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CLIENT CENTERED CARE EXAM 2W
GI Tract is made up of what - CORRECT ANSWER✔✔The mouth, pharynx, esophagus, stomach, small and large intestines, rectum, and anus. Accessory organs of the GI - CORRECT ANSWER✔✔The liver, gallbladder, and pancreas Functions of the upper GI - CORRECT ANSWER✔✔Chewing, swallowing, and breaking down food particles. Risk factors for oral cancer - CORRECT ANSWER✔✔Cigarette smoking, tobacco use, pipe smoking, excessive alcohol use, infection with HPV, and genetic predisposition Signs and symptoms of oral cancer - CORRECT ANSWER✔✔Lesions on the tongue or mucosa, sores or discoloration of the lips or mouth that don't heal treatment of oral cancer - CORRECT ANSWER✔✔radiation, chemotherapy, surgery that may require the creation of a tracheostomy Nursing care of a patient with oral cancer - CORRECT ANSWER✔✔Involves monitoring respiratory status, nutritional support, and comfort measures Esophageal cancer/ gastric cancer risk factors - CORRECT ANSWER✔✔Smoking, excessive alcohol use cause of esophageal cancer - CORRECT ANSWER✔✔Barrett esophagus Barrett esophagus - CORRECT ANSWER✔✔Precancerous condition due to longstanding GERD, the constant irritation of the esophagus by stomach fluids can cause cells to become malignant.
Signs and symptoms of esophageal cancer - CORRECT ANSWER✔✔dysphagia, hoarseness, persistent cough, halitosis, regurgitation of foods, and weight loss. Treatment of esophageal cancer - CORRECT ANSWER✔✔Endoscopic therapies and surgeries. Esophagectomy is less commonly done due to complication rate respiratory acidosis - CORRECT ANSWER✔✔A drop in blood pH due to hypoventilation (too little breathing) and a resulting accumulation of Co2. respiratory alkalosis - CORRECT ANSWER✔✔Arise in blood pH due to hyperventilation (excessive breathing) and a resulting decrease in CO2. metabolic acidosis - CORRECT ANSWER✔✔decreased pH in blood and body tissues as a result of an upset in metabolism metabolic alkalosis - CORRECT ANSWER✔✔elevation of HCO3- usually caused by an excessive loss of metabolic acids respiratory acidosis - CORRECT ANSWER✔✔Causes: shallow, slow respirations-> HYPOventilation; respiratory congestion or obstruction. Can be due to COPD, severe pneumonia, or excessive sedation; respiratory muscle weakness. Signs and symptoms of respiratory acidosis - CORRECT ANSWER✔✔Hypoventilation, dyspnea, anxiety, and confusion ABG values for respiratory acidosis - CORRECT ANSWER✔✔pH less than 7.35, PaCO greater than 45 causes of metabolic acidosis - CORRECT ANSWER✔✔shock, DKA, lactic acidosis, renal failure, diarrhea, and starvation
Normal PaCO2 levels - CORRECT ANSWER✔✔35-45 mmHg Normal HCO3 levels - CORRECT ANSWER✔✔22- A common cause of liver toxicity is? - CORRECT ANSWER✔✔Taking extra strength acetaminophen at doses of 4500 mg per day Measures used to teach patients to prevent gastrointestinal ulcers include? - CORRECT ANSWER✔✔Limiting the amount of routine alcohol consumption. You are planning care for several patients who had diagnostic testing. Which patient will require the most time for post procedural care? - CORRECT ANSWER✔✔Patient who had a liver biopsy You are preparing a patient for a liver biopsy. Which nursing intervention should be included? - CORRECT ANSWER✔✔Attending to patient's fears and anxiety, checking for a signed consent form the procedure, checking coagulation studies for bleeding problems, noting any allergy to local anesthetics. An 82 year old patient is undergoing bowel preparation for a diagnostic procedure. What are potential complications of the bowel prep? - CORRECT ANSWER✔✔Dehydration, muscle cramps, and hypotension A decreased secretion of intrinsic factor is a physiologic change associated with the aging process; therefore, you suspect decreased intrinsic factor should assess for which behavior? - CORRECT ANSWER✔✔Fatigue and activity intolerance. A lack of intrinsic factor may cause pernicious anemia, which can manifest as fatigue and activity intolerance. Which laboratory values would you use to assess liver function? - CORRECT ANSWER✔✔ALT, ammonia, INR
You emphasize the importance of eating natural sources of fiber to a patient who has frequent constipation. which patient statement indicates effective health teaching? - CORRECT ANSWER✔✔"I will eat more fruits and vegetables" A 30-year-old woman is admitted with complaints of severe nausea and vomiting over the past 2 days. On admission she is hypotensive and extremely weak. what is the priority problem? - CORRECT ANSWER✔✔deficient fluid volume A nurse is discussing healthy lifestyle measures with a group of older adults during a senior seminar. What instructions should you include as accurate information? - CORRECT ANSWER✔✔Consume sufficient fiber, eat a normal, well-balanced diet, and exercise regularly An older adult woman of Puerto Rican descent is admitted for persistent anorexia and dehydration. There are no apparent underlying organic causes for loss of appetite. Which interventions would be culturally appropriate? - CORRECT ANSWER✔✔Determine food preferences, encourage family visits, and provide small amounts of food and fluid frequently. When working with an obese patient who wants to lose weight, which statement would indicate that the teaching has been understood? - CORRECT ANSWER✔✔"a program such as weight watchers will help me cut calories and keep on track" When screening for the presence of risk factors for oral and pharyngeal cancers, which questions would you ask? - CORRECT ANSWER✔✔How much alcohol do you consume? Have you had any oral lesions? Do you have family members who have cancer? Do you smoke? You reinforce diet recommendations to a patient with GERD. Which patient statement indicates a need for further teaching? - CORRECT ANSWER✔✔"I need to wait 30 minutes after eating before laying down" Patient should be waiting at least 3 hours before laying down
A family member tells you, "dad seems to be having some trouble swallowing lately." What is your priority action? - CORRECT ANSWER✔✔Observe during "practice swallows" The older adult is at greater risk for dehydration than the middle-aged adult is because? - CORRECT ANSWER✔✔Older adults have a diminished sense of thirst, and compensatory mechanisms work less efficiently An 82-year old male patient is admitted with vomiting and diarrhea. On assessment, you note that he is apprehensive and his skin is cool, dry, and pale. His pulse is rapid, and his blood pressure is lower than normal. These symptoms are indicative of? - CORRECT ANSWER✔✔Dehydration Your male patient has been ill with pneumonia and was admitted yesterday to start IV antibiotic therapy. He has a history of heart failure adn is taking digitalis and fuosemide. He has not been eating well the past 3 days because he was feeling so bad. The primary care provider ordered fluids and daily lab work yesterday. The patient seems more confused this morning and is very weak. His urine output has fallen. To determine what is causing these symptoms, you would first? - CORRECT ANSWER✔✔Check the morning electrolyte levels. A patient with heart failure has lost 4.6 pounds. This represents a fluid loss of approximately? - CORRECT ANSWER✔✔2 Liters Patients who are undergoing diuretic therapy to decrease excess bod fluid tend to lose potassium. If too much potassium is lost, the patient will have which electrolyte and acid-base imbalance? - CORRECT ANSWER✔✔Hypokalemia, and metabolic alkalosis. One of the best methods to assess whether peripheral edema is increasing or decreasing is to? - CORRECT ANSWER✔✔Measure the circumference of the affected extremity in the same location each day.
Daily fluid intake i the adult must be at least how many mL/ day to maintain homeostatsis? - CORRECT ANSWER✔✔1500 mL Whenever a water imbalance exists, there will be an accompanying imbalance of what? - CORRECT ANSWER✔✔Sodium imbalance An increase in hydrogen ions results in? - CORRECT ANSWER✔✔Acidosis, which is evidenced by a decrease in pH Acidosis depresses which system? - CORRECT ANSWER✔✔nervous system, causing headache, lethargy, weakness, and confusion. Can progress to coma and death. A decrease in hydrogen ions results in? - CORRECT ANSWER✔✔Alkalosis, evidenced by an increase in pH Alkalosis causes irritability of which system? - CORRECT ANSWER✔✔nervous system, causing restlessness, muscle twitching, and tingling/ numbness of the fingers. Can also progress to tetany, seizures, and coma What should nurses monitor when a patient is receiving a diuretic regularly? - CORRECT ANSWER✔✔Skin turgor, daily weight, and electrolyte status Which patients can be considered at high risk for fluid and electrolyte imbalance? - CORRECT ANSWER✔✔A 45-year-old woman with thyroid crisis, A 35-year-old trauma victim on a ventilatory, a 30-year-old complaining of persistent diarrhea. An older adult man is admitted for severe disorientation, confusion, and general weakness. His souse reports that he is not able to tolerate any food or fluids and
Dietary changes that help reduce the incidence of constipation includes? - CORRECT ANSWER✔✔Increasing fluid intake A major difficulty in treating hepatitis is? - CORRECT ANSWER✔✔The person usually has a poor appetite Nutrition therapy for patients with irritable bowel syndrome include? - CORRECT ANSWER✔✔Eliminating food allergens and intolerances Inflammation of pockets of tissue in the lining of the mucous membrane of the colon is referred to as? - CORRECT ANSWER✔✔Diverticulitis The bacteria associated with peptic ulcer disease is? - CORRECT ANSWER✔✔Helicobacter pylori An intolerance to gluten is associated with? - CORRECT ANSWER✔✔celiac disease A characteristic of cystic fibrosis is? - CORRECT ANSWER✔✔pancreatic insufficiency Dietary care of a patient with GERD includes - CORRECT ANSWER✔✔Lower intake of fat Compared with healthy children, children with cystic fibrosis need? - CORRECT ANSWER✔✔More kilocalories Dryness of the mouth form lack of normal secretions is called? - CORRECT ANSWER✔✔Xerostomia An example of a meal that may cause an increase in symptoms for a patient with peptic ulcer disease is? - CORRECT ANSWER✔✔Chicken curry
Achalasia - CORRECT ANSWER✔✔failure of the lower esophagus sphincter (LES) muscle to relax What are common contributors to chronic GERD? - CORRECT ANSWER✔✔impaired esophageal peristalsis, prolonged LES relaxation, and hiatal hernias What medication class is the mainstay of pharmacologic treatment for GERD? - CORRECT ANSWER✔✔Proton pump inhibitors (PPI's) If PPI's are unsuccessful, patients can get the surgical procedure done that restores the LES function and esophageal peristalsis - CORRECT ANSWER✔✔Laparoscopic fundoplication hiatal hernia - CORRECT ANSWER✔✔protrusion of a part of the stomach upward through the opening in the diaphragm Patients with hiatal hernias are advised to? - CORRECT ANSWER✔✔Eat small amounts of food at a time, avoid lying down after meals, and sleep with the head of the bed elevated. The frequent use of what helps to control the symptoms of heartburn? - CORRECT ANSWER✔✔Antacids Ulcers are common in where? - CORRECT ANSWER✔✔Duodenal bulb because the gastric contents emptying are the most concentrated. Most common causes of peptic ulcer disease are? - CORRECT ANSWER✔✔H. pylori infection and long term use of NSAIDs.
