A patient with severe esophageal spasms is diagnosed with achalasia. For which surgical procedures should the nurse prepare teaching for this patient?
Select all that apply.
1. esophagectomy
2. gastric resection
3. laparoscopic myotomy
4. balloon dilation of the lower esophageal sphincter
5. endoscopically guided injection of botulinum toxin
Correct Answer: 3, 4, 5
Treatment of achalasia may include endoscopically guided injection of botulinum toxin into the lower esophageal sphincter or balloon dilation of the LES. Botulinum toxin injection lowers LES pressure, but may need to be repeated every 6 to 9 months. Balloon dilation tears muscle fibers in the LES, reducing its pressure. A laparoscopic myotomy reduces pressure and relieves symptoms. An esophagectomy is indicated for esophageal cancer. Gastric resection is indicated for gastric cancer.
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A nurse on a postsurgical unit is providing care for a 76-year-old female client who is 2 days posthemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours,
though she is not exhibiting signs of pain. Which of the following guidelines should the nurse use for short-term and long-term treatment of the client's pain? A) Reconciling the client's need for opioid analgesics with the risk of addiction to these drugs B) Recognizing the client's pain is not likely self-limiting C) Knowing that the client's self-report of pain is the most reliable indicator of pain D) Realizing that chronic pain is likely to require innovative and complex treatment
Ethical perspectives discussed in this chapter are (choose two):
a. Ethical relativism b. Bioethical studies c. Ethical objectivism d. Moral reasoning
In the case of Tarosoff v. The Regents of the University of California (1976), the court said that health care providers have a duty to breach confidentiality when:
a. a mentally ill person has a history of violence b. a client, with a psychiatric diagnosis that carries any risk of harm to others, returns to his or her family c. a client tells the health care provider that he or she is going to harm anyone who mistreats him or her d. a client makes a specific threat to an identifiable person
A nursing student that immediately informs her clinical instructor after she realizes that she has administered the wrong dose of medication to a patient is best described professionally as:
1. Confident 2. Trustworthy 3. Compliant 4. Accountable