Gail Lewis is a 48-year-old woman who has worked as a legal secretary for a high-powered defense attorney for the last 12 years. She has never been married, and she lives alone. She has been experiencing a burning sensation in her stomach for the last few months, which is now worsening. Gail finally makes an appointment with her healthcare provider (HCP) to find out what is causing the stomach pain. Show Scheduled maintenance: Saturday, September 10 from 11PM to 12AM PDT
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Terms in this set (26)Which information is most significant when assessing a client suspected of having a peptic ulcer? Frequent use of aspirin or products containing aspirin. Long term use of NSAIDs damages the stomach lining and causes ulvers. Which response by Gail supports a peptic ulcer? (select all that apply) The pain sometimes wakes me up at night. Because gastric acid production at night can cause extreme abdominal pain, individuals with ulcers may wake up during the night. Although antacids and milk usually provide temporary relief for the pain because they neutralize the gastric acid in the
stomach, milk can make an ulcer worse because it stimulates the stomach to produce more acid and digestive juices that can aggravate an ulcer. Which intervention should the nurse include? Instruct Gail not to take any antibiotics for 4 weeks prior to the test. Antibiotics and pepto bismol should be withheld for 4 weeks so that they do not interfere with the results of the H. pylori breath test. Which information should the nurse provide? A pleasant-tasting solution is ingested and you breathe into a balloon. Exhaling into a balloon like bag is performed first to obtain a baseline sample. Then a small amount of pleasant lemon-flavored solution is ingested, and 15 minutes later another balloon breath sample is obtained. This sample is tested for an increase in Co2 which indicates a positive H. pylori breath test. Gail asks the nurse. "What happens if my pain is due to the H. pylori bacteria?" Antibiotics and acid-suppressing medications are prescribed. H. pylori is eradicated with a 14 day treatment of antibiotics (tetracycline) a proton-pump inhibitor and pepto-bismol.
Which priority intervention should the nurse implement when providing immediate post procedure care? Confirm the return of the gag reflex. During an EGD, a local anesthetic is used to suppress the gag reflex prior to insertion of endoscope down the esophagus. Food and liquids are not given until the gag reflex returns, so this is the priority intervention. Which action should the nurse include in the discharge preparation? Discuss the need to notify the HCP if fever or shoulder pain develop. The client should contact the HCP if difficulty swallowing or epigastric, substernal, or shoulder pain occurs. How should the nurse respond to Gail's question? "The medication adheres to the lining of the stomach." Which instruction should the nurse discuss with Gail? Take the medication daily even if pain is not present. Which action should the nurse include in the teaching plan? Instruct Gail to eat three small meals and three snacks daily. Which information should the nurse provide? Foods that cause gastric pain should be avoided. What information should the nurse obtain from Gail during the teaching session? Ingestion of alcoholic beverages. Which nursing action takes priority when discussing stress and PUD with Gail? Discuss ways with Gail to reduce stress in her current work environment.
Which intervention would the ED nurse implement first? Start an 18 gauge angiocath and infuse a normal saline solution. The priority is maintaining circulation because Gail is in hypovolemic shock (hypotension and tachycardia). An 18 gauge is used for administering blood products as well as normal saline, which is isotonic and increases vascular volume. Which intervention should the nurse implement next? Place Gail in a recumbent position with her legs elevated. This position directly helps with hypotension by increasing blood flow to the brain, this intervention should be implemented next. At how many mL/hr should the infusion pump be set? 200 In order to infuse the pantoprazole (Protonix), which intervention should the nurse implement? Start a saline lock in the other arm and infuse the medication over 30 minutes. The nurse should start another IV access site, which does not require another prescription, and administer pantoprazole as soon as possible to help decrease gastric secretion. Which intervention should the implement during the procedure? Observe the client's telemetry for dysrhythmias. Which action should the nurse implement? Notify the surgeon immediately. Which intervention should the nurse implement? Document the normal finding in the client's record. Which action should the nurse implement? Explain to Gail the symptoms of dumping syndrome. Which information should the nurse include in the discussion with Gail? Eat between four and six small meals a day. Which task(s) should the primary nurse delegate to the UAP)? Assist Gail with ambulation down the hall while using a gait belt. Which action should the primary nurse implement? Continue charting and take no action towards the unit clerk? Which intervention should the nurse include in discharge preparation? Explain that vitamin B12 levels should be routinely monitors after this surgery. Which instruction should the nurse include? Inspect the abdominal incisional site in the mirror. Sets with similar termsHESI Case Studies - Peptic Ulcer Disease26 terms Mimigift HESI- Peptic Ulcer Disease26 terms xpliu PN Peptic Ulcer Disease (PUD) HESI Case Study23 terms kendall_davee Sets found in the same folderHESI CASE STUDY - COPD with Pneumonia (2019 Update)19 terms sl1222 Chapter 38: Assessment of Gastrointestinal System18 terms chamberlaintx Vitamins: Functions & Food Sources14 terms grapefruitsani Coronary Vascular Disorders81 terms morgan_phillips417 Other sets by this creatorMark Klimek - Diabetes18 terms
nurse_susan NCLEX: Mark Klimek364 terms nurse_susan Psych Meds [Mark Klimek]33 terms nurse_susan Mark Klimek Lab Values78 terms nurse_susan Other Quizlet setsu.s History study guide21 terms cracjac Gene Expression, Bacteria, Operons16 terms meghan_stoup Environmental Biology Final Exam158 terms Petersonsd Chapter 725 terms Matthew_C367 Related questionsQUESTION T/F: When using a bougie, tactile clicking felt while holding the device indicates the distal tip is in the esophagus. 8 answers QUESTION how does diffuse tenosynovial giant cell tumor present? 15 answers QUESTION what is the most common IVC pathology 15 answers QUESTION The nurse is assisting with data collection on an ambulatory postoperative patient. What criterion would the nurse evaluate as indicating patient readiness for discharge after ambulatory? 2 answers How do you assess for peptic ulcer?How do doctors diagnose a peptic ulcer? Your doctor will use information from your medical history, a physical exam, and tests to diagnose an ulcer and its cause. The presence of an ulcer can only be determined by looking directly at the stomach with endoscopy or an X-ray test.
Which of the following are signs and symptoms that could indicate a peptic ulcer?Symptoms. Burning stomach pain.. Feeling of fullness, bloating or belching.. Intolerance to fatty foods.. Heartburn.. Nausea.. What are the clinical features of peptic ulcer disease?These symptoms include epigastric pain that worsens with eating, postprandial belching and epigastric fullness, early satiety, fatty food intolerance, nausea, and occasional vomiting [2,5].
When assessing a client with a diagnosis of peptic ulcer disease which physical examination should the nurse implement first?Endoscopy is the preferred diagnostic procedure because it allows direct visualization of inflammatory changes, ulcers, and lesions. Occult blood. Stools may be tested periodically until they are negative for occult blood. Carbon 13 (13C) urea breath test.
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Which information is most significant when assessing a client suspected of having a peptic ulcer?
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