Which factor(s) prevent(s) breakdown of the body's normal defense barriers that protect against ulcer formation? (Select all that apply.)
a. Stomach pH
b. Prostaglandins
c. Intrinsic factor
d. Mucous cells
e. Hydrochloric acid
ANS: B, D
Prostaglandins play a major role in protecting the stomach walls from injury by stomach acids and enzymes. They inhibit gastric acid secretion, maintain blood flow, and stimulate mucus and bicarbonate production. Mucous cells secrete mucus that coats the stomach wall and protects the stomach wall from hydrochloric acid and the digestive enzyme pepsin. For decades, ulcer treatment focused on reducing acid secretions (anticholinergic agents, H2 antagonists, proton pump inhibitors), neutralizing acid (antacids), or coating ulcer craters to hasten healing (sucralfate). Major changes in therapy have come about because the FDA has approved antibiotics to eradicate H. pylori. Intrinsic factor is a glycoprotein secreted by parietal cells of the gastric mucosa. It has an important role in the absorption of vitamin B12 (cobalamin) in the intestine, and failure to produce or use intrinsic factor results in the condition termed pernicious anemia.
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A nurse is caring for an 82-year-old woman in the postanesthesia care unit (PACU). The woman begins to awaken and responds to her name but is confused, restless, and agitated. The nurse is aware that:
A) Postoperative confusion indicates an oxygen problem or possibly a stroke during surgery. B) Confusion, restlessness, and agitation are normal postoperative findings and will diminish in time. C) Postoperative confusion is common in the elderly, but it could also indicate a significant blood loss. D) Confusion, restlessness, and agitation indicate inadequate pain management; analgesics will help.
A patient is scheduled to have a fecal occult blood test. Before the test, the nurse should instruct the patient to avoid:
A) Nonsteroidal anti-inflammatory drugs B) Acetaminophen C) Fish D) Carrots
When administering a blood transfusion to a client, which tasks can the nurse delegate to the experienced unlicensed personnel? (Select all that apply.)
a. Assisting the client to a comfortable position b. Reporting any complaints to the physician c. Taking the client's vital signs d. Verifying the client's identity with the nurse
When collecting information for a psychosocial assessment, the nurse should question which of the following clients about their history of alcohol and drug use?
A) clients who have a history of substance abuse B) clients admitted with elevated drug or alcohol levels C) all clients D) clients who display unhealthy coping skills