A client presents with a possible bowel obstruction, and the nurse completes a detailed abdominal assessment. Which of the following clinical manifestations are consistent with a large bowel obstruction? (Select all that apply).
Profuse vomiting with fecal odor
Epigastric abdominal distention
Intermittent abdominal cramping
Ribbon-like stools or diarrhea
Metabolic acidosis
Severe fluid and electrolyte imbalance
Correct Answer : A,B,C,D,E,F
Choice A reason:Profuse vomiting with a fecal odor can occur in large bowel obstructions due to the backward flow of bowel contents.
Choice B reason:Epigastric abdominal distention is a common finding in bowel obstructions due to the accumulation of gas and fluids.
Choice C reason:Intermittent abdominal cramping results from the bowel's attempt to push contents through the obstructed area.
Choice D reason:Ribbon-like stools or diarrhea may occur if there is a partial obstruction allowing some contents to pass.
Choice E reason:Metabolic acidosis can develop due to the accumulation of lactic acid from tissue hypoxia and decreased perfusion.
Choice F reason:Severe fluid and electrolyte imbalance can result from vomiting and the inability to absorb fluids and nutrients properly.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Tenderness in the left upper abdomen is not typically associated with an obstruction of the common bile duct. This symptom is more commonly related to conditions affecting the stomach, pancreas, or spleen. The common bile duct is in the right upper quadrant of the abdomen, and tenderness in this area might be expected with its obstruction.
Choice B reason: Ecchymosis of the extremities is not a common finding in common bile duct obstruction. Ecchymosis, or bruising, is usually due to trauma, blood disorders, or other causes of fragile blood vessels and is not related to bile duct issues.
Choice C reason: Pale-colored urine is the opposite of what might be expected with common bile duct obstruction. Typically, the urine may become dark due to increased bilirubin levels that are excreted by the kidneys when the bile duct is obstructed.
Choice D reason: Fatty stools, or steatorrhea, are a classic finding in common bile duct obstruction. When bile flow is blocked, fats are not properly digested and absorbed, leading to stools that are bulky, greasy, and often have a foul odor. This occurs because bile is necessary for the emulsification and absorption of dietary fats in the intestine.
Correct Answer is ["125"]
Explanation
- Step 1: Identify the required dose in micrograms (mcg). The client is scheduled to receive 125 mcg of digoxin.
- Step 2: Identify the concentration of the available tablet. The available tablet contains 0.25 mg of digoxin.
- Step 3: Convert the tablet concentration from mg to mcg. We know that 1 mg = 1000 mcg. So, 0.25 mg = 0.25 × 1000 mcg = 250 mcg.
- Step 4: Calculate the number of tablets needed to deliver the required dose. We can set up a proportion to solve for this:
- 250 mcg is to 1 tablet as 125 mcg is to X tablets.
- In other words, 250 mcg : 1 tablet = 125 mcg : X tablets.
- Step 5: Solve for X using cross-multiplication and division:
- Cross-multiplication gives us: 250 mcg × X tablets = 125 mcg × 1 tablet.
- Simplifying this gives us: 250X = 125.
- Dividing both sides by 250 gives us: X = 125 ÷ 250.
- Calculating the division gives us: X = 0.5.
So, the nurse should administer 0.5 tablets per dose to deliver the required dose of 125 mcg.
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