A nurse is providing care for a patient who had a stroke and is experiencing difficulty swallowing. Which of the following complications should the nurse monitor for in this patient?
Peptic ulcer disease
Dumping syndrome
Aspiration
Gastroesophageal reflux disease
The Correct Answer is C
Choice A rationale
Peptic ulcer disease is not a common complication of difficulty swallowing after a stroke. It is typically caused by an infection with the bacterium Helicobacter pylori or long-term use of nonsteroidal anti-inflammatory drugs.
Choice B rationale
Dumping syndrome is not a common complication of difficulty swallowing after a stroke. It is a condition that can occur after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight.
Choice C rationale
Aspiration is a common problem for people with dysphagia, a condition that can occur after a stroke. It occurs when something you’ve swallowed enters the airway and lungs. Normally, aspiration causes a violent cough, but a stroke can reduce sensation. In this case, you may not know you’re aspirating (silent aspiration)5.
Choice D rationale
Gastroesophageal reflux disease (GERD) is not a common complication of difficulty swallowing after a stroke. GERD is a chronic disease that occurs when stomach acid or bile flows into the food pipe and irritates the lining.
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Correct Answer is D
Explanation
Choice A rationale
An erythrocyte sedimentation rate (ESR) is a blood test that can detect and monitor inflammation in the body. It measures the rate at which red blood cells (erythrocytes) in a test tube separate from blood serum over time, with the rate being faster in people with inflammatory diseases. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice B rationale
D-dimer is a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is typically used to rule out thrombosis (blood clots), not to diagnose liver disease.
Choice C rationale
C-reactive protein (CRP) is a protein made by the liver and sent into the bloodstream in response to inflammation. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice D rationale
Albumin is a protein made by the liver, and measuring its levels can help diagnose liver disease. When the liver is damaged, it can’t make enough albumin, so the level of albumin in the blood gets lower. This is why albumin is often used as a marker of liver function, and why it would be anticipated in the laboratory values ordered to confirm a diagnosis of liver disease.
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Correct Answer is A
Explanation
Choice A rationale
Gastroesophageal reflux disease (GERD) is a condition where stomach acid frequently flows back into the esophagus, causing discomfort. Certain lifestyle habits and diet can trigger or worsen GERD symptoms. Alcohol and caffeine are among the substances that can aggravate
GERD123. They can relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus. Therefore, reducing or avoiding alcohol and caffeine can help manage GERD symptoms.
Choice B rationale
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can cause or worsen GERD symptoms. It can irritate the esophagus and stomach lining, leading to heartburn and other GERD symptoms. Therefore, it’s not advisable to take aspirin if you have GERD12.
Choice C rationale
While it’s important to avoid mercury-containing foods due to their potential health risks, there’s no specific link between these foods and GERD12. GERD is primarily triggered by foods that relax the lower esophageal sphincter, cause stomach distension, or irritate the esophagus. Mercury-containing foods do not fall into these categories.
Choice D rationale
Lying down after eating can indeed increase the onset of GERD123. When you lie down, it’s easier for stomach acid to backflow into the esophagus. This is why it’s recommended to wait at least 2-3 hours after eating before lying down.
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