A client is complaining of abdominal pain and feeling hot about 24 hours after an appendectomy. The nurse determines the client's temperature is 102°F. The nurse suspects peritonitis as a possible complication based on the results of her assessment. Which of the following symptoms would support the development of this complication?

Decreased body temperature

Increased bowel sounds

Rigidity of the abdomen upon palpation

Decreased pain intensity with palpation

Answer and Explanation

The Correct Answer is C

A. Decreased body temperature: Peritonitis typically causes fever (elevated temperature) due to infection/inflammation, not a decreased temperature.

B. Increased bowel sounds: Peritonitis usually leads to hypoactive or absent bowel sounds because inflammation causes intestinal ileus, not increased sounds.

C. Rigidity of the abdomen upon palpation: Rigid, board-like abdominal muscles (guarding/rigidity) with rebound tenderness are classic signs of peritoneal irritation/inflammation.

D. Decreased pain intensity with palpation: Pain typically increases with palpation and rebound in peritonitis; decreased pain with palpation would not support peritonitis.

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Correct Answer is D

Explanation

A. Administer a laxative to promote bowel movement:Laxatives are contraindicated - they increase bowel motility and could precipitate perforation or worsen obstruction/peritonitis in an acute abdomen.

B. Offer the client pain medication:Analgesia is important but not the priority if the client shows signs of worsening/complication (increasing pain, distention, vomiting). Masking worsening signs without prompt evaluation could be harmful. Pain meds may be given after notifying the provider and as ordered.

C. Assist the client to ambulate in the hallway:Ambulation is inappropriate for a client with a potentially worsening acute abdominal process (risk of perforation, hemodynamic instability, or sudden deterioration). It could increase discomfort and risk.

D. Notify the healthcare provider immediately:These signs suggest possible complication (perforation, bowel obstruction, or peritonitis). Immediate notification allows urgent reassessment and possible expediting of surgery or additional interventions - this is the most appropriate immediate action.

A. Bradycardia B. Severe upper abdominal pain C. Hyperactive bowel sounds D. Report of epigastric fullness

Correct Answer is B

Explanation

A. Bradycardia:Gastrointestinal perforation usually triggers tachycardia due to hypovolemia, pain, and shock. Bradycardia is not typical in this context.

B. Severe upper abdominal pain:Perforation causes sudden, severe, and rigid abdominal pain due to leakage of gastric contents into the peritoneal cavity, resulting in peritonitis.

C. Hyperactive bowel sounds:Perforation typically causes absent or hypoactive bowel sounds because intestinal motility ceases in peritonitis. Hyperactive sounds are more typical of obstruction or early gastritis.

D. Report of epigastric fullness:Epigastric fullness is a common symptom of dyspepsia or non-complicated ulcer disease. It is not indicative of the acute, life-threatening complication of perforation.

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Naxlex Comprehensive Predictor Exams

A client admitted with appendicitis who is scheduled for surgery in 2 hours complains of increased abdominal pain, vomiting, distended abdomen, and diminished bowel sounds. What is the most appropriate nursing intervention?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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