Nokea
A patient was treated in the emergency department and critical care unit after ingesting bleach. What possible complication of the resulting gastritis should the nurse recognize?
- A. Esophageal or pyloric obstruction related to scarring
- B. Uncontrolled proliferation of H. pylori
- C. Gastric hyperacidity related to excessive gastrin secretion
- D. Chronic referred pain in the lower abdomen
Correct Answer: A
Rationale: A severe form of acute gastritis is caused by the ingestion of strong acid or alkali, which may cause the mucosa to become gangrenous or to perforate. Scarring can occur, resulting in pyloric stenosis (narrowing or tightening) or obstruction. Chronic referred pain to the lower abdomen is a symptom of peptic ulcer disease, but would not be an expected finding for a patient who has ingested a corrosive substance. Bacterial proliferation and hyperacidity would not occur.
You may also like to solve these questions
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.
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.
A patient who is obese has been unable to lose weight successfully using lifestyle modifications and has mentioned the possibility of using weight-loss medications. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity?
- A. Weight loss drugs have many side effects, and most doctors think theyll all be off the market in a few years.
- B. There used to be a lot of hope that medications would help people lose weight, but its been shown to be mostly a placebo effect.
- C. Medications can be helpful, but few people achieve and maintain their desired weight loss with medications alone.
- D. Medications are rapidly become the preferred method of weight loss in people for whom diet and exercise have not worked.
Correct Answer: C
Rationale: Though antiobesity drugs help some patients lose weight, their use rarely results in loss of more than 10% of total body weight. Patients are consequently unlikely to attain their desired weight through medication alone. They are not predicted to disappear from the market and results are not attributed to a placebo effect.
A patient presents to the walk-in clinic complaining of vomiting and burning in her mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the physician is likely to order a diagnostic test to detect the presence of what?
- A. Infection with Helicobacter pylori
- B. Excessive stomach acid secretion
- C. An incompetent pyloric sphincter
- D. A metabolic acid-base imbalance
Correct Answer: A
Rationale: H. pylori infection may be determined by endoscopy and histologic examination of a tissue specimen obtained by biopsy, or a rapid urease test of the biopsy specimen. Excessive stomach acid secretion leads to gastritis; however, peptic ulcers are caused by colonization of the stomach by H. pylori. Sphincter dysfunction and acid-base imbalances do not cause peptic ulcer disease.