Your patient has a GI tract that is functioning, but has the inability to swallow foods. Which is the preferred method of feeding for your patient?

Correct Answer: C

Rationale: In this scenario, the preferred method of feeding for a patient with the inability to swallow foods but with a functioning GI tract is Nasogastric (NG) feeding, which is option C. NG feeding involves the insertion of a tube through the nose into the stomach, allowing for the delivery of liquid nutrition directly into the gastrointestinal system. The correct answer is NG feeding because it bypasses the oral route while still utilizing the patient's functional GI tract for absorption of nutrients. This method helps maintain the integrity of the GI system and prevents complications associated with total parenteral nutrition (TPN) and peripheral parenteral nutrition (PPN), which are options A and B, respectively. TPN and PPN are reserved for patients who cannot tolerate enteral feeding or have non-functional GI tracts. Oral liquid supplements (option D) are not suitable for this patient as they cannot swallow foods effectively. From an educational perspective, understanding the rationale behind choosing NG feeding in this situation highlights the importance of considering the most appropriate and least invasive method of providing nutrition to patients with specific feeding requirements based on their clinical condition. It also emphasizes the significance of maintaining GI function whenever possible to support overall patient well-being and prevent complications associated with alternative feeding methods.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Lower the height of the enema container. Intestinal cramps during enema administration can indicate that the solution is flowing too quickly or with too much force into the intestines. Lowering the height of the enema container will reduce the rate of flow, alleviating the cramps and making the procedure more tolerable for the patient. Discontinuing the procedure (Option A) without addressing the cause of cramps may not be necessary if the issue can be resolved by adjusting the flow rate. Completing the procedure as quickly as possible (Option C) may exacerbate the cramps and cause discomfort for the patient. Continuing administration without adjustments (Option D) can lead to increased discomfort and potential harm to the patient. Educationally, understanding the importance of monitoring patient responses during procedures like enema administration is crucial for nurses. It is essential to recognize signs of discomfort and know how to intervene appropriately to ensure patient safety and comfort. Lowering the enema container height is a simple yet effective intervention that can make a significant difference in the patient's experience.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: "Stools are less fatty and decreased in frequency." This observation indicates that the treatment with pancrelipase (Viokase) for chronic pancreatitis is effective. Pancrelipase is an enzyme replacement therapy that helps in the digestion of fats, proteins, and carbohydrates by providing the necessary enzymes that the pancreas is unable to produce in sufficient quantities due to pancreatitis. When the stools are less fatty and decreased in frequency, it signifies that the pancrelipase is aiding in the proper digestion and absorption of fats, which is a key indicator of treatment effectiveness in chronic pancreatitis. This observation reflects that the patient's malabsorption issues are improving, leading to better nutritional status and overall health. Option A, "There is no skin breakdown," is not directly related to the effectiveness of pancrelipase therapy for chronic pancreatitis. While malabsorption issues can lead to nutritional deficiencies that may impact skin health, the absence of skin breakdown alone does not specifically indicate the effectiveness of pancrelipase therapy. Option B, "Her appetite improves," is a general and non-specific observation that may not directly correlate with the effectiveness of pancrelipase therapy. While improved appetite can be a positive sign, it does not provide a direct measure of the digestive function and absorption of nutrients, which are the primary goals of pancrelipase therapy. Option C, "She loses more than 10 lbs," is actually a negative outcome in this context. Weight loss in a patient with chronic pancreatitis can indicate ongoing malabsorption and inadequate digestion of nutrients, which suggests that the treatment is not effective. Weight loss is often a concerning sign in patients with chronic pancreatitis and should be monitored closely. In an educational context, it is crucial for nursing students to understand the rationale behind assessing the effectiveness of specific treatments for gastrointestinal disorders like chronic pancreatitis. By recognizing the significance of key indicators such as stool characteristics in this case, students can develop critical thinking skills to evaluate patient responses to therapy and make informed clinical decisions to optimize patient outcomes.

Correct Answer: B

Rationale: In the context of a patient with a history of alcohol abuse and acute pancreatitis, the correct lab value most likely to be elevated is glucose (Option B). This is because acute pancreatitis can lead to impaired insulin secretion, causing an increase in blood glucose levels. Elevated glucose levels in this scenario can be indicative of the pancreas' compromised ability to regulate blood sugar due to inflammation and damage. Regarding the other options: A) Calcium levels are not typically directly affected by acute pancreatitis unless severe complications like hypocalcemia due to fat necrosis occur. C) Magnesium levels are usually not directly impacted by acute pancreatitis unless there are associated complications. D) Potassium levels are generally not specifically affected by acute pancreatitis unless complications such as dehydration or other electrolyte imbalances are present. In an educational context, understanding the relationship between certain medical conditions like acute pancreatitis, alcohol abuse, and lab values is crucial for nurses caring for patients with these conditions. This knowledge helps nurses anticipate potential complications, interpret lab results accurately, and provide appropriate interventions to ensure the best possible patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct postoperative nursing care option is keeping Anna NPO until the return of peristalsis (Option D). After a partial gastrectomy for a bleeding ulcer, it is crucial to allow the gastrointestinal tract to rest and recover before reintroducing oral intake. This helps prevent complications such as aspiration, nausea, vomiting, and potential damage to the surgical site. Option A, giving pain medication Q6H, is important for managing Anna's pain postoperatively, but it is not the priority in this situation. Pain management can be adjusted based on Anna's individual needs. Option B, flushing the NG tube with sterile water, is not necessary in this case as the NG tube is typically removed once peristalsis returns and Anna can tolerate oral intake. Option C, positioning her in high Fowler's position, may be beneficial for respiratory function but is not directly related to the immediate postoperative care following a gastrectomy. Understanding the rationale behind postoperative care after gastrointestinal surgery is essential for nurses to provide safe and effective care to their patients. By prioritizing interventions based on physiological needs and surgical outcomes, nurses can help promote optimal recovery and prevent complications.