CARE OFCLIENTS WITH PROBLEM IN

NUTRITION, AND GASTRO-INTERNAL,

METABOLISM AND ENDOCRINE,
PERCEPTION AND COORDINATION, (ACUTE
AND
CHRONIC) STUDENT’S ACTIVITY SHEET
BS NURSING / THIRD YEAR
Session # 2 (2 hours and 30 minutes)

Materials:
LESSON TITLE: GASTROINTESTINAL INTUBATION AND Book, pen and notebook, projector
SPECIAL NUTRITIONAL MODALITIES; GASTRITIS

LEARNING OUTCOMES: References:

Upon completion of this lesson, the nursing student can: Smeltzer, S., Bare, B., Hinkle, J., & Cheever, K.
1. Identify indications of GI intubation and special nutritional
modalities. (2008)Medical. Brunner &Suddarth’s Textbook of -Surgical Nursing 11th Edition.
2. State foods and other substances that may cause gastritis. Lippincott Williams &Wilkins 3. Recognize
nursing diagnosis related to the disorder.
4. Identify nursing interventions to relieve pain.

RATIONALIZATION ACTIVITY (DURING THE FACE TO FACE INTERACTION WITH THE STUDENTS)
The instructor will now rationalize the answers to the students and will encourage them to ask questions and to discuss
among their classmates for 20 minutes.
1. Acute gastritis is often caused by:
A. Ingestion of strong acids
B. Irritating foods
C. Overuse of Aspirin
D. All of the above
ANSWER: D. All of the above
RATIO: All of the above

2. Which of the following definitions best describes gastritis?

A. Erosion of the gastric mucosa
B. Inflammation of a diverticulum
C. Inflammation of the gastric mucosa
D. Reflux of stomach acid into the esophagus
ANSWER: C. Inflammation of the gastric mucosa
RATIO: Gastritis is an inflammation of the gastric mucosa that may be acute (often resulting from exposure to local irritants)
or chronic (associated with autoimmune infections or atrophic disorders of the stomach).

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 3. Which of the following substances is most likely to cause gastritis?
A. Milk
B. Bicarbonate of soda, or baking soda
C. Enteric coated aspirin
D. Nonsteriodal anti-imflammatory drugs
ANSWER: D. Nonsteriodal anti-imflammatory drugs
RATIO: NSAIDS are a common cause of gastritis because they inhibit prostaglandin synthesis. Milk, once thought to help
gastritis, has little effect on the stomach mucosa

4. The nurse is caring for a client with chronic gastritis. The nurse monitors the client, knowing that this client is at risk for
which of the following vitamin deficiencies?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin E
ANSWER:
RATIO:

5. The nurse is reviewing the medication record of a client with gastritis. Which medication, if noted on the
client’s record, would the nurse question?
A. Amoxicillin (Amoxil)
B. Indomethacin (Indocin)
C. Lansoprazole (Prevacid)
D. Clarithromycin (Biazin)
ANSWER: C, Lansoprazole (Prevacid)
RATIO: Indomethacin (Indocin) is a nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus,
stomach, or small intestine.

6. Which of the following treatments should be included in the immediate management of acute gastritis?
A. Reducing work stress
B. Completing gastric resection
C. Treating the underlying cause
D. Administering enteral tube feedings
ANSWER: B, Completing gastric resection
RATIO: Completing gastric resection should be included in the immediate management of acute gastritis

7. Which of the following risk factors can lead to chronic gastritis?

A. Young age
B. Antibiotic usage
C. Gallbladder disease
D. Helicobacter pylori infection
ANSWER: D, Helicobacter pylori infection
RATIO: Chronic gastritis caused by H pylori infection – This is the most common cause of chronic gastritis

8. Which of the following factors associates chronic gastritis with pernicious anemia?

A. Chronic blood loss

B. Inability to absorb vitamin B12
C. Overproduction of stomach acid
D. Overproduction of vitamin B12

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ANSWER: B. Inability to absorb vitamin B12
RATIO: Inability to absorb vitamin B12 the factors associates chronic gastritis with pernicious anemia

9. Which of the following measures helps relieve pain to a client with gastritis?
A. Avoid foods and beverages that may be irritating to the gastric mucosa.
B. Monitor fluid intake and output daily to detect early signs of dehydration.
C. Administer Amoxicillin (Amoxil) twice a day.
D. Start intravenous fluid therapy.
ANSWER: A. avoid foods and beverages that may be irritating to the gastric mucosa
RATIO: Avoid foods and beverages that may be irritating to the gastric mucosa

10 A patient with gastritis is nauseated and vomited 10 times at home, which of the following nursing diagnoses
is appropriate for this patient? Select all that apply.
A. Acute pain related to irritated stomach mucosa
B. Anxiety related to treatment
C. Imbalanced nutrition, less than body requirements related to inadequate intake of nutrients
D. Risk for imbalanced fluid volume related to insufficient fluid intake and excessive fluid loss
ANSWER: A, C, D
RATIO: Are correct

11. Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse
96, Resps 22 and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube.
Before inserting the tube, you explain the purpose to patient. Which of the following is a most accurate explanation?
A. “It empties the stomach of fluids and gas.”
B. “It prevents spasms at the sphincter of Oddi.”
C. “It prevents air from forming in the small intestine and large intestine.”
D. “It removes bile from the gallbladder.”
ANSWER: A, “It empties the stomach of fluids and gas.”
RATIO: An NG tube is inserted into the patients stomach to drain fluid and gas

12. Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you immediately do after inserting an NG
tube for liquid enteral feedings?
A. Aspirate for gastric secretions with a syringe.
B. Begin feeding slowly to prevent cramping.
C. Get an X-ray of the tip of the tube within 24 hours.
D. Clamp off the tube until the feedings begin.
ANSWER: A, Aspirate for gastric secretions with a syringe.
RATIO: Aspirating the stomach contents confirms correct placement. If an X-ray is ordered, it should be done immediately,
not in 24 hours.

13. Stephanie, a 28 y.o. accident victim, requires TPN. The rationale for TPN is to provide: A.
Necessary fluids and electrolytes to the body.
B. Complete nutrition by the I.V. route.
C. Tube feedings for nutritional supplementation.
D. Dietary supplementation with liquid protein given between meals.
ANSWER: C, Complete nutrition by the I.V. route.
RATIO: Complete nutrition by the I.V. route.

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 14. 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?
A. TPN
B. PPN
C. NG feeding
D. Oral liquid supplements
ANSWER: C, NG feeding
RATIO: NG feeding is the best way to do

15. An intubated patient is receiving continuous enteral feedings through a Salem sump tube at a rate of 60ml/hr. Gastric
residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first
response to this finding?
A. Notify the doctor immediately.
B. Stop the feeding, and clamp the NG tube.
C. Discard the 220ml, and clamp the NG tube.
D. Give a prescribed GI stimulant such as metoclopramide (Reglan).
ANSWER: B, Stop the feeding, and clamp the NG tube.
RATIO: The feeding should be stopped; NG tube clamped, and then allow time for the stomach to empty before additional
feeding is added.

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