Term
| A client newly diagnosed with ulcerative colitis who has been place on steroids asks the nurse why steroids are prescribed. What should the nurse tell the client? |
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Definition
| Steroids are use in severe flare-ups because they can decrease the incidence of bleeding. (When you decrease inflammation then you decrease bleeding) |
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Term
| A client with ulcerative colitis is to take Sulfasalazine (Azulfidine). Which of the following instructions should the nurse provide for the client about taking this medication at home? (Select all that apply - 3 answers) |
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Definition
1. Drink enough fluids to maintain a urine output of at least 1,200-1,500 mL per day. (To prevent crystal urea and stone formation)
2. Discontinue therapy if symptoms of acute intolerance develop and notify the health care provider. (Any intolerance, need to discontinue)
3. Avoid activities that require alertness. (May cause dizziness) |
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Term
| A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the patient for: |
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Definition
Hypokalemia (Low potassium level).
This is the most expected finding related to diarrhea. A lot of diarrhea can cause a low electrolyte level. Having a low potassium level can cause cardiac arrest. |
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Term
| The nurse is developing a plan of care for a client with Crohn's disease who is receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include? (Select all that apply- 3 answers) |
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Definition
1. Weighing the patient daily.
2. Monitor the IV infusion rate hourly
3. Taping all IV tubing connections securely.
TPN = Hypertonic solution. The greater the dextrose solution, the greater the tenacity. TPN contains electrolytes, vitamins, lipids |
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Term
| Using a sliding-scale schedule, the nurse is preparing to administer an evening dose of Regular insulin to a client who is receiving TPN. Which action is most appropriate for the nurse to take to determine the amount of Insulin to give? |
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Definition
Base the dosage on the glucometer reading of the client's Glucose level obtained immediately before administering the Insulin.
*You use a sliding-scale with TPN. It is checked every four hours. Not like regular insulin. |
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Term
| Which of the following should the nurse interpret as an indication of a complication after the first few days of TPN therapy? |
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Definition
| Elevated temperature. (This would be an indication of an infection) |
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Term
| What adverse effect would the nurse expect the client to exhibit in the event of too rapid an infusion of TPN solution? |
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Definition
Fluid overload (excess fluid volume).
This would affect the respiratory system- difficulty breathing, crackles.
Nitrogen levels would decrease, increased electrolyte levels- at risk for high calcium and potassium. |
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Term
| A client with Diverticulitis has developed Peritonitis following Diverticular rupture. The nurse should assess the client to determine which of the following. (Select all that apply- 3 answers). |
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Definition
1. Percuss the abdomen to note resonance and tympany. (checking if air in liver)
2. Percuss the liver to note lack of dullness.
3. Auscultate bowel sounds to note frequency (absent bowel sounds) |
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Term
| A client with diverticular disease is receiving psyllium hydrophilic mucilloid (Metamucil). The drug has been effective when the client tells the nurse that he: |
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Definition
| Passes stool without cramping. |
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Term
| A client with acute Appendicitis develops a fever, tachycardia, and hypotension. Based on these assessment findings, the nurse should further assess the client for which of the following complications? |
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Definition
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Term
| The nurse is taking care of a client with Clostridium difficile (C. difficile). The nurse should do which of the following to prevent the spread of infection? |
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Definition
Wear a protective gown when in client's room.
*Also wash hands with soap, not an alcohol based hand sanitizer. |
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Term
| Postoperative nursing care for a client after an Appendectomy should include which of the following? |
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Definition
| Noting the first bowel movement after surgery. |
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Term
| A client is admitted to the hospital with a diagnosis of Cholecystitis from Cholelithiasis. The client has severe abdominal pain, nausea, and has vomited several times. Based on this data, which nursing diagnosis would have the highest priority for intervention at this time? |
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Definition
| Pain related to gallbladder inflammation. |
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Term
| A client with Cholecystitis continues to have severe right upper quadrant pain. The nurse obtains the following vitals: Temp 38.4C, pulse 114, resp 22, blood pressure 142/90. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse recommends to the primary care provider for the client to receive: |
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Definition
Hydromorphone (Dilaudid) IV
*Pain is very important to control. |
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Term
| When providing care for a client hospitalized with Acute Pancreatitis who has acute abdominal pain, which of the following nursing interventions would be the most appropriate for this client? (Select all that apply- 2 answers) |
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Definition
1. Placing the client in a side-lying position.
2. Maintain the client's respiratory status. |
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Term
| Pancreatic enzyme replacements are ordered for the client with chronic pancreatitis. What should the nurse instruct the client to take them to obtain the most therapeutic effect? |
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Definition
| With each meal and snack. |
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Term
| A client is receiving Propantheline bromide (Pro-Banthine) in the management of acute pancreatitis. Which of the following would indicate that the nurse should withhold the medication? |
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Definition
Absent bowel sounds.
Propantheline bromide is an anticholinergic. Giving this medication would be contraindicated. |
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Term
| The nurse assesses a client who has jsut received morphine sulfate. The client's blood pressure is 90/50 mm Hg, pulse rate 58 bpm, resp rate 4 breaths/min. The nurse should check the client's chart for an order to administer? |
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Definition
Naloxone hydrochloride (Narcan).
*Patient is in resp depression. Narcan reverse morphine. |
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Term
| A client had Total Abdominal Hysterectomy and bilateral Oophorectomy for Ovarian Carcinoma yesterday. She received 2mg of Morphine Sulfate IV by patient-controlled analgesia (PCA) 10 minutes ago. The nurse was assisting her from bed to a chair when a client felt dizzy and fell into the chair. The nurse should ____? |
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Definition
Take the client's blood pressure.
*Feeling dizzy and fell into the chair indicates orthostatic hypotension and requires a BP reading. |
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Term
| Metoclopramide (Reglan) is ordered as a premedication for a client about to undergo a Gastroduodenoscopy. The nurse expects which of the following as a PRIMARY therapeutic effect? |
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Definition
Increased gastric emptying.
*Reglan - given before surgery. Increases gastric emptying. Used when needed to clear deudenum for scope. |
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