A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. What action by the nurse is appropriate?

Allow the client cool liquids only.

Tell the client to wait 4 hours.

Remind the client to remain NPO.

Check the client’s gag reflex.

Answer and Explanation

The Correct Answer is D

An esophagogastroduodenoscopy (EGD) is an invasive diagnostic procedure where an endoscope is passed through the esophagus into the stomach. To facilitate the procedure, the posterior pharynx is typically numbed with a topical anesthetic spray to suppress the gag reflex. Until the effects of this anesthesia wear off, the patient is at high risk for aspiration and airway obstruction if they attempt to swallow liquids or solids.

Rationale:

A. Allowing cool liquids before confirming the return of the gag reflex is dangerous and places the patient at risk for aspiration pneumonia. Even if the liquids are cool, the inability to coordinate swallowing due to pharyngeal anesthesia can cause the fluid to enter the trachea instead of the esophagus, leading to acute respiratory distress.

B. Telling the client to wait a fixed 4 hours is an arbitrary instruction that may not reflect the patient's actual physiological recovery. The duration of topical anesthesia varies between individuals. The nurse should use an objective clinical assessment, such as testing the gag reflex, rather than a timed interval to determine when it is safe to resume oral intake.

C. While the patient is temporarily NPO after the procedure, the nurse's role is to facilitate the transition back to oral intake as soon as it is safe. Simply reminding the patient to remain NPO does not include the necessary assessment to determine when the restriction can be lifted. The nurse must actively evaluate the patient's readiness for fluids.

D. Checking the client's gag reflex is the most appropriate and essential nursing action. By stimulating the back of the throat with a tongue depressor, the nurse can confirm that the protective airway reflexes have returned. This ensures that the patient can safely swallow without the risk of aspiration, which is the primary safety concern following upper GI endoscopy.

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Correct Answer is D

Explanation

Celiac diseaseis an autoimmune enteropathy triggered by the ingestion of glutenin genetically predisposed individuals. The immune response causes villous atrophy in the small intestine, significantly reducing the surface area available for nutrient absorption. This leading to profound malabsorptionof fats and fat-soluble vitamins, which alters the composition and appearance of the stool as unabsorbed nutrients are excreted.

Rationale:

A.Joint pain and inflammation are extra-intestinal manifestations that can occur in celiac disease but are not considered "classic" symptoms. These systemic symptoms are common to many autoimmune disorders. The hallmark signs of celiac disease are primarily gastrointestinal, reflecting the direct damage to the intestinal mucosa and the resulting failure of the digestive process.

B.Secondary lactose intolerance often accompanies celiac disease because the damaged villi cannot produce enough lactase enzyme. However, this is a secondary effect rather than the defining classic symptom of the primary disease process. Many other conditions cause lactose intolerance, making it less specific than the malabsorption signs directly linked to gluten-induced intestinal injury.

C.Iron deficiency anemia is a frequent consequence of the malabsorption seen in celiac disease because iron is absorbed in the duodenum, where damage is often most severe. While it is a common diagnostic clue, it is a secondary complication. The most characteristic and direct clinical indicator of the intestinal failure associated with celiac disease involves the nature of the stool.

D.Steatorrheais the classic symptom of Celiac Disease. It refers to the presence of excess fat in the feces, resulting from the malabsorption caused by villous atrophy. These stools are typically foul-smelling, oily, and frothy, and they often float in the toilet. This finding directly reflects the primary pathophysiology of the disease: the inability of the small intestine to absorb lipids.

A. "Maintaining a low-fiber diet will manage my constipation." B. "Limiting the amount of fluid that I drink with meals is very important." C. "A cup of caffeinated coffee with cream & sugar at dinner is OK for me." D. "I need to go for a walk every day if possible."

Correct Answer is D

Explanation

Irritable bowel syndrome(IBS) is a functional gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits. Management of the constipation-predominant subtype (IBS-C) focuses on enhancing colonic motilityand improving stool consistency through lifestyle modifications. Physical activityand dietary fiber intake are foundational to reducing intestinal transit time.

Rationale:

A.Maintaining a low-fiber diet is contraindicated for managing constipation in IBS. Low fiber intake contributes to hard, infrequent stools and prolonged colonic transit time. Increasing soluble fiber to 25 to 35 grams daily is recommended to increase stool bulk and facilitate easier passage through the gastrointestinal tract.

B.Limiting fluid intake is counterproductive for a patient with constipation. Adequate hydration is essential for fiber to function effectively within the intestinal lumen. Restricting fluids can lead to excessively dry fecal matter, worsening the straining and discomfort associated with IBS-C, whereas 2 liters of water daily is usually advised.

C.Caffeine, cream, and sugar are common triggers that can exacerbate IBS symptoms. Caffeine acts as a chemical stimulant that can cause irregular peristaltic contractions and abdominal cramping. High-fat dairy products like cream and refined sugars may lead to increased gas production and bloating, making this an inappropriate dinner choice.

D.Walking every day is an effective non-pharmacological intervention for IBS-C because it stimulates natural peristalsis. Regular aerobic exercise helps regulate autonomic nervous system activity within the gut, promoting more consistent bowel movements. This statement confirms the client understands the importance of physical activity in maintaining healthy gastrointestinal motility and reducing symptoms.

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A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. What action by the nurse is appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the classic symptom of Celiac Disease?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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