Diet & Nutrition
This type of diet, low in fat and high in protein, is recommended for patients with GERD to reduce lower esophageal sphincter relaxation.
What is a low-fat, high-protein diet?
This class of drugs, ending in "-prazole," must be taken 30 to 60 minutes before the first meal of the day.
What are proton pump inhibitors (PPIs)?
This disease is suggested by heartburn, regurgitation, a morning sour taste, and hoarseness that worsen after large meals and when lying down.
What is GERD (gastroesophageal reflux disease)?
These two findings — vomiting blood and black, tarry stools — signal upper GI bleeding and must be reported immediately in a patient with PUD.
What are hematemesis and melena?
After an upper endoscopy (EGD), the nurse must assess for the return of this reflex before giving the patient anything by mouth.
What is the gag reflex (to prevent aspiration)?
These two beverages — one containing caffeine and one containing alcohol — should be limited in both GERD and peptic ulcer disease because they stimulate acid and irritate the mucosa.
What are coffee (caffeine) and alcohol?
This laxative treats hepatic encephalopathy by acidifying the gut and promoting the excretion of ammonia through the stool.
What is lactulose?
This ulcer type causes pain about two hours after eating or at night, and the pain is relieved by food.
What is a duodenal ulcer?
This precancerous change in the esophageal lining results from long-standing, untreated GERD.
What is Barrett's esophagus?
In acute pancreatitis and acute cholecystitis, this order rests the organ by reducing stimulation of digestive enzyme or bile release.
What is NPO (nothing by mouth) status?
This phased elimination diet is used in IBS to identify trigger carbohydrates and is not meant to be followed forever.
What is the low FODMAP diet?
This enzyme-replacement medication must be taken with every meal and snack, swallowed whole, and never crushed or chewed.
What is pancrelipase?
This inflammatory bowel disease is suggested by frequent bloody diarrhea, mucus, and a persistent urge to defecate even when the bowel is empty.
What is ulcerative colitis?
This life-threatening complication of ulcerative colitis involves severe colonic dilation, distension, diminished bowel sounds, fever, and systemic toxicity.
What is toxic megacolon?
If a patient receiving IV promethazine (Phenergan) reports burning or pain at the site, this is the nurse's immediate priority action because the drug is highly caustic to tissue.
What is stop the infusion immediately (and discontinue the IV)?
During a flare of ulcerative colitis, the nurse teaches the patient to follow this type of easy-to-digest diet, along with small, frequent meals to reduce bowel workload.
What is a low-fiber, low-residue (bland) diet?
This mucosal protective agent used in PUD forms a barrier over the ulcer and must be separated from other medications by about two hours because it interferes with their absorption.
What is sucralfate?
In cirrhosis, these two skin findings — small spider-like vessels and reddened palms — develop because the failing liver cannot metabolize this hormone.
What are spider angiomas and palmar erythema, caused by elevated estrogen?
These two bruising signs — one around the navel and one along the flank — indicate hemorrhagic (necrotizing) pancreatitis with retroperitoneal bleeding.
What are Cullen's sign (periumbilical) and Turner's sign (flank)?
Before a paracentesis, the nurse has the patient do this to reduce the risk of bladder puncture, and afterward monitors closely for this vital sign change from large-volume fluid shifts.
What is have the patient void (empty the bladder), then monitor for hypotension?
For a patient with cirrhosis and hepatic encephalopathy, this is the current protein recommendation — and the reason severe restriction is no longer advised.
What is adequate, moderate protein intake (because severe restriction causes muscle breakdown that actually raises ammonia and worsens malnutrition)?
When a patient allergic to penicillin needs H. pylori triple therapy, this antibiotic replaces amoxicillin — and requires strict teaching to avoid all alcohol during therapy and for 48 hours after.
What is metronidazole (due to the disulfiram-like reaction)?
A patient with severe epigastric pain radiating straight through to the back that eases with leaning forward, plus perioral tingling and a positive Trousseau's sign, points to this condition with this accompanying electrolyte imbalance.
What is acute pancreatitis with hypocalcemia (from lipase-driven fat saponification binding calcium)?
A patient with severe pancreatitis develops worsening hypoxemia and labored breathing from inflammatory injury to the alveolar-capillary membrane; this systemic complication carries a high mortality risk.
What is acute respiratory distress syndrome (ARDS)?
In cirrhosis, the combination of low platelets, prolonged clotting times, and fragile esophageal varices makes this set of nursing precautions essential — name three specific measures.
What are bleeding precautions — for example, using a soft toothbrush and electric razor, applying prolonged pressure after injections/draws, using small-gauge needles, avoiding IM injections and NSAIDs/aspirin, and preventing falls and trauma?