Digestive & Gastrointestinal System Disorders NCLEX Quiz

Endoscopic retrograde cholangiopancreatography (ERCP) is a useful test in the biliary system because it allows for both diagnosis and treatment of conditions affecting the biliary system. ERCP involves the use of an endoscope to visualize the biliary and pancreatic ducts, and it can be used to identify and remove gallstones, place stents to relieve obstructions, and obtain tissue samples for further analysis. This procedure is particularly useful in cases of suspected bile duct obstruction, biliary strictures, or pancreatitis. Ultrasonography, MRI, and CT scan can also provide valuable information, but they are not as comprehensive or interventional as ERCP.

The first nursing diagnosis for a 4th to 10th-day postoperative liver transplant patient would be "Risk for Rejection." This is because during this time period, the patient is at a high risk of rejecting the transplanted liver as their immune system may recognize it as foreign. Nurses need to closely monitor the patient for signs and symptoms of rejection, such as fever, jaundice, and abdominal pain, and take appropriate interventions to prevent or manage rejection.

Oliguria refers to a decreased urine output, while azotemia refers to an increase in nitrogenous waste products in the blood. Both of these assessment data are indicative of kidney dysfunction, which is a characteristic of hepatorenal syndrome. In this condition, liver cirrhosis leads to impaired kidney function, causing a decrease in urine production and an accumulation of waste products in the blood. Therefore, the presence of oliguria and azotemia would support the diagnosis of hepatorenal syndrome in a patient with high cirrhosis of the liver.

The most appropriate evaluation criteria for a patient in a hepatic coma would be an increase in the level of consciousness. This is because a hepatic coma is a state of unconsciousness caused by severe liver dysfunction. Therefore, any improvement or increase in the patient's level of consciousness would indicate progress in their condition.

The given ABG results show an acidic pH and an acidic CO2 level, indicating an increase in carbon dioxide in the blood. This suggests that the patient is experiencing respiratory acidosis, which occurs when there is inadequate removal of carbon dioxide from the body, leading to an accumulation of carbonic acid and a decrease in pH. The normal bicarbonate level indicates that the acidosis is primarily due to a respiratory issue rather than a metabolic one.

Hepatorenal syndrome is a condition characterized by impaired kidney function due to liver disease. It is caused by a redistribution of renal blood flow, leading to decreased blood flow to the kidneys. This redistribution occurs as a result of changes in the circulatory system caused by liver dysfunction. Therefore, the correct answer is renal blood flow.

Cullen's sign refers to the bluish discoloration around the umbilicus that can be observed in patients with acute pancreatitis. This discoloration is caused by the leakage of pancreatic enzymes into the surrounding tissues, leading to hemorrhage and subsequent bruising. Cullen's sign is a clinical finding that can be indicative of severe pancreatitis and is often associated with intra-abdominal bleeding. It is named after the physician Thomas Stephen Cullen, who first described this sign in 1918.

In this scenario, the nurse observes absent bowel sounds, tachycardia, and abdominal distention in a patient post-endoscope. These signs and symptoms are indicative of a perforated bowel. A perforated bowel occurs when there is a hole or tear in the wall of the intestine, allowing the contents to leak into the abdominal cavity. This can lead to infection, inflammation, and potentially life-threatening complications. The combination of absent bowel sounds, tachycardia (rapid heart rate), and abdominal distention suggests a perforated bowel as the most likely diagnosis.

Somatostatin is the correct answer because it is a pharmacologic agent commonly used to inhibit pancreatic secretions in patients with acute pancreatitis. Somatostatin works by inhibiting the release of various hormones, including insulin and glucagon, which in turn reduces the secretion of pancreatic enzymes. By inhibiting pancreatic secretions, somatostatin helps to alleviate the inflammation and pain associated with acute pancreatitis. Nitroglycerin is not typically used for this purpose and Pancrelipase is an enzyme supplement used to aid digestion, not inhibit secretions. Pepcid is an antacid medication used to reduce stomach acid production and is not specific to inhibiting pancreatic secretions.

During the pre-icteric phase of hepatitis, the individual may not show any symptoms and the virus is multiplying rapidly in the liver. This phase is considered highly contagious as the person may unknowingly transmit the infection to others. Therefore, strict precautionary measures should be taken by the nurse during this phase to prevent the spread of the virus to other individuals.