PNP 102 Inflammatory/GI Review

A nurse is reinforcing teaching with a client who has gastroesophageal reflux disease (GERD) about minimizing the effects of reflux during sleep. Which of the following client statements indicates an understanding of the teaching?

• "I will have a snack 1 hour before going to bed."

• "I should elevate the head of the bed."

• "I can have 6 ounces of alcohol before bed, to help me sleep."

• "I will sleep on my stomach with my head flat."

Answer explanation

The nurse should recommend the client elevate the head of the bed on 10 to 15 cm (4 to 6 in) blocks. This will allow gravity to assist in preventing the reflux of gastric contents into the esophagus.

A nurse is reinforcing dietary teaching with a client who has GERD. Which of the following food choices by the client indicates an understanding of the teaching?

• Spaghetti with red sauce

• Lemon pepper fish

• Corned beef brisket

• Baked turkey breast

Answer explanation

The nurse should reinforce that the client should choose foods that do not cause relaxation of the lower esophageal sphincter to minimize reflux. Food should be consumed slowly and in small amounts. A serving of baked turkey breast is low in fat and provides adequate protein.

A nurse is reinforcing teaching a client who is scheduled for a barium swallow to evaluate dysphagia. Which of the following statements should indicate to the nurse that the client understands the instructions?

• "I will expect a warm feeling when the dye is injected."

• "I will drink plenty of fluids after the test."

• "I will maintain a clear liquid diet 24 hours before the test."

• "I will expect my stool to be black after this procedure."

Answer explanation

The client should drink plenty of fluids after the barium swallow to promote elimination of the barium and prevent constipation.

Ensure that you review the nursing considerations of a barium swallow.

​A nurse is reinforcing dietary instructions with a client who has episodes of right upper quadrant pain from chronic cholecystitis. Which of the following diets should the nurse reinforce in the teaching plan?

• A high protein diet

• A high fiber diet

• A low fat diet

• A low sodium diet

Answer explanation

The nurse should instruct the client to consume a low fat diet to decrease episodes of biliary colic. Clients who have chronic cholecystitis can experience pain and flatulence after consuming fatty foods.

A nurse is collecting data from a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Which of the following findings is expected for this condition?

• Fatty stools

• Straw-colored urine

• Tenderness in the left upper abdomen

• Ecchymosis of the extremities

Answer explanation

An expected client finding is fatty stools due to biliary obstruction, causing a lack of bile for the absorption of fats in the intestines

A nurse is reinforcing teaching about an esophagogastroduodenoscopy with a client who has upper gastric pain. Which of the following statements should the nurse include in the teaching?

• "A flexible tube is introduced through the nose during the procedure."

• "During the procedure you are in a sitting position."

• "You will remain NPO for 8 hours before the procedure."

• "You will be awake while the procedure is performed."

Answer explanation

The nurse should include in the teaching for the client to remain NPO for 8 hr before the procedure to have the stomach free of food contents, decrease vomiting, and decrease the risk for aspiration.

A nurse is reinforcing teaching about cimetidine with a client who has peptic ulcer disease. Which of the following information should the nurse include in the teaching?

• Wait at least 1 hr after taking the medication before taking an antacid.

• Expect breast tenderness while taking this medication.

• Take this medication on an empty stomach.

• Take ibuprofen for occasional aches and pains.

Answer explanation

The nurse should instruct the client to wait at least 1 hr after taking cimetidine before taking an antacid. These medications can decrease absorption of the medication

A nurse is reinforcing teaching a client who has peptic ulcer disease and is starting therapy with sucralfate. Which of the following instructions should the nurse include in the teaching?

• Take the medication with an antacid.

• Take the medication 1 hr before meals.

• Store the medication in the refrigerator.

• Take as needed for pain relief.

Answer explanation

The nurse should instruct the client to take sucralfate on an empty stomach, 1 hr before meals, and at bedtime for maximum effectiveness.

Are there any other meds we should take 1 hour before meals?

A nurse is collecting data from a client in the health clinic who is reporting epigastric pain. Which of the following statements made by the client should the nurse identify as being consistent with peptic ulcer disease?

• "The pain is worse after I eat a meal high in fat."

• "My pain is relieved by having a bowel movement."

• "I feel so much better after eating."

• "The pain radiates down to my lower back."

Answer explanation

A client who has peptic ulcer disease usually experiences pain when the stomach is empty, 2 to 3 hr after meals or in the middle of the night. It is usually relieved by eating.

A charge nurse is reinforcing teaching with a newly licensed nurse about the common link between ulcerative colitis and Crohn's disease. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

• "Both illnesses are inflammatory in nature."

• "Both illnesses begin in the rectum."

• "Both illnesses manifest fistula formation."

• "Both illnesses result in malabsorption of nutrients."

Answer explanation

The nurse should reinforce that there are many linking components between ulcerative colitis and Crohn’s disease, one of them being the inflammatory nature of the illnesses. Other similarities include a genetic component, the chronicity of the illnesses, and the predominant manifestation of both diseases is diarrhea.