Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Gastric pH. A gastric vagotomy involves cutting the vagus nerve to reduce acid secretion in the stomach. As a result, gastric pH increases because there is less stimulation for acid production. This surgical procedure is often done to manage peptic ulcers by decreasing the acidity in the stomach, which can help in ulcer healing and prevention of recurrence. Option A) Peristalsis is not affected by a vagotomy as it is primarily controlled by the autonomic nervous system and smooth muscle in the gastrointestinal tract. Option B) Gastric acidity decreases after a vagotomy due to reduced acid secretion as a direct result of cutting the vagus nerve. Option C) Gastric motility may be decreased after a vagotomy because the vagus nerve plays a role in regulating gastrointestinal motility, but it is not the factor that increases as a result of vagotomy. Understanding the effects of a gastric vagotomy on various physiological processes is crucial for nurses caring for patients who have undergone this procedure. It helps in providing appropriate postoperative care, monitoring for complications, and educating patients about dietary and lifestyle modifications to promote recovery.

Correct Answer: C

Rationale: The correct answer is C: Provide frequent mouth care. In a patient with peritonitis who is NPO and thirsty, the priority is to maintain oral hygiene and provide comfort by moistening the mouth with frequent mouth care. This helps alleviate the sensation of thirst and maintains oral health. Increasing the IV infusion rate (choice A) may not address the patient's discomfort directly related to thirst. Using diversion activities (choice B) is not as critical as addressing the patient's immediate need for oral care. Giving ice chips every 15 minutes (choice D) is not recommended for a patient with peritonitis who is NPO, as it can lead to complications or worsen the condition.

Correct Answer: C

Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Red. Following a partial gastrectomy for adenocarcinoma of the stomach, the gastric secretions are expected to be red due to the presence of blood. This is a crucial indicator of potential postoperative complications such as bleeding, which requires immediate attention to prevent further complications. Option A) Brown is incorrect as brown gastric secretions are more indicative of older blood or bile present. Option B) Clear is incorrect as clear gastric secretions are not typically expected postoperatively in this context. Option D) Yellow is incorrect as yellow gastric secretions may indicate the presence of bile. In an educational context, understanding the color and consistency of gastric secretions postoperatively is vital for nurses to assess and monitor patients for any potential complications. Recognizing abnormal findings promptly can lead to timely interventions and improved patient outcomes. This knowledge also helps nurses provide comprehensive care and communicate effectively with the healthcare team regarding the patient's condition.

Correct Answer: D

Rationale: In the context of a patient with a retractable gastric peptic ulcer who has undergone a gastric vagotomy, it is crucial to understand the effects of this surgical procedure on various factors within the gastrointestinal system. In this scenario, the correct answer is D) Gastric pH increases as a result of vagotomy. A gastric vagotomy involves cutting the vagus nerve, which plays a significant role in stimulating gastric acid secretion. Without this neural input, the production of gastric acid is reduced, leading to an increase in gastric pH. This change in pH can have implications for the patient's overall digestive process and ulcer healing. Now let's analyze why the other options are incorrect: A) Peristalsis: Vagotomy does not have a direct effect on peristalsis, which is the involuntary contraction and relaxation of muscles in the GI tract to move food along the digestive system. B) Gastric acidity: Vagotomy actually decreases gastric acidity due to the reduction in acid secretion. C) Gastric motility: While vagotomy can affect gastric motility to some extent, it does not directly increase gastric motility. The impact on motility is more complex and not as straightforward as the effect on pH. Understanding the effects of gastric vagotomy on gastric pH is essential for nurses caring for patients who have undergone this procedure. It influences the management of conditions such as peptic ulcers and requires close monitoring and appropriate interventions to support the patient's recovery and overall gastrointestinal health.