Adult 1- FINAL- ch. 59 Care of pts w/problems of the Biliary system & Pancreas – Flashcards
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A patient is admitted to the patient care unit with obstructive jaundice. Which sign/ symptom does the nurse expect to find upon assessment of the patient?
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pruritus
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the daughter of a patient with cholelithiasis has heard that there is a genetic disposition for cholelithiasis. The daughter asks the nurse about the risk factors. how does the nurse respond?
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Hormone replacement therapy has been associated with increased risk for cholecystitis.
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which patient is at low risk for development of gallbladder disorders?
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Patient who is 20 years old and male.
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the nurse on a medical surgical unit is caring for several patients with acute cholecystitis. Which task is best to delegate to the UAP?
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Obtain the patient's vital signs.
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The nurse is assessing a patient with acute cholecystitis whose abdominal pain is severe. The patient has a heart rate of 118 a minute, is pale, diaphragmatic, and describes extreme fatigue. What is the nurse's priority action at this time?
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Notify the patient's healthcare provider.
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The healthcare provider has assessed a patient's abdomen and found rebound tenderness on deep palpitation. What does the nurse recognize?
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Blumberg's sign.
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a patient is scheduled for tests to verify the medical diagnosis of cholecystitis. For which diagnostic test does the nurse provide patient teaching?
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Ultrasonography of the right upper quadrant.
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which type of drug is used to treat acute severe biliary pain?
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opioids, morphine.
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The nurse is administering ketorolac, Toradol, to a 78-year-old patient for mild to moderate pain management. Which assessment finding indicates the patient is experiencing a side effect of this drug?
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Abdominal bloating and cramping.
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The nurse is caring for an older adult patient with acute biliary pain. Which drug order does the nurse question?
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Meperidine, Demerol.
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Which factor renders the patient the least likely to benefit from ESWL for the treatment of gallbladder stones?
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Height 5'10", 325 pounds
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which statement about the care of a patient with a Jackson Pratt, JP, drain after a traditional cholecystectomy is true?
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serosanguineous draninage stained with bile is expected for 24 hours.
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The female patient is to have her gallbladder removed by natural orifice transluminal endoscopic surgery. What does the nurse teach about the surgery?
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The surgeon will use a vaginal approach to remove your gallbladder.
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After removal of the gallbladder, a patient experiences abdominal pain with vomiting for several weeks. What does the nurse recognize?
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Postcholecystectomy syndrome
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patient with acute cholecystitis has a pacemaker. Which diagnostic test is contraindicated?
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Magnetic resonance cholangiopancreatography, MRCP
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the nurse is evaluating electrolyte values for a patient with acute pancreatitis and notes that the serum calcium is 6.8 mEq/L. how does the nurse interpret this finding?
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A result of the body not been able to use bound calcium.
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Disseminated intravascular coagulation, DIC, is a complication of pancreatitis. What pathophysiology leads to this complication?
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Consumption of clotting factors in micro thrombi formation.
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the patient with acute pancreatitis experiences of abdominal pain. What is the best intervention to begin management of this pain?
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IV opioids by means of patient controlled analgesia, PCA.
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the patient comes to the emergency department with severe abdominal pain and the mid-epigastric area. The patient states that the pain began suddenly, is continuous, radiates to his back, and it is worst when he lies flat on his back. What conditions is the nurse suspect?
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Acute pancreatitis.
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Which diagnostic test is the most accurate in verifying a diagnosis of acute pancreatitis?
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Lipase.
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A patient with acute pancreatitis is at risk for the development of paralytic, a dynamic, ileus. Which option provides the nurse with the best indication of bowel function?
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Asking the patient if he or she has passed flatus or had a stool.
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which condition is most likely to be treated with antibiotics?
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Acute necrotizing pancreatitis.
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The nurse has instructed a patient in the recovery phase of acute pancreatitis about diet therapy. Which statement by the patient indicates the teaching has been successful?
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I will avoid eating chocolate and drinking coffee.
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The nursing student is caring for a patient with chronic pancreatitis who is receiving pancreatic enzyme replacement therapy. Which statement by the student indicates the need for further study concerning this therapy?
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If the patient has difficulty swallowing the enzyme preparation, I will crush it and mix it with foods.
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The nurse detects an epigastric mass while assessing a patient with acute pancreatitis. The patient describes epigastric pain that radiates to his back. What does the nurse suspect?
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Pancreatic pseudocyst
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what is the most common and serious complication after a Whipple procedure?
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Fistula development
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the nurse is teaching a patient and family how to prevent exacerbations of chronic pancreatitis. which teaching point does the nurse include?
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Avoidance of alcohol and nicotine.
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The patient is to continue pancreatic enzyme replacement therapy, PERT, after discharge. Which statement indicates that the patient understands teaching about this therapy?
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I will take the enzymes after I take my ranitidine, Zantac.
