A client is admitted with a possible small bowel obstruction. The nurse anticipates that the client's care will include: (SELECT ALL THAT APPLY)

keeping the client NPO.

measuring abdominal girth.

relieving pain with opioid narcotics.

administering fluid replacement therapy.

preparing the client for radiologic studies.

Answer and Explanation

Correct Answer : A,B,D,E

A.   Keeping the client NPO (nothing by mouth) helps to rest the gastrointestinal tract, reduces the risk of further obstruction, and prevents exacerbation of symptoms such as vomiting.
B.   Measuring abdominal girth is an important nursing assessment for a client with a possible small bowel obstruction. An increase in abdominal girth can indicate abdominal distension, which is a common sign of bowel obstruction.
C.   Severe abdominal pain is a common symptom of bowel obstruction, and opioids may be necessary to manage pain effectively. However, opioids should be used cautiously due to the risk of exacerbating bowel obstruction by reducing bowel motility.
D.   Fluid replacement therapy is important for clients with small bowel obstruction, especially if they are vomiting or have fluid loss due to intestinal secretions. Intravenous fluids may be administered to maintain hydration, correct electrolyte imbalances, and prevent dehydration.
E.   Radiologic studies, such as abdominal X-rays or computed tomography (CT) scans, are often used to confirm the diagnosis of small bowel obstruction and assess its severity.

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Correct Answer is A

Explanation

A. Sit the client up and provide supplemental oxygen is the correct priority intervention. Chest pain and shortness of breath can be indicative of pulmonary embolism or other respiratory complications, which require immediate attention. Sitting the client up helps improve respiratory mechanics, and providing supplemental oxygen can support oxygenation while further assessments are conducted.
B. While contacting the physician and obtaining an arterial blood gas may be necessary to assess respiratory status and oxygenation, it is not the immediate priority. The client's symptoms require immediate intervention to ensure adequate oxygenation and prevent further deterioration.
C. Chest pain and shortness of breath are not typically expected findings after bariatric surgery and could indicate serious complications. It is essential not to dismiss the client's symptoms but to take them seriously and initiate appropriate interventions.
D. While the use of an incentive spirometer is important for preventing respiratory complications after surgery, it is not the priority intervention in this situation. The client's current symptoms require immediate attention to address potential respiratory distress or other serious complications.

A. Fluid overload B. Altered body image C. Imbalanced nutrition - less than body requirements D. Social isolation

Correct Answer is C

Explanation

C. Crohn's disease exacerbation often leads to malnutrition due to decreased oral intake, malabsorption, and increased nutrient losses through diarrhea. Addressing imbalanced nutrition is crucial to replenish depleted nutrient stores, support healing, and prevent further complications.
A. While fluid overload can be a concern in certain situations, such as when administering intravenous fluids or in clients with renal impairment, it is not typically a primary concern in clients hospitalized with Crohn's disease exacerbation. Crohn's disease is more commonly associated with dehydration due to diarrhea and malabsorption rather than fluid overload.
B. In the acute phase of Crohn's disease exacerbation, addressing immediate physiological needs and stabilizing the client's condition typically take precedence over psychosocial concerns.
D. Social isolation can be a concern for clients with chronic illnesses, including Crohn's disease, as it may impact their quality of life and emotional well-being. However, in the acute phase of exacerbation, addressing physiological needs and stabilizing the client's condition typically takes precedence over psychosocial concerns such as social isolation.

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A client is admitted with a possible small bowel obstruction. The nurse anticipates that the client's care will include: (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client after bariatric surgery. The client complains of chest pain and shortness of breath. What is the priority nursing Intervention at this time?

Correct Answer is A

Explanation

The nurse is writing a care plan for a client who was diagnosed with Crohn's disease a year ago and is now hospitalized with a fourth acute exacerbation. Which client problem should receive the highest priority?

Correct Answer is C

Explanation

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