Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 45- Disorders of Gastrointestinal Function
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | The nurse walks into a room and finds the patient forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term | |
| A) | nauseous. | |
| B) | retching. | |
| C) | vomiting. | |
| D) | expatriate. | |
| Ans: | C | |
| Feedback: | ||
| Vomiting or emesis is the sudden and forceful oral expulsion of the contents of the stomach. It is usually preceded by nausea. Nausea is a subjective and unpleasant sensation. Retching consists of rhythmic spasmodic movements of the diaphragm, chest wall, and abdominal muscles. It usually precedes or alternates with periods of vomiting. Expatriate means to banish or withdraw. | ||
| 2. | A middle-aged male walks into the emergency department complaining of chest pain radiating to the neck, shortness of breath, and nausea. His heart rate is 120 and BP is 94/60. The ED physician recognizes the patient is having an acute MI with decreased cardiac output. The nurse identifies the nausea to be in response to | |
| A) | the patient not having a very high pain tolerance. | |
| B) | hypoxia exerting a direct effect on the chemoreceptor trigger zone. | |
| C) | the patient not having digested his meal completely. | |
| D) | fear of having to make major lifestyle changes. | |
| Ans: | B | |
| Feedback: | ||
| Hypoxia exerts a direct effect on the vomiting center (chemoreceptor trigger zone), producing nausea and vomiting. This direct effect probably accounts for the vomiting that occurs during periods of decreased cardiac output, shock, and environmental hypoxia. We are given no information about the patient’s pain tolerance, when he last had a meal, or his routine lifestyle. This patient is going into shock (rapid pulse, low BP) that can result in shunting of blood away from the gut and other organs. During shock, the priority organs for oxygenation include the heart, brain, lungs, and kidneys. | ||
| 3. | A female neonate has been in respiratory distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistulae (EA/TEF). Which of the following explanations should the care team provide to the infant’s parents? | |
| A) | “We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally.” | |
| B) | “This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time.” | |
| C) | “The biggest risk that your daughter will face until this is fixed is the danger of malnutrition and dehydration.” | |
| D) | “The priority in our immediate treatment prior to her surgery will be pain management, as the contents of her stomach can burn her lungs.” | |
| Ans: | A | |
| Feedback: | ||
| EA/TFE necessitate surgery and preclude both normal respiration and swallowing. Aspiration is the primary immediate risk and the priority for treatment. Although the infant will require respiratory therapy to assist with proper tube placement and ventilator maintenance, the only effective treatment is surgery. Aspiration of feeding (aspiration pneumonia) is a major complication that can occur immediately and can be life threatening. Maintaining an open airway and adequate gas exchange are the priority nursing diagnoses for this infant. | ||
| 4. | A stroke patient is having difficulty swallowing food and beverages. The patient complains that he feels like “the food is sticking to the back of his throat.” Given this information, the priority nursing interventions would be to | |
| A) | make the patient “nothing per os” (NPO) and call the physician. | |
| B) | feed the patient while he is sitting in an upright position. | |
| C) | add a thickening agent to all of the patient’s beverages. | |
| D) | warrant no action since this is a normal occurrence after a stroke. | |
| Ans: | A | |
| Feedback: | ||
| People with dysphagia usually complain of choking, coughing, or an abnormal sensation of food sticking in the back of the throat or upper chest when they swallow. A neuromuscular cause involves lesions of the CNS, such as a stroke, which often involve the cranial nerves that control swallowing. Feeding in upright position is good once it is determined by swallowing evaluation that the patient can swallow food without it going into the lungs. Likewise, thickening agents help dysphagia patients after a swallow evaluation has been performed. No action could put the patient at risk for aspiration pneumonia. | ||
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