Exam (elaborations)
Gerontological Nursing, 4e (Tabloski) Chapter 20 The Gastrointestinal System
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Gerontological Nursing, 4e (Tabloski) Chapter 20 The Gastrointestinal System
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Gerontological Nursing, 4e (Tabloski)Chapter 20 The Gastrointestinal System
1) Anrolderrresidentrisrcomplainingrofrbeingrconstipated.rWhichractionrshouldrthernursertakerfirstrwh
enrcaringrforrthisrpatient?
1. Assessrtherdietrforradequacyrofrfiberrandrfluids.
2. Determinerwhatrtherpatientrmeansrbyrconstipation.
3. Obtainranrorderrforrarlaxativerandranrenemarifrneeded.
4. Encouragertherpatientrtorincreaserfluidrintakerandractivity.rA
nswer:r 2
Explanation:r 1.rAssessingrtherdietrforradequacyrofrfiberrandrfluidsrmightrberappropriaterafterrthernurs
erdeterminesrhowrtherpatientrdefinesrconstipation.
2. Thernursershouldrfirstrcarefullyrevaluatertherpatient'srconcernrandrquestionrtherpersonrasrtorwha
trisrconsideredrasrbeingrconstipation.rDeterminingrtherpatient'srnormalrfrequencyrofrbowelrmovem
ent,rconsistencyrofrstool,randreffortrinrpassingrstoolrisrimportantrbeforerdecidingrtoract.
3. Obtainingranrorderrforrarlaxativerandrenemarmightrberappropriaterafterrthernurserdeterminesrho
wrtherpatientrdefinesrconstipation.
4. Encouragingrtherpatientrtorincreaserfluidrintakerandractivityrmightrberappropriaterafterrthernur
serdeterminesrhowrtherpatientrdefinesrconstipation.
PagerRef:r574
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrityrClient
rNeedrSub:r BasicrCarerandrComfort
Nurs/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 2.rRecognizertherimpactrofrage-relatedrchangesronrgastrointestinalrfunction.
2) Whichrpatientrisratrmostrriskrforrliverrcancerrandrneedsreducationrregardingrliverrcancerrsignsrandr
symptoms?rSelectrtherbestranswer.
1. Arclientrwithrarhistoryrofrcolonrpolyps
2. Arclientrwithrardiagnosisrofrdiverticulitis
3. Arclientrwithrarpastrhistoryrofrsmoking
4. ArclientrwithrarhistoryrofrhepatitisrBrinfectionrA
nswer:r 4
Explanation:r 1.rArhistoryrofrcolonrpolypsrisrnotrarriskrfactorrforrliverrcancer.
2. Ardiagnosisrofrdiverticulitisrisrnotrarriskrfactorrforrliverrcancer.
3. Thisrclientrhasralreadyrceasedrtherbehavior.
4. HistoryrofrhepatitisrBrinfectionrisrarriskrfactorrforrliverrcancer.rPa
gerRef:r558
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r3.rIdentifyrriskrfactorsrtorhealthrforrtherolderrpersonrwithrgastrointestinalrproble
ms.
1
Copyrightr©r2019rPearsonrEducation,rInc.
, 3) AnrolderrpatientrisrexperiencingrdiarrhearandrhasrrecentlyrbeenrdiagnosedrwithrClostridiumrdiff
icile?rThisrtendsrtoroccurrinrwhichrtyperofrpatient?
1. Arpatientrwithrarhistoryrofrulcerativercolitis
2. Arpatientrwhorhasrhadrarrecentrboutrofrpneumonia
3. Arpatientrwhorhasrbeenronrsteroidsrforrseveralrmonths
4. ArpatientrwhorhasrconsistentlyrhadrarnutrientrpoorrdietrA
nswer:r 2
Explanation:r 1.rArhistoryrofrulcerativercolitisrwouldrnotrnecessarilyrberassociatedrwith
Clostridiumrdifficile.
2. Clostridiumrdifficilercanrberthercauserofrdiarrhearinranrolderrpatientrwhorhasrrecentlyrco
mpletedrantibioticruse.
3. SteroidruserisrnotrassociatedrwithrtherdevelopmentrofrarClostridiumrdifficilerinfection.
4. Ardietrpoorrinrfreshrfruitsrandrvegetablesrwouldrcontributertortherdevelopmentrofrconstipationrandr
notrdiarrhearcausedrbyrClostridiumrdifficile.
PagerRef:r551
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rPhysiologicalrAdaptationrNurs/
IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r4.rInterpretruniquerpresentationsrofrgastrointestinalrproblemsrinrtherolderrperson
.
4) Arnurserisrperformingrargastrointestinalrassessmentronranrolderradult.rWhatrassessmentrfin
dingrwouldrthernurserberconcernedrwith?
1. Dyspepsia
2. Hiatalrhernia
3. Hyperactiverbowelrsounds
4. Decreasedrabilityrtortasterfoodsr
Answer:r 2
Explanation:r1.rDyspepsiar(indigestionrwithrbloating,rearlyrsatiety,rabdominalrdistention,ranor
exia,rvomiting,rdysphagia,rbelching,rorrnausea)risrarcommonrsymptom,rbutroftenrisrnotrvigorou
slyrinvestigatedrandrisrattributedrtornormalrchangesrofraging.
2. Hiatalrhernias,rorrdiaphragmaticrherniasrthatrallowrarsmallrportionrofrtherstomachrtorsliderintorther
chest,rarersorcommonrinrolderrpeoplerthatrtheyrarersometimesrclassifiedrasrarnormalrchangerofragingr
andrareroftenrasymptomatic.
3. Hyperactiverbowelrsounds,rreboundrtenderness,rorrtherpresencerofranrabdominalrmassrmayrindica
terarbowelrobstructionrorrperforationrandrrequirerimmediaterreferralrandrmedicalrattention.
4. Thererisrardecreaserinrtheramountrofrtasterbudsrinrolderradults;rthisrisrarnormalrage-
relatedrfinding.
PagerRef:r538-
550rCognitiverLevel:r Analy
zing
ClientrNeed:r HealthrPromotionrandrMaintenancer
ClientrNeedrSub:rBasicrCarerandrComfortrNurs/Int
egrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 1.rDescriberage-relatedrchangesrthatraffectrgastrointestinalrfunction.
2
Copyrightr©r2019rPearsonrEducation,rInc.
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