Gastrointestinal System Disorders Q 201 - Gyan Darpan : Learning Portal
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Tuesday 12 April 2022

Gastrointestinal System Disorders Q 201

Which of the following tasks should be included in the immediate postoperative management of a client who has undergone gastric resection?
    A. Monitoring gastric pH to detect complications.
    B. Assessing for bowel sounds.
    C. Providing nutritional support.
    D. Monitoring for symptoms of hemorrhage.

Correct Answer: D. Monitoring for symptoms of hemorrhage.

The client should be monitored closely for signs and symptoms of hemorrhage, such as bright red blood in the nasogastric tube suction, tachycardia, or a drop in blood pressure. Identify signs and symptoms requiring medical evaluation such as persistent nausea and vomiting or abdominal fullness; weight loss; diarrhea; foul-smelling fatty or tarry stools; bloody or coffee-ground vomitus or presence of bile, fever. Instruct the patient to report changes in pain characteristics.

Option A: Gastric pH may be monitored to evaluate the need for histamine-2 receptor antagonists. Caution the patient to read labels and avoid products containing ASA, ibuprofen. This can cause gastric irritation and bleeding. Review medication purpose, dosage, and schedule, and possible side effects.
Option B: Bowel sounds may not return for up to 72 hours postoperatively. Auscultate for resumption of bowel sounds and note passage of flatus. Peristalsis can be expected to return about the third postoperative day, signaling readiness to resume oral intake.
Option C: Nutritional needs should be addressed soon after surgery. Monitor tolerance to fluid and food intake, noting abdominal distension, reports of increased pain, cramping, nausea, and vomiting. Avoid milk and high-carbohydrate foods in the diet because this may trigger dumping syndrome.

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