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 A
Explanation
Choice A: Oatmeal is often considered a source of gluten, which should be avoided by individuals with celiac disease. The nurse should inform the client that oatmeal may not be suitable for a gluten-free diet.
Choice B: Encouraging the client to choose decaffeinated coffee is a minor consideration and is not the most important action related to celiac disease.
Choice C: Commending the client for selecting fat-free milk is unrelated to the issue of gluten in the oatmeal and is not the most important action.
Choice D: Advising the client about the potential irritant effects of too much fruit on the colon is not directly related to the issue of gluten in the oatmeal and is not the most important action.
Correct Answer is B
Explanation
Choice A: Taking the medication before meals is not a specific instruction for anticoagulant therapy. The timing of anticoagulant administration can vary depending on the specific medication and dosing regimen.
Choice B: Using an electric razor when shaving is an important instruction for clients on anticoagulant therapy. Anticoagulants can increase the risk of bleeding, and using a manual razor could lead to cuts or nicks that may be harder to control.
Choice C: Eating green leafy vegetables high in vitamin K is a relevant instruction for clients taking warfarin, an anticoagulant. However, it should be emphasized that consistent intake of vitamin K-rich foods is important to maintain consistent anticoagulation levels, rather than avoiding these foods altogether.
Choice D: Instructing the client to double the next dose if a dose is missed is not appropriate for anticoagulant therapy. Missing a dose should be addressed according to the healthcare provider's guidance and may involve taking the missed dose as soon as remembered or skipping it and continuing with the regular dosing schedule.
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