Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 1

i-Clicker Question Suitei-Clicker Question Suite

Chapter 43Chapter 43

Nursing Management:Nursing Management:Lower Gastrointestinal ProblemsLower Gastrointestinal Problems

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 2

1. 1. On the second postoperative day, a patient who had an exploratory On the second postoperative day, a patient who had an exploratory laparotomy complains of abdominal distention and gas pains. The laparotomy complains of abdominal distention and gas pains. The patient asks the nurse if this indicates damage to the bowel during patient asks the nurse if this indicates damage to the bowel during surgery. The nurse’s best response to the patient issurgery. The nurse’s best response to the patient is

1. “Abdominal distention occurs as a normal response to 1. “Abdominal distention occurs as a normal response to inflammation and healing of the bowel.”inflammation and healing of the bowel.”

2. “Gas pains occur when a nasogastric tube is not used during 2. “Gas pains occur when a nasogastric tube is not used during surgery to remove air from the stomach.”surgery to remove air from the stomach.”

3. “This is a common complication of abdominal surgery but usually 3. “This is a common complication of abdominal surgery but usually can be relieved by having a bowel movement.”can be relieved by having a bowel movement.”

4. “This occurs because of bowel immobility caused by anesthesia 4. “This occurs because of bowel immobility caused by anesthesia and manipulation of abdominal contents during surgery.” and manipulation of abdominal contents during surgery.”

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 3

2. 2. Which of the following comments made by the patient indicates Which of the following comments made by the patient indicates that additional instruction about the care of a new ileostomy is that additional instruction about the care of a new ileostomy is needed?needed?

1. “I should clean around the stoma with mild soap and water 1. “I should clean around the stoma with mild soap and water and pat dry.”and pat dry.”

2. “I should change the appliance daily to prevent odors.”2. “I should change the appliance daily to prevent odors.”

3. “When I change the appliance, I should check the skin for 3. “When I change the appliance, I should check the skin for irritation.”irritation.”

4. “I’ll need to alter the appliance opening when the stoma 4. “I’ll need to alter the appliance opening when the stoma becomes smaller as the area heals.” becomes smaller as the area heals.”

Copyright © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 4

3. 3. After teaching the patient with inflammatory bowel disease After teaching the patient with inflammatory bowel disease about dietary modifications, the nurse determines that teaching about dietary modifications, the nurse determines that teaching was effective when the patient chooses which of the following was effective when the patient chooses which of the following menus?menus?

1. Turkey burger with cheese on a whole wheat bun, french 1. Turkey burger with cheese on a whole wheat bun, french fries, and an orangefries, and an orange

2. Barbecued brisket, coleslaw, baked beans, and angel food 2. Barbecued brisket, coleslaw, baked beans, and angel food cake cake

3. Baked cod, baked sweet potato, and canned pears3. Baked cod, baked sweet potato, and canned pears

4. Fried shrimp with cocktail sauce, corn on the cob, and a fruit 4. Fried shrimp with cocktail sauce, corn on the cob, and a fruit roll-up roll-up