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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.
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A nurse in the postanesthesia care unit admits a patient following resection of a gastric tumor. Following immediate recovery, the patient should be placed in which position to facilitate patient comfort and gastric emptying?
- A. Fowlers
- B. Supine
- C. Left lateral
- D. Left Sims
Correct Answer: A
Rationale: Positioning the patient in a Fowlers position postoperatively promotes comfort and facilitates emptying of the stomach following gastric surgery. Any position that involves lying down delays stomach emptying and is not recommended for this type of patient. Supine positioning and the left lateral (left Sims) position do not achieve this goal.
A nurse is caring for a patient hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize?
- A. Strategies for maintaining an alkaline gastric environment
- B. Safe technique for self-suctioning
- C. Techniques for positioning correctly to promote gastric healing
- D. Strategies for avoiding irritating foods and beverages
Correct Answer: D
Rationale: Measures to help relieve pain include instructing the patient to avoid foods and beverages that may be irritating to the gastric mucosa and instructing the patient about the correct use of medications to relieve chronic gastritis. An alkaline gastric environment is neither possible nor desirable. There is no plausible need for self-suctioning. Positioning does not have a significant effect on the presence or absence of gastric healing.
A community health nurse is preparing for an initial home visit to a patient discharged following a total gastrectomy for treatment of gastric cancer. What would the nurse anticipate that the plan of care is most likely to include?
- A. Enteral feeding via gastrostomy tube (G tube)
- B. Gastrointestinal decompression by nasogastric tube
- C. Periodic assessment for esophageal distension
- D. Monthly administration of injections of vitamin B12
Correct Answer: D
Rationale: Since vitamin B12 is absorbed in the stomach, the patient requires vitamin B12 replacement to prevent pernicious anemia. A gastrectomy precludes the use of a G tube. Since the stomach is absent, a nasogastric tube would not be indicated. As well, this is not possible in the home setting. Since there is no stomach to act as a reservoir and fluids and nutrients are passing directly into the jejunum, distension is unlikely.
A nurse is preparing to discharge a patient after recovery from gastric surgery. What is an appropriate discharge outcome for this patient?
- A. The patients bowel movements maintain a loose consistency.
- B. The patient is able to tolerate three large meals a day.
- C. The patient maintains or gains weight.
- D. The patient consumes a diet high in calcium.
Correct Answer: C
Rationale: Expected outcomes for the patient following gastric surgery include ensuring that the patient is maintaining or gaining weight (patient should be weighed daily), experiencing no excessive diarrhea, and tolerating six small meals a day. Patients may require vitamin B12 supplementation by the intramuscular route and do not require a diet excessively rich in calcium.
A patient has experienced symptoms of dumping syndrome following bariatric surgery. To what physiologic phenomenon does the nurse attribute this syndrome?
- A. Irritation of the phrenic nerve due to diaphragmatic pressure
- B. Chronic malabsorption of iron and vitamins A and C
- C. Reflux of bile into the distal esophagus
- D. A sudden release of peptides
Correct Answer: D
Rationale: For many years, it had been theorized that the hypertonic gastric food boluses that quickly transit into the intestines drew extracellular fluid from the circulating blood volume into the small intestines to dilute the high concentration of electrolytes and sugars, resulting in symptoms. Now, it is thought that this rapid transit of the food bolus from the stomach into the small intestines instead causes a rapid and exuberant release of metabolic peptides that are responsible for the symptoms of dumping syndrome. It is not a result of phrenic nerve irritation, malabsorption, or bile reflux.