PUD
A patient has developed a duodenal ulcer. As the nurse, you know that what factors play a role in the formation of peptic ulcers
H. pylori bacteria, NSAIDs
A patient comes into the clinic with concerns of getting oral cancer due to social drinking once a week. What would you educate this patient on in terms of risk factors.
You are providing an in-service to new graduate nurse about esophageal varies in patients with cirrhosis. You ask them to list activities that should be avoided by a patient with this type of condition. What types of activities should be avoided.
A patient admitted with acute pancreatitis is reporting polydipsia, polyuria, and altered LOC. As the nurse, what is the priority action for this patient?
Check their glucose level
A patient is admitted foe suspected upper GI bleed. What types of labs would be expected to be ordered?
CBC, Clotting studies, type and crossmatch
The physician orders a patient with a duodenal ulcer to take a urea breath test. What lab value would indicate the presents of h. pylori?
Carbon Dioxide
A patient just returned to the unit after having a esophagectomy/laryngectomy done due to the diagnosis of esophageal cancer. The patient's order to be NPO is still ordered. The surgeon does not want to discontinue the order yet. Why?
Airway concerns - the surgeon must declare there is no leakage from the surgical site before NPO order can be discontinued.
A patient with late-stage cirrhosis develops portal hypertension. What possible complications may arise due to this condition?
Ascites, Splenomegaly, Esophageal varices
While assisting a patient with chronic pancreatitis to the bathroom, you note the patient's stool looking oily/greasy in appearance. How would you document this finding?
Steatorrhea
Acute pancreatitis is diagnosed based on what lab findings?
Serum amylase and lipase will be elevated
A patient arrives to the clinical for evaluation of epigastric pain. The patient reports waking up in the middle of the night with gnawing pain in the stomach and seems to be relieved by the intake of food. What type of ulcer is present based on the description?
A patient comes in with concerns of developing colorectal cancer. He explains that this his mother's great aunt passed away due to colorectal cancer. He wants to know if he is at risk. What do you tell this patient?
No he is not at risk. First degree relatives put you at risk (mother, father, siblings)
A patient is admitted to the unit with hepatic encephalopathy secondary cirrhosis diagnosis. What types of foods would you advise this patient to avoid when ordering their dinner tray.
Protein - beef, chicken
You are caring for a 50 year old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. As the nurse, you know the two most common causes of acute pancreatitis are:
Gallstones and alcohol usage
What medications may be ordered by the physician to treat H. pylori that is causing a peptic ulcer?
PPIs, Antibiotics, H2 blockers, Bismuth Subsalicylates
A patient admitted with a peptic ulcer disease suddenly begins to vomit dark coffee ground emesis. Upon assessment of the patient, you notice their abdomen to be bloated and an epigastric mass. What complication do you think the patient is experiencing?
Upper gastrointestinal bleeding
A patient is scheduled for a total gastrectomy. The patient doesn't understand why she must be on Vitamin B12 injections. How would you explain this to her.
The parietal cells in stomach secrete a intrinsic factor that is responsible for the absorption of Vitamin B12.
You are completing your assessment on a patient admitted with cirrhosis. You note the patient being disoriented to both person and place. In addition to this finding, the patient's upper extremities are demonstrating a flapping motion. What lab result would you expect to be high?
Ammonia levels will be increased
Your patient with acute pancreatitis is is scheduled for a test that will use a scope to assess the pancreas, bile ducts, and gallbladder. The patient asks you what is this procedure called. You tell the patient it is called:
ERCP - Endoscopic Retrograde Cholangio-Pancreatography
A patient diagnosed with chronic pancreatitis is prescribed Creon. What should you as the nurse educate your patient on for taking this drug appropriately.
Take it before the meal or with the first bite of food and snacks
A patient with chronic peptic ulcer disease underwent a gastric resection 1 month ago and is now back in the clinic reporting nausea, bloating, and diarrhea 30 minutes after eating. What do you expect this patient to be experiencing? How should they prevent further issues?
Dumping Syndrome
Lay down for 30 minutes after eating a meal.
Eat a diet high in protein, fiber, and low in carbohydrates.
NPO, emesis sample, prep for colonoscopy
A 45 year old male has been previously diagnosed with cirrhosis. The patient reports concern of body changes relating to development of enlarged breasts. How do you explain to the patient what is happening?
The liver cells are failing to remove the hormone estrogen from the body, because of this it causes the level to increase within the body leading to gynecomastia.
What is a cause of acute pancreatitis that is NOT a common cause of chronic pancreatitis?
Bacterial infection, viral infection (mumps)
A patient is prescribed Cholestyramine after going through Billroth 1. The patient asks what is this is used for. You respond with:
Cholestyramine is used to help prevent inflammation by combining with bile salts. Should be taken before or with meals