A client with peptic ulcer disease (PUD) is admitted to the emergency room complaining of sudden severe upper abdominal pain. Assessment indicates an extremely tender and rigid abdomen, blood pressure 90/60 mmHg, and pulse of 110 beats/minute. Which procedure should the emergency department nurse plan for immediate implementation?
Nasogastric tube insertion.
Iced saline lavage.
Administration pantoprazole (Protonix) IV, a proton pump inhibitor.
Emergency abdominal surgery.
The Correct Answer is D
Choice A: Nasogastric tube insertion may be indicated in the management of a client with peptic ulcer disease (PUD) to assess bleeding, relieve gastric distention, or administer medications. However, in this scenario, the client's presentation with sudden severe upper abdominal pain, a tender and rigid abdomen, hypotension, and tachycardia suggests a potentially life-threatening condition that requires immediate intervention beyond nasogastric tube insertion.
Choice B: Iced saline lavage is not a standard procedure for managing peptic ulcer disease (PUD) or its complications. It is not the immediate intervention required for the client's presentation.
Choice C: Administration of pantoprazole (Protonix) IV, a proton pump inhibitor, is a relevant intervention for managing peptic ulcer disease (PUD), but it may not be the most immediate action needed for a client with sudden severe abdominal pain, hypotension, and tachycardia. More urgent interventions are required.
Choice D: Emergency abdominal surgery is the most appropriate and immediate intervention for a client with sudden severe upper abdominal pain, a tender and rigid abdomen, hypotension, and tachycardia. These signs and symptoms may indicate a perforated peptic ulcer, which is a surgical emergency requiring prompt exploration and repair of the perforation to prevent peritonitis and sepsis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A: Praising the client for weight loss without knowing the underlying cause may not be appropriate. Rapid and unexplained weight loss can be a sign of underlying health issues.
Choice B: Advising the client to schedule an appointment with a healthcare provider is the most appropriate action. Rapid and unexplained weight loss should be evaluated by a healthcare professional to identify any potential underlying health concerns.
Choice C: Advising the client to begin taking a multivitamin daily does not address the underlying cause of the weight loss and may not be the most appropriate action.
Choice D: Documenting the client's reason for using the herb is important but should be accompanied by further evaluation and intervention by a healthcare provider due to the significant weight loss.
Correct Answer is D
Explanation
Choice A: Hematocrit is a measure of the proportion of blood volume occupied by red blood cells. While it can provide information about anemia or dehydration, it is not typically the first consideration in evaluating numbness and tingling in the extremities.
Choice B: Reviewing albumin and protein levels may be important for assessing overall nutritional status and potential causes of neuropathy but is not the immediate priority when a client reports numbness and tingling in the extremities.
Choice C: White blood cell count (WBC) is important for assessing immune function and the presence of infections. However, it is not typically the primary focus when evaluating numbness and tingling in the extremities.
Choice D: Electrolytes, such as serum sodium and potassium levels, are crucial to review when a client reports numbness and tingling in the extremities. Abnormal electrolyte levels can lead to neurological symptoms, and a review of electrolyte levels can help identify potential causes.
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