk factors for peptic
ulcers. Chronic renal failure, not acute renal failure, is associated with duodenal ulcers.
To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which
discharge instruction?
"Avoid coffee and alcoholic beverages."
Explanation:
To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods
and beverages that increase stomach acid, such as coffee and alcohol. The nurse also should teach the
client to avoid lying down after meals, which can aggravate reflux, and to take antacids after eating. The
client need not limit fluid intake with meals as long as the fluids aren't gastric irritants.
Which is an accurate statement regarding cancer of [Show Less]