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A patient comes to the bariatric clinic to obtain information about bariatric surgery. The nurse assesses the obese patient knowing that in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate what?
- A. Knowledge of the causes of obesity and its associated risks
- B. Adequate understanding of required lifestyle changes
- C. Positive body image and high self-esteem
- D. Insight into why past weight loss efforts failed
Correct Answer: B
Rationale: Patients seeking bariatric surgery should be free of serious mental disorders and motivated to comply with lifestyle changes related to eating patterns, dietary choices, and elimination. While assessment of knowledge about causes of obesity and its associated risks as well as insight into the reasons why previous diets have been ineffective are included in the clients plan of care, these do not predict positive client outcomes following bariatric surgery. Most obese patients have an impaired body image and alteration in self-esteem. An obese patient with a positive body image would be unlikely to seek this surgery unless he or she was experiencing significant comorbidities.
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A patient has been diagnosed with peptic ulcer disease and the nurse is reviewing his prescribed medication regimen with him. What is currently the most commonly used drug regimen for peptic ulcers?
- A. Bismuth salts, antivirals, and histamine-2 (H2) antagonists
- B. H2 antagonists, antibiotics, and bicarbonate salts
- C. Bicarbonate salts, antibiotics, and ZES
- D. Antibiotics, proton pump inhibitors, and bismuth salts
Correct Answer: D
Rationale: Currently, the most commonly used therapy for peptic ulcers is a combination of antibiotics, proton pump inhibitors, and bismuth salts that suppress or eradicate H. pylori. H2 receptor antagonists are used to treat NSAID-induced ulcers and other ulcers not associated with H. pylori infection, but they are not the drug of choice. Bicarbonate salts are not used. ZES is the Zollinger-Ellison syndrome and not a drug.
A nurse is presenting a class at a bariatric clinic about the different types of surgical procedures offered by the clinic. When describing the implications of different types of surgeries, the nurse should address which of the following topics? Select all that apply.
- A. Specific lifestyle changes associated with each procedure
- B. Implications of each procedure for eating habits
- C. Effects of different surgeries on bowel function
- D. Effects of various bariatric surgeries on fertility
- E. Effects of different surgeries on safety of future immunizations
Correct Answer: A,B,C
Rationale: Different bariatric surgical procedures entail different lifestyle modifications; patients must be well informed about the specific lifestyle changes, eating habits, and bowel habits that may result from a particular procedure. Bariatric surgeries do not influence the future use of immunizations or fertility, though pregnancy should be avoided for 18 months after bariatric surgery.
A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medications therapeutic action?
- A. This medication will reduce the amount of acid secreted in your stomach.
- B. This medication will make the lining of your stomach more resistant to damage.
- C. This medication will specifically address the pain that accompanies peptic ulcer disease.
- D. This medication will help your stomach lining to repair itself.
Correct Answer: A
Rationale: Proton pump inhibitors like Prilosec inhibit the synthesis of stomach acid. PPIs do not increase the durability of the stomach lining, relieve pain, or stimulate tissue repair.
A patient is one month postoperative following restrictive bariatric surgery. The patient tells the clinic nurse that he has been having trouble swallowing for the past few days. What recommendation should the nurse make?
- A. Eating more slowly and chewing food more thoroughly
- B. Taking an OTC antacid or drinking a glass of milk prior to each meal
- C. Chewing gum to cause relaxation of the lower esophageal sphincter
- D. Drinking at least 12 ounces of liquid with each meal
Correct Answer: A
Rationale: Dysphagia may be prevented by educating patients to eat slowly, to chew food thoroughly, and to avoid eating tough foods such as steak or dry chicken or doughy bread. After bariatric procedures, patients should normally not drink beverages with meals. Medications or chewing gum will not alleviate this problem.
A nurse is providing care for a patient who is postoperative day 2 following gastric surgery. The nurses assessment should be planned in light of the possibility of what potential complications? Select all that apply.
- A. Malignant hyperthermia
- B. Atelectasis
- C. Pneumonia
- D. Metabolic imbalances
- E. Chronic gastritis
Correct Answer: B,C,D
Rationale: After surgery, the nurse assesses the patient for complications secondary to the surgical intervention, such as pneumonia, atelectasis, or metabolic imbalances resulting from the GI disruption. Malignant hyperthermia is an intraoperative complication. Chronic gastritis is not a surgical complication.