The nurse is caring for a client who has had a gastroscopy. Which of the following symptoms may indicate that the client is developing a complication related to the procedure? Select all that apply.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) The client has a temperature of 100*F. This symptom may indicate the development of a complication post-gastroscopy, such as infection. A fever post-procedure can be a sign of an inflammatory response or infection, which are potential complications that need prompt attention. Option A) The client complains of a sore throat is a common and expected side effect of gastroscopy due to irritation from the scope. It is not typically indicative of a complication. Option C) The client appears drowsy following the procedure is a common side effect of sedation administered during gastroscopy and does not necessarily indicate a complication. Option D) The client complains of epigastric pain is also a common side effect of gastroscopy and is not specific to complications. Educationally, understanding post-procedure complications is crucial for nurses to provide safe and effective care. Recognizing and responding to signs of complications promptly can prevent further deterioration in the client's condition. Nurses should closely monitor clients post-gastroscopy for any signs of infection or other complications to ensure optimal outcomes.

Correct Answer: B

Rationale: The most appropriate nursing diagnosis for the client with a peptic ulcer experiencing epigastric pain that awakens her at night, a feeling of fullness in the abdomen, and anxiety about her health would be option B) Disturbed Sleep Pattern related to epigastric pain. This choice is correct because the client's symptoms directly indicate disrupted sleep patterns due to the pain she is experiencing, which is interfering with her ability to sleep through the night. Addressing this issue is crucial to improving her overall well-being and quality of life. Option A) Imbalanced Nutrition: Less than Body Requirements related to anorexia is incorrect because the client's symptoms do not suggest a lack of appetite or food intake as the primary issue. Option C) Ineffective Coping related to exacerbation of duodenal ulcer is not the most appropriate choice as the client's anxiety about her health is a secondary symptom to her physical discomfort and not the primary concern at this point. Option D) Activity Intolerance related to abdominal pain is not the best choice because the client's symptoms primarily point towards sleep disturbance rather than an inability to perform physical activities. Understanding the rationale behind selecting the correct nursing diagnosis is crucial for nurses to provide targeted and effective care to their patients, especially in scenarios involving complex health conditions like peptic ulcers.

Correct Answer: C

Rationale: In the context of medical surgical nursing, it is crucial for nurses to educate clients on the proper administration of medications to ensure optimal therapeutic outcomes. In the case of ranitidine, which is a histamine-2 receptor antagonist used to treat peptic ulcers by reducing stomach acid production, taking it at bedtime is the most appropriate time. The correct answer, option C, is right because ranitidine is most effective when taken at bedtime due to its mechanism of action in inhibiting nocturnal acid secretion when the stomach is most active. This timing helps in providing sustained acid suppression throughout the night, which is beneficial for ulcer healing and symptom relief. Option A (before meals) and option B (with meals) are incorrect because ranitidine does not need to be timed with meals for effectiveness. Taking it before or with meals may not align with the physiological basis of the drug's action in reducing nocturnal acid production. Option D (when pain occurs) is also incorrect as ranitidine is not a rescue medication for immediate pain relief. It is intended for prevention and maintenance therapy in the treatment of peptic ulcers. In an educational context, understanding the rationale behind the timing of medication administration is essential for nurses to teach clients to optimize treatment outcomes. By explaining the pharmacological principles underlying the timing of ranitidine administration, nurses can empower clients to adhere to the prescribed regimen effectively.

Correct Answer: C

Rationale: The correct answer is C) The client is experiencing a side effect of the aluminum hydroxide. Rationale: Aluminum hydroxide is an antacid commonly used to treat peptic ulcers. One of its common side effects is constipation. Aluminum-based antacids can lead to constipation due to their ability to absorb water in the gastrointestinal tract, which can result in decreased bowel motility and difficulty passing stool. Option A) The client has not been including enough fiber in his diet: While fiber intake can impact bowel movements, in this case, the primary reason for constipation is the side effect of the medication, not solely a lack of dietary fiber. Option B) The client needs to increase his daily exercise: While exercise can promote bowel regularity, the client's constipation in this scenario is more likely related to the medication side effect rather than lack of exercise. Option D) The client has developed a gastrointestinal obstruction: This option is less likely as a cause of constipation in this case, as the client's history of aluminum hydroxide use and the duration of constipation make medication side effects a more probable cause. Educational Context: Understanding common side effects of medications used in gastrointestinal disorders is crucial for nurses caring for clients with peptic ulcers. Recognizing the effects of aluminum hydroxide on bowel function can help nurses anticipate and manage constipation in patients taking this medication, ensuring optimal patient outcomes. Nurses should educate clients on potential side effects of medications and encourage open communication about any changes in bowel habits to provide timely interventions.

Correct Answer: D

Rationale: In the context of medical surgical nursing, understanding the correct administration of medications is crucial for client care. The correct answer, option D, "It is best for me to take my antacid 1 to 3 hours after meals," is the most appropriate because antacids work by neutralizing gastric acid, thereby providing relief from symptoms of peptic ulcers. Taking antacids after meals ensures that there is food in the stomach to buffer the acid, maximizing the effectiveness of the medication. Option A is incorrect because antacids should not be taken simultaneously with other medications to avoid potential drug interactions. Option B is incorrect as adequate fluid intake is necessary to help the antacid dissolve and be effective. Option C is incorrect as antacids are preventive rather than reactive medications; they should be taken as a regular part of the treatment regimen, not just when symptoms occur. Educationally, this question highlights the importance of proper medication administration in the management of gastrointestinal disorders. Nurses must educate clients on the correct timing and administration of antacids to optimize their therapeutic effects and promote positive outcomes in the management of peptic ulcers.