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The nurse educator is reviewing the blood supply of the GI tract with a group of medical nurses. The nurse is explaining the fact that the veins that return blood from the digestive organs and the spleen form the portal venous system. What large veins will the nurse list when describing this system?
- A. Splenic vein
- B. Inferior mesenteric vein
- C. Gastric vein
- D. Inferior vena cava
- E. Saphenous vein
Correct Answer: A,B,C
Rationale: This portal venous system is composed of five large veins: the superior mesenteric, inferior mesenteric, gastric, splenic, and cystic veins, which eventually form the vena portac that enters the liver. The inferior vena cava is not part of the portal system. The saphenous vein is located in the leg.
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A patient asks the nursing assistant for a bedpan. When the patient is finished, the nursing assistant notifies the nurse that the patient has bright red streaking of blood in the stool. What is this most likely a result of?
- A. Diet high in red meat
- B. Upper GI bleed
- C. Hemorrhoids
- D. Use of iron supplements
Correct Answer: C
Rationale: Lower rectal or anal bleeding is suspected if there is streaking of blood on the surface of the stool. Hemorrhoids are often a cause of anal bleeding since they occur in the rectum. Blood from an upper GI bleed would be dark rather than frank. Iron supplements make the stool dark, but not bloody and red meat consumption would not cause frank blood.
A nurse is providing preprocedure education for a patient who will undergo a lower GI tract study the following week. What should the nurse teach the patient about bowel preparation?
- A. You'll need to fast for at least 18 hours prior to your test.
- B. Starting today, take over-the-counter stool softeners twice daily.
- C. You'll need to have enemas the day before the test.
- D. For 24 hours before the test, insert a glycerin suppository every 4 hours.
Correct Answer: C
Rationale: Preparation of the patient includes emptying and cleansing the lower bowel. This often necessitates a low-residue diet 1 to 2 days before the test; a clear liquid diet and a laxative the evening before; NPO after midnight; and cleansing enemas until returns are clear the following morning.
A patient has been scheduled for a urea breath test in one month's time. What nursing diagnosis most likely prompted this diagnostic test?
- A. Impaired Dentition Related to Gingivitis
- B. Risk For Impaired Skin Integrity Related to Peptic Ulcers
- C. Imbalanced Nutrition: Less Than Body Requirements Related to Enzyme Deficiency
- D. Diarrhea Related to Clostridium Difficile Infection
Correct Answer: B
Rationale: Urea breath tests detect the presence of Helicobacter pylori, the bacteria that can live in the mucosal lining of the stomach and cause peptic ulcer disease. This test does not address fluid volume, nutritional status, or dentition.
A patient who has been experiencing changes in his bowel function is scheduled for a barium enema. What instruction should the nurse provide for postprocedure recovery?
- A. Remain NPO for 6 hours postprocedure.
- B. Administer a Fleet enema to cleanse the bowel of the barium.
- C. Increase fluid intake to evacuate the barium.
- D. Avoid dairy products for 24 hours postprocedure.
Correct Answer: C
Rationale: Adequate fluid intake is necessary to rid the GI tract of barium. The patient must not remain NPO after the test and enemas are not used to cleanse the bowel of barium. There is no need to avoid dairy products.
A patient has been brought to the emergency department with abdominal pain and is subsequently diagnosed with appendicitis. The patient is scheduled for an appendectomy but questions the nurse about how his health will be affected by the absence of an appendix. How should the nurse best respond?
- A. Your appendix doesn't play a major role, so you won't notice any difference after you recovery from surgery.
- B. The surgeon will encourage you to limit your fat intake for a few weeks after the surgery, but your body will then begin to compensate.
- C. Your body will absorb slightly fewer nutrients from the food you eat, but you won't be aware of this.
- D. Your large intestine will adapt over time to the absence of your appendix.
Correct Answer: A
Rationale: The appendix is an appendage of the cecum (not the large intestine) that has little or no physiologic function. Its absence does not affect digestion or absorption.