After hiatal hernia repair surgery a client is on iv

After hiatal hernia repair surgery, a client is on IV pantoprazole (Protonix). The client asks the nurse why
this medication is given since there is no history of ulcers. What response by the nurse is best?
a. Bacteria can often cause ulcers.
b. This operation often causes ulcers.
c. The medication keeps your blood pH
low.
d. It prevents stress-related ulcers.
RESPONSE: D
After surgery, anti-ulcer medications such as pantoprazole are often given to prevent stress-related ulcers. The
other responses are incorrect.
DIF:Understanding/Comprehension REF: 1090
KEY: Gastrointestinal disorders| proton pump inhibitors| patient education
MSC:Integrated Process: Teaching/Learning
NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies
13.A nurse works on the surgical unit. After receiving the hand-off report, which client should the nurse see
first?
a. Client who underwent diverticula removal with a pulse of 106/min

Test Bank - Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care 9e 451
b. Client who had esophageal dilation and is attempting first postprocedure oral
intake
c. Client who had an esophagectomy with a respiratory rate of 32/min
d. Client who underwent hernia repair, reporting incisional pain of 7/10
RESPONSE: C
The client who had an esophagectomy has a respiratory rate of 32/min, which is an early sign of sepsis; this
client needs to be assessed first. The client who underwent diverticula removal has a pulse that is out of the
normal range (106/min), but not terribly so. The client reporting pain needs pain medication, but the client with
the elevated respiratory rate needs investigation first. The nurse should see the client who had esophageal
dilation prior to and during the first attempt at oral feedings, but this can wait until the other clients are cared
for.
DIF:Analyzing/Analysis REF: 1098
KEY:Gastrointestinal disorders| sepsis| nursing assessment
MSC:Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care
14.
The following data relate to an older client who is 2 hours postoperative after an esophagogastrostomy:
Physical Assessment Vital Signs Physician Orders
Skin dry
Urine output 20 mL/hr
NG tube patent with 100 mL brown
drainage/hr
Restless
Pulse: 128 beats/min
Blood pressure: 88/50 mm
Hg
Respiratory rate: 20 on
ventilator
Cardiac output: 2.1 L/min
Oxygen saturation: 99%
Normal saline at 75 mL/hr
Morphine sulfate 2 mg IV push every 1 hr
PRN pain
Intake and output every hour
Vital signs every hour
Vancomycin (Vancocin) 1 g IV every 8 hr
What action by the nurse is best?
a. Administer the prescribed pain medication.
b. Consult the surgeon about a different antibiotic.
c. Consult the surgeon about increased IV fluids.
d. Have respiratory therapy reduce the respiratory rate.