Gastrointestinal and Hepatic Care Flashcards
7 cards from real CMSRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Gastrointestinal and Hepatic Care flashcards as text
A patient returns to the unit after a Whipple procedure (pancreaticoduodenectomy). Which complication should the nurse be most vigilant for in the first 24 postoperative hours?
Answer: Anastomotic leak and hemorrhage
Anastomotic leak and hemorrhage are the most serious early life-threatening complications of the Whipple procedure due to the extensive resection and multiple bowel anastomoses.
A patient with a nasogastric tube on low suction reports nausea and abdominal cramping. What is the nurse's first action?
Answer: Verify tube placement and patency
Verifying NG tube placement and patency is the priority because a misplaced or occluded tube will not drain gastric contents, directly causing the reported symptoms.
Following a right hemicolectomy, which assessment finding best indicates the return of bowel function?
Answer: Passage of flatus
Passage of flatus is the earliest reliable indicator that peristalsis has returned following bowel surgery and is the standard marker for resuming oral intake.
A patient with irritable bowel syndrome (IBS) asks about dietary modifications to reduce symptoms. Which recommendation has the strongest evidence base?
Answer: Follow a low-FODMAP diet
The low-FODMAP diet, which restricts fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, has the strongest clinical evidence for reducing IBS symptoms.
A patient post-gastric bypass surgery is being discharged. Which dietary teaching is most important to prevent dumping syndrome?
Answer: Eat small, frequent meals and avoid concentrated sweets
Small frequent meals and eliminating concentrated sweets prevent rapid gastric emptying that triggers early and late dumping syndrome after gastric bypass.
A patient is admitted with suspected small bowel obstruction. Which assessment finding is most consistent with this diagnosis?
Answer: High-pitched hyperactive bowel sounds with abdominal distension
High-pitched, hyperactive (borborygmi) bowel sounds with crampy abdominal pain and distension are the classic early findings as the bowel attempts to propel contents past the obstruction.
Which electrolyte imbalance should the nurse most vigilantly monitor for in a patient with prolonged vomiting from a bowel obstruction?
Answer: Hypokalemia and metabolic alkalosis
Prolonged vomiting causes loss of hydrochloric acid and potassium from gastric contents, resulting in hypokalemia and metabolic alkalosis (hypochloremic alkalosis).