A client who had a biliopancreatic diversion procedure (BDP) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?

Loose bowel movements.

Occult positive emesis.

Strong foul smelling flatus.

Report of poor night vision.

Answer and Explanation

The Correct Answer is B

B. Occult positive emesis refers to vomiting that occurs without the client's awareness, meaning that the vomitus may not be easily visible or readily apparent. Vomiting can lead to significant fluid loss and dehydration, which is particularly concerning in a client who has undergone a biliopancreatic diversion procedure (BDP).
A. Loose bowel movements may indicate gastrointestinal disturbances or malabsorption issues commonly seen after biliopancreatic diversion procedure (BDP). BDP involves rerouting a significant portion of the small intestine, which can affect digestion and absorption of nutrients and fluids.
C. Strong foul-smelling flatus may indicate bacterial overgrowth or malabsorption issues in the gastrointestinal tract, which can occur after BDP. While foul-smelling flatus can be uncomfortable and indicative of gastrointestinal disturbances, it may not require immediate intervention.
D. Poor night vision may suggest vitamin deficiencies, particularly deficiencies in fat-soluble vitamins such as vitamin A, which can occur after BDP due to reduced absorption of nutrients. While poor night vision should be addressed to prevent long-term complications, it may not pose an immediate threat to the client's health.

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Correct Answer is ["B","C","F"]

Explanation

B. Sugary beverages and juices are major sources of added sugars and can contribute to weight gain, insulin resistance, and an increased risk of type 2 diabetes mellitus. By eliminating these beverages from the diet, the client can reduce their intake of empty calories and excess sugars, which may help improve blood sugar control and reduce the risk of diabetes.
C. Fiber-rich foods, such as fruits, vegetables, whole grains, and legumes, can help improve blood sugar control, promote satiety, and support weight management. Fiber also helps regulate bowel movements and may reduce the risk of developing type 2 diabetes mellitus.
F. Refined grains, such as white bread, white rice, and sugary cereals, have been stripped of their fiber and nutrients during processing, leading to rapid spikes in blood sugar levels. Minimizing the intake of refined grains and opting for whole grains instead can help stabilize blood sugar levels, improve insulin sensitivity, and reduce the risk of type 2 diabetes mellitus.
A. While some studies have suggested that cinnamon may have beneficial effects on blood sugar control, the evidence is limited and inconsistent. Additionally, taking high doses of cinnamon supplements may not be safe for everyone, particularly those with liver disease or taking certain medications.
D. While reducing intake of unhealthy fats, such as saturated and trans fats, is important for overall health and reducing the risk of heart disease, eliminating all fats from the diet is unnecessary and potentially harmful. Healthy fats, such as those found in nuts, seeds, avocados, and olive oil, are essential for nutrient absorption, hormone production, and overall well-being.
E. Increasing protein intake significantly may not be necessary or advisable for this client, especially without knowing their specific dietary needs and preferences. While protein is an important macronutrient for muscle repair and maintenance, doubling the usual amount of protein in the diet may not offer additional benefits and could potentially lead to imbalances in other nutrients.

A. Hold the next dose of lactulose. B. Continue the prescribed dose of lactulose. C. Replace total volume voided with oral or IV fluids. D. Report the number of diarrhea stools to the healthcare provider (HCP).

Correct Answer is B

Explanation

B. Lactulose works by acidifying the colonic contents, which promotes the conversion of ammonia (NH3) to ammonium (NH4+). Ammonium is less readily absorbed from the colon into the bloodstream, reducing systemic ammonia levels. This action helps alleviate the neurotoxic effects of ammonia on the brain, thereby improving neurological symptoms associated with hepatic encephalopathy.
A. Lactulose is required in clients with hepatic encephalopathy to excrete ammonia lowering its levels in blood. Holding the lactulose dose is inappropriate as the client’s ammonia levels are still high
C. Rehydrating the clients to replace lost fluids in the loose stools is important but does not address
the client’s elevated ammonia levels which may be exacerbating the client’s encephalopathy.
D. Reporting the number of diarrhea stools to the healthcare provider is important for ongoing assessment and management of the client's condition. However, it does not address the clients high ammonia levels.

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A client who had a biliopancreatic diversion procedure (BDP) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Exhibits Review H and P, nurse's note, and laboratory results. What other nutritional recommendation(s) would be helpful for this client in reducing risk for type 2 diabetes mellitus? Select all that apply.

Correct Answer is ["B","C","F"]

Explanation

Correct Answer is B

Explanation

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