Nokea
A client has undergone a barium swallow test. Which would be an appropriate action by the nurse to ensure that the client does not retain any barium after a barium swallow?
- A. Placing any stool passed in a specific preservative
- B. Monitoring the stool passage and its color
- C. Observing the color of urine
- D. Monitoring the volume of urine
Correct Answer: B
Rationale: Monitoring stool passage and its color will ensure that the client eliminates barium following a barium swallow test. The white or clay color of the stool would indicate barium retention. The stool should be placed in a special preservative if the client undergoes a stool analysis. Observing the color and volume of urine will not ensure that the client is barium free because barium is not eliminated through urine but through stool.
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The nurse is reviewing the results of a Hemoccult test with the client. Which question(s) asked by the nurse is important in screening for the potential of a false-positive result? Select all that apply.
- A. Do you take an iron supplement on a daily basis?
- B. Does your diet include a moderate amount of vitamin C?
- C. Are you prescribed regular strength aspirin daily?
- D. Can you tell me the amount of alcohol that you drink on an average week?
- E. When was the last time that you included red meat in your diet?
Correct Answer: C,D,E
Rationale: When obtaining a positive Hemoccult test, the client needs to be screened for a false-positive test result. Substances that may cause a false-positive include red meat, aspirin, and excessive alcohol. Screening for the frequency and amount of these are important. False-negative results are screened in individuals who ingest ascorbic acid and iron supplements.
The nurse is instructing a client prior to a colonoscopy. The client asks, 'Why do I have to drink this disgusting liquid?' The nurse is most correct to verbalize the goal of the oral preparation as which of the following?
- A. To allow ease of passage of the scope through the colon
- B. To decrease pain associated with fecal matter being pressed against the colon wall
- C. To cleanse the bowel to promote clear visualization of structures
- D. To eliminate gas from the internal portion of the colon
Correct Answer: C
Rationale: The goal of the oral preparation is to eliminate fecal matter to visualize the colon structures. Having a clean colon free of fecal matter does allow for ease of passage of the scope and eliminates gas. The client is sedated throughout the procedure so does not experience pain.
The nurse is scheduling gastrointestinal (GI) diagnostic testing for a client. Which GI test should be scheduled first?
- A. Radiography of the gallbladder
- B. Barium enema
- C. Small bowel series
- D. Barium swallow
Correct Answer: A
Rationale: Radiography of the gallbladder should be performed before the other GI exams listed in which barium is used because residual barium tends to obscure the images of the gallbladder and its duct.
The nurse is providing care to a client who has had a percutaneous liver biopsy. For what would the nurse monitor the client?
- A. Signs and symptoms of bleeding
- B. Return of the gag reflex
- C. Passage of stool
- D. Intake and output
Correct Answer: A
Rationale: A major complication after a liver biopsy is bleeding, so it would be important for the nurse to monitor the client for signs and symptoms of bleeding. Return of the gag reflex would be important for the client who had an esophagogastroduodenoscopy to prevent aspiration. Monitoring the passage of stool would be important for a client who had a barium enema or colonoscopy. Monitoring intake and output is a general measure indicated for any client. It is not specific to a liver biopsy.
The nurse is caring for a client following a colonoscopy. During the procedure, two medium-sized polyps were removed. Which nursing assessment in the recovery area is a priority?
- A. Assessment of level of consciousness
- B. Hemoccult test of stool
- C. Vital signs
- D. Ability to tolerate liquids
Correct Answer: C
Rationale: The nurse is correct in assessing vital signs following a colonoscopy with polyp removal as a priority. Vital signs of an increased pulse rate and falling blood pressure can indicate a perforation and bleeding. If a perforation occurs and is not addressed at an early stage, the client's level of consciousness can become affected. There would be no reliable stool present in the bowel to Hemoccult test due to the cleansing agent and potential bleeding from the polyp removal. The ability to tolerate fluids relates to the sedation process and is not as high of a priority.