A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the mid epigastric region along with a rigid, board-like abdomen. These clinical manifestations are most likely indicative of which of the following?
The esophagus has become inflamed
An intestinal obstruction has developed
Additional ulcers have developed
The ulcer has perforated
The Correct Answer is D
A. Inflammation of the esophagus (esophagitis) may cause symptoms like heartburn or dysphagia, but it would not explain the sudden, sharp pain or rigid abdomen seen with a perforated ulcer.
B. An intestinal obstruction can cause abdominal pain and distension, but the rigid, board-like abdomen is more characteristic of peritonitis from a perforated ulcer, not an obstruction.
C. Additional ulcers could cause pain and bleeding, but they would not explain the sudden, sharp pain and rigid abdomen that typically result from perforation.
D. The sudden onset of sharp, severe pain in the mid epigastric area, along with a rigid, board-like abdomen, are hallmark signs of a perforated ulcer, which causes peritonitis. This is a medical emergency, as the perforation allows gastric contents to leak into the peritoneal cavity, leading to widespread infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. 3% sodium chloride is a hypertonic solution used to treat severe hyponatremia and should not be used as a substitute for TPN.
B. Lactated Ringer's is an isotonic solution typically used for fluid resuscitation, but it lacks the necessary components (glucose, amino acids) that are found in TPN.
C. 0.9% sodium chloride is an isotonic saline solution and can be used for hydration, but it does not provide the calories and nutrients that the client is receiving through TPN.
D. Dextrose 10% in water is the best choice in this scenario. It provides glucose for energy and can help maintain blood sugar levels until the next TPN solution is available. It is commonly used as a temporary substitute for TPN to prevent hypoglycemia.
Correct Answer is B
Explanation
A. Fever and chills are often indicative of infection, which may be a concern with TPN, but they are not typically the immediate concern if the TPN solution is not infusing.
B. Shakiness and diaphoresis (sweating) can occur due to hypoglycemia, which is a potential consequence of an interrupted TPN infusion. TPN provides glucose to the client, and a disruption in the infusion could cause a drop in blood sugar, leading to shakiness and diaphoresis.
C. Excessive thirst and urination are common symptoms of hyperglycemia or diabetes, but they are not typically seen with an interrupted TPN infusion.
D. Hypertension and crackles are more related to fluid overload or heart failure, which would not be an immediate concern in the case of an infusion pump malfunction for TPN.
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