The nurse is assessing a patient diagnosed with gastrointestinal ...

[tiffannnnyyyyyy]

The nurse is assessing a patient diagnosed with gastrointestinal bleeding. Which finding should alert the nurse that the patient's condition is deteriorating?
 
  1. The patient reports feeling very tired.
  2. Urinary output has increased over the previous hour to 50 mL.
  3. The patient's skin is warm and dry.
  4. Capillary refill time has increased.

Question 2

The nurse is caring for a patient with gastroesophageal reflux disease (GERD). What should the nurse include when teaching the patient about this health problem?
 
  Select all that apply.
  1. Limit last food intake to 3 hours before bedtime.
  2. Eat the largest meal of the day at midday.
  3. Sleep in a bed with the head elevated 6 to 8 inches.
  4. Follow a daily exercise routine.
  5. Drink coffee with meals.

[owenfalvey]

Answer to Question 1

Correct Answer: 1
Alterations in level of consciousness can signal an increase in blood loss. This warrants further investigation. Urinary output should remain greater than 30 mL per hour. Skin characteristics such as warmth and dryness are normal. Capillary refill time decreases, not increases, with increased blood loss.

Answer to Question 2

Correct Answer: 1, 3
The patient should avoid eating anything within 3 hours of bedtime. The head of the bed should be elevated on 6- to 8-inch blocks. The patient should be instructed to eat small, frequent meals. An exercise routine is not identified in the treatment of GERD. Coffee increases gastric acidity and interferes with gastric emptying, increasing the incidence of gastroesophageal reflux.