A patient has severe trauma from an automobile accident.

The nurse is checking the gastric pH and is administering Protonix 40 mg IV piggyback two times a day as ordered.

This is prophylactic to prevent which of the following?

Choice A rationale
Pancreatitis can lead to gastrointestinal bleeding. Inflammation of the pancreas can cause damage to the organ’s blood vessels, leading to bleeding. This can be a serious complication of pancreatitis.
Choice B rationale
Peptic ulcer disease is a common cause of gastrointestinal bleeding. Ulcers are sores that develop on the lining of the stomach, upper small intestine, or esophagus. When these ulcers erode into blood vessels, bleeding can occur.
Choice C rationale
Inflammatory bowel disease (IBD), which includes conditions like Crohn’s disease and ulcerative colitis, can cause ulcers in the digestive tract. These ulcers can bleed, leading to gastrointestinal bleeding.
Choice D rationale
Gastrointestinal malignancy, or cancer, can cause gastrointestinal bleeding. Tumors can erode into blood vessels or cause ulcers that bleed.
Choice E rationale
Diverticulosis involves the formation of small pouches in the wall of the digestive tract. These pouches can bleed, leading to gastrointestinal bleeding.
Choice F rationale
Gallbladder disease typically does not cause gastrointestinal bleeding. The gallbladder stores bile, a fluid produced by the liver to digest fats. While gallstones and inflammation of the gallbladder are common, they do not usually lead to gastrointestinal bleeding.
Choice G rationale
Hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone, is not typically associated with gastrointestinal bleeding. Symptoms of hypothyroidism can include fatigue, weight gain, and depression, but not gastrointestinal bleeding.

Choice A rationale
Maintaining the client on bed rest is not a recommended intervention for a client with urolithiasis. Bed rest does not facilitate the passage of stones and can lead to complications such as deep vein thrombosis.
Choice B rationale
Encouraging the client to drink 3 L of fluids per day is the correct intervention. Increased fluid intake can help flush out the urinary system and facilitate the passage of stones. It also helps prevent new stone formation by diluting the substances that lead to stones.
Choice C rationale
Providing the client a high protein diet is not a recommended intervention for a client with urolithiasis. High protein diets can increase the amount of calcium and uric acid in urine, which can contribute to stone formation.
Choice D rationale
Telling the client to expect a decrease in urine output is not a recommended intervention for a client with urolithiasis. Decreased urine output can lead to urinary stasis and contribute to stone formation.