Biliary Disorders Flashcards
A nurse is assessing a patient who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the patient’s pain, the nurse should anticipate that it may radiate to what region?
A. Left upper chest
B. Inguinal region
C. Neck or jaw
D. Right shoulder
D. Right shoulder
A 55-year old man has been newly diagnosed with acute pancreatitis and admitted to the acute medical unit. How should the nurse most likely explain the pathophysiology of this patient’s health problem?
A. Toxins have accumulated and inflamed your pancreas
B. Bacteria likely migrated from your intestines and became lodged in your pancreas
C. A virus that was likely already present in your body has begun to attack your pancreatic cells
D. The enzymes that your pancreas produces have damaged the pancreas itself
D. The enzymes that your pancreas produces have damaged the pancreas itself
A patient’s assessment and diagnostic testing are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment questions address likely etiologies factors? SATA.
A. How many alcoholic drinks do you typically consume in a week?
B. Have you been tested for diabetes?
C. Have you ever been diagnosed with gallstones?
D. Would you say that you eat a particularly high-fat diet?
E. Does anyone in your family have cystic fibrosis?
A. How many alcoholic drinks do you typically consume in a week?
C. Have you ever been diagnosed with gallstones?
A patient’s abdominal ultrasound indicates cholelithiasis. When the nurse is reviewing the patient’s laboratory studies, what finding is most closely associated with this diagnosis?
A. Increased bilirubin
B. Decreased sodium cholesterol
C. Increased BUN
D. Decreased serum alkaline phosphatase level
A. Increased bilirubin
A nurse who provides care in a walk-in clinic assesses a wide range of individuals. The nurse should identify which of the following patients as having the highest risk for chronic pancreatitis?
A. A 45-year old obese woman with a high-fat diet
B. An 18-year old man who is a weekend binge drinker
C. A 39-year old man with chronic alcoholism
D. A 51-year old woman who smokes one-and-a-half packs of cigarettes per day
C. A 39-year old man with chronic alcoholism
A 37-year old male patients presents at the ED complaining of nausea and vomiting and severe abdominal pain. The patient’s abdomen is rigid, and there is bruising to the patient’s flank. The patient’s wife states that he was on a drinking binge for the past 2 days. The ED nurse should assist in assessing the patient for what health problem?
A. Severe pancreatitis with possible peritonitis
B. Acute cholecystitis
C. Chronic pancreatitis
D. Acute appendicitis with possible perforation
A. Severe pancreatitis with possible peritonitis
A patient has been scheduled for an ultrasound of the gallbladder the following morning. What should the nurse do in preparation for this diagnostic study?
A. Have the patient refrain from food and fluids after midnight
B. Administer the contrast agent orally 10 to 12 hours before the study
C. Administer the radioactive agent intravenously the evening before the study
D. Encourage the intake of 64 ounces of water 8 hours before the study
A. Have the patient refrain from food and fluids after midnight
A patient who had surgery for gallbladder disease has just returned to the post surgical unit from postanesthetic recovery. The nurse caring for this patient knows to immediately report what assessment finding to the physician?
A. Decreased breath sounds
B. Drainage of bile-colored fluid onto the abdominal dressing
C. Rigidity of the abdomen
D. Acute pain with movement
C. Rigidity of the abdomen
A patient with chronic pancreatitis had a pancreaticojejunostomy created 3 months ago for relief of pain and to restore drainage of pancreatic secretions. The patient has come to the office for a routine post surgical appointment. The patient is frustrated that the pain has not decreased. What is the most appropriate initial response by the nurse?
A. “The majority of patients who have a pancreaticojejunostomy have their normal digestion restored but do not achieve pain relief”
B. “Pain relief occurs by 6 months in most patients who undergo this procedure but some people experience a recurrence of their pain”
C. “Your physician will likely want to discuss the removal of your gallbladder to achieve pain relief”
D. “You are probably not appropriately taking the medications for your pancreatitis and pain, so we will need to discuss your medication regimen in detail”
B. “Pain relief occurs by 6 months in most patients who undergo this procedure but some people experience a recurrence of their pain”
A nurse is caring for a patient who has been scheduled for endoscopic retrograde cholangiopancreatography (ERCP) the following day. When providing anticipatory guidance for this patient, the nurse should describe what aspect of this diagnostic procedure?
A. The need to protect the incision post procedure
B. The use of moderate sedation
C. The need to infuse 50% dextrose during the procedure
D. The use of general anesthesia
B. The use of moderate sedation
A patient has undergone a laparoscopic cholecystectomy and is being prepared for discharge home. When providing health education, the nurse should prioritize which of the following topics?
A. Management of fluid balance in the home setting
B. The need for blood glucose monitoring for the next week
C. Signs and symptoms of intra-abdominal complications
D. Appropriate use of prescribed pancreatic enzymes
C. Signs and symptoms of intra-abdominal complications
A nurse is preparing a plan of care for a patient with pancreatic cysts that have necessitated drainage through the abdominal wall. What nursing diagnosis should the nurse prioritize?
A. Disturbed body image
B. Impaired skin integrity
C. Nausea
D. Risk for deficient fluid volume
B. Impaired skin integrity
A home health nurse is caring for a patient discharged home after pancreatic surgery. The nurse documents the nursing diagnosis Risk for Imbalanced Nutrition: Less than Body Requirements on the care plan based on the potential complications that may occur after surgery. What are the most likely complications for the patient who has had pancreatic surgery?
A. Proteinuria and hyperkalemia
B. Hemorrhage and Hypercalcemia
C. Weight loss and hypoglycemia
D. Malabsorption and hyperglycemia
D. Malabsorption and hyperglycemia
A patient has had a laparoscopic cholecystectomy. The patient is now complaining of right shoulder pain. What should the nurse suggest to relieve pain?
A. Aspirin every 4-6 hours as ordered
B. Application of heat 15 to 20 minutes each hour
C. Application of an ice pack for no more than 15 minutes
D. Application of liniment rub to affected area
B. Application of heat 15 to 20 minutes each hour
A patient returns to the floor after a laparoscopic cholecystectomy. The nurse should assess the patient for signs and symptoms of what serious potential complication of this surgery?
A. Diabetic coma
B. Decubitus ulcer
C. Wound evisceration
D. Bile duct injury
D. Bile duct injury
A patient has been treated in the hospital for an episode of acute pancreatitis. The patient has acknowledged the role that his alcohol use played in the development of his health problem, but has not expressed specific plans for lifestyle changes after discharge. What is the nurse’s most appropriate response?
A. Educate the patient about the link between alcohol use and pancreatitis
B. Ensure the patient knows the importance of attending follow-up appointments
C. Refer the patient to social work or spiritual care
D. Encourage the patient to connect with a community-based support group
D. Encourage the patient to connect with a community-based support group
A patient is being treated on the acute medical unit for acute pancreatitis. The nurse has identified a diagnosis of Ineffective Breathing Pattern Related to Pain. What intervention should the nurse perform in order to best address this diagnosis?
A. Position the patient supine to facilitate diaphragm movement
B. Administer corticosteroids by nebulizer as ordered
C. Perform oral suctioning to remove secretions
D. Maintain the patient in a semi-fowler’s position whenever possible
D. Maintain the patient in a semi-fowler’s position whenever possible
A patient with gallstones has been prescribed ursodeoxycholic acid (UDCA). The nurse understands that additional teaching is needed regarded this medication when the patient states:
A. “It is important that I see my physician for scheduled follow-up appointments while taking this medication”
B. “I will take this medication for 2 weeks and then gradually stop taking it”
C. “If I lose weight, the dose of the medication may need to be changed”
D. “This medication will help dissolve small gallstones made of cholesterol”
B. “I will take this medication for 2 weeks and then gradually stop taking it”
A nurse is assisting with serving dinner trays on the unit. Upon receiving the dinner tray for a patient admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray?
A. Fried chicken
B. Mashed potatoes
C. Dinner roll
D. Tapioca pudding
A. Fried chicken
A nurse is assessing an elderly patient with gallstones. The nurse is aware that the patient may not exhibit typical symptoms, and that particular symptoms that may be exhibited in the elderly patient may include what?
A. Fever and pain
B. Chills and jaundice
C. Nausea and vomiting
D. Signs and symptoms of septic shock
D. Signs and symptoms of septic shock
A nurse is creating a care plan for a patient with acute pancreatitis. The care plan includes reduced activity. What rationale for this intervention should be cited in the care plan?
A. Bed rest reduces the patient’s metabolism and reduces the risk of metabolic acidosis
B. Reduced activity protects the physical integrity of pancreatic cells
C. Bed rest lowers the metabolic rate and reduces enzyme production
D. Inactivity reduces caloric need and GI motility
C. Bed rest lowers the metabolic rate and reduces enzyme production
The nurse is caring for a patient who has just returned from the ERCP removal of gallstones. The nurse should monitor the patient for signs of what complications?
A. Pain and peritonitis
B. Bleeding and perforation
C. Acidosis and hypoglycemia
D. Gangrene of the gallbladder and hyperglycemia
B. Bleeding and perforation
A patient with pancreatic cancer has been scheduled for a pancreaticoduodenectomy (Whipple procedure). During health education, the patient should be informed that this procedure will involve the removal of which of the following? SATA.
A. Gallbladder
B. Part of the stomach
C. Duodenum
D. Part of the common bile duct
E. Part of the rectum
A. Gallbladder
B. Part of the stomach
C. Duodenum
D. Part of the common bile duct
An adult patient has been admitted to the medical unit for the treatment of acute pancreatitis. What nursing action should be included in this patient’s plan of care?
A. Measure the patient’s abdominal girth daily
B. Limit the use of opioid analgesics
C. Monitor the patient for signs of dysphagia
D. Encourage activity as tolerated
A. Measure the patient’s abdominal girth daily
