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An adult patient is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the patient has completed the test?
- A. Stool will be yellow for the first 24 hours postprocedure.
- B. The barium may cause diarrhea for the next 24 hours.
- C. Fluids must be increased to facilitate the evacuation of the stool.
- D. Slight anal bleeding may be noted as the barium is passed.
Correct Answer: C
Rationale: Postprocedural patient education includes information about increasing fluid intake; evaluating bowel movements for evacuation of barium; and noting increased number of bowel movements, because barium, due to its high osmolarity, may draw fluid into the bowel, thus increasing the intraluminal contents and resulting in greater output. Yellow stool, diarrhea, and anal bleeding are not expected.
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The nurse is caring for a patient who has a diagnosis of AIDS. Inspection of the patient's mouth reveals the new presence of white lesions on the patient's oral mucosa. What is the nurse's most appropriate response?
- A. Encourage the patient to gargle with salt water twice daily.
- B. Attempt to remove the lesions with a tongue depressor.
- C. Make a referral to the unit's dietitian.
- D. Inform the primary care provider of this finding.
Correct Answer: D
Rationale: The nurse should inform the primary care provider of this abnormal finding in the patient's oral cavity, since it necessitates medical treatment. It would be inappropriate to try to remove skin lesions from a patient's mouth and salt water will not resolve this problem, which is likely due to candidiasis. A dietitian referral is unnecessary.
A patient with a recent history of intermittent bleeding is undergoing capsule endoscopy to determine the source of the bleeding. When explaining this diagnostic test to the patient, what advantage should the nurse describe?
- A. The test allows visualization of the entire peritoneal cavity.
- B. The test allows for painless biopsy collection.
- C. The test does not require fasting.
- D. The test is noninvasive.
Correct Answer: D
Rationale: Capsule endoscopy allows the noninvasive visualization of the mucosa throughout the entire small intestine. Bowel preparation is necessary and biopsies cannot be collected. This procedure allows visualization of the entire GI tract, but not the peritoneal cavity.
Probably the most widely used in-office or at-home occult blood test is the Hemoccult II. The patient has come to the clinic because he thinks there is blood in his stool. When you reviewed his medications, you noted he is on antihypertensive drugs and NSAIDs for early arthritic pain. You are sending the patient home with the supplies necessary to perform 2 hemoccult tests on his stool and mail the samples back to the clinic. What instruction would you give this patient?
- A. Take all your medications as usual.
- B. Take all your medications except the antihypertensive medications.
- C. Don't eat highly acidic foods 72 hours before you start the test.
- D. Avoid vitamin C for 72 hours before you start the test.
Correct Answer: D
Rationale: Red meats, aspirin, nonsteroidal anti-inflammatory drugs, turnips, and horseradish should be avoided for 72 hours prior to the study, because they may cause a false-positive result. Also, ingestion of vitamin C from supplements or foods can cause a false-negative result. Acidic foods do not need to be avoided.
The nurse is providing health education to a patient scheduled for a colonoscopy. The nurse should explain that she will be placed in what position during this diagnostic test?
- A. In a knee-chest position (lithotomy position)
- B. Lying prone with legs drawn toward the chest
- C. Lying on the left side with legs drawn toward the chest
- D. In a prone position with two pillows elevating the buttocks
Correct Answer: C
Rationale: For best visualization, colonoscopy is performed while the patient is lying on the left side with the legs drawn up toward the chest. A knee-chest position, lying on the stomach with legs drawn to the chest, and a prone position with two pillows elevating the legs do not allow for the best visualization.
A nurse is caring for a patient who is scheduled for a colonoscopy and whose bowel preparation will include polyethylene glycol electrolyte lavage prior to the procedure. The presence of what health problem would contraindicate the use of this form of bowel preparation?
- A. Inflammatory bowel disease
- B. Intestinal polyps
- C. Diverticulitis
- D. Colon cancer
Correct Answer: A
Rationale: The use of a lavage solution is contraindicated in patients with intestinal obstruction or inflammatory bowel disease. It can safely be used with patients who have polyps, colon cancer, or diverticulitis.