A female patient presents to the emergency department with severe abdominal pain localized to the right lower quadrant, nausea, and a low-grade fever. After performing a physical examination and diagnostic imaging, the patient is diagnosed with acute appendicitis. What is the most appropriate initial intervention?
Administer intravenous antibiotics and observe the patient for 24 hours.
Provide the patient with oral pain medications and discharge them with a follow-up appointment.
Recommend a liquid diet and bed rest to reduce inflammation.
Prepare the patient for an appendectomy.
The Correct Answer is D
A. Administer intravenous antibiotics and observe the patient for 24 hours: IV antibiotics may be given preoperatively, but observation without surgery is not the standard treatment for confirmed appendicitis due to the risk of rupture.
B. Provide the patient with oral pain medications and discharge them with a follow-up appointment: Oral pain medications are not appropriate as the patient needs surgical intervention. Discharging the patient without surgery could result in life-threatening complications.
C. Recommend a liquid diet and bed rest to reduce inflammation: A liquid diet and bed rest will not address the underlying issue of appendicitis, which requires surgical removal of the inflamed appendix.
D. Prepare the patient for an appendectomy. The standard treatment for acute appendicitis is an appendectomy. Delaying surgery can lead to complications such as perforation, peritonitis, or abscess formation. This is the most appropriate intervention.
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Related Questions
Correct Answer is B
Explanation
A. Intestinal obstruction: While peritonitis can lead to intestinal obstruction, it is not the most immediate life-threatening complication compared to hypovolemic shock or sepsis.
B. Hypovolemic shock: This is a critical condition that can occur due to severe fluid loss, which might be a concern in peritonitis due to fluid shifts into the abdominal cavity. However, the patient’s signs of systemic infection (fever, elevated heart rate, low blood pressure) suggest that sepsis is a more imminent threat.
C. Electrolyte imbalance: Electrolyte imbalances are possible due to fluid loss, but they would be secondary to the more urgent concern of hypovolemic shock.
D. Sepsis: Sepsis is the highest priority due to the patient’s vital signs and symptoms indicating a systemic infection. Early recognition and treatment of sepsis are crucial to prevent organ failure and other severe complications.
Correct Answer is D
Explanation
A. "You will need to avoid high-fiber foods to prevent blockages": While caution with high-fiber foods may be needed initially, long-term, a balanced diet including fiber can help regulate bowel movements and prevent constipation. This statement could cause unnecessary concern.
B. "The output from your stoma will be mostly liquid": This statement is incorrect for a sigmoid colostomy, where the stool tends to be more formed since it is further along the digestive tract. Liquid output is more common with ileostomies or colostomies higher in the colon.
C. "You will need to change your colostomy bag every 24 hours":
Rationale: Colostomy bag changes depend on several factors, including the type of appliance and personal preferences. Bags are not changed on a strict 24-hour schedule but are emptied as needed and changed every few days or when required.
D. "Your stoma will be located on the left side of your abdomen." A sigmoid colostomy is typically located on the left lower quadrant of the abdomen, as this is the anatomical location of the sigmoid colon.
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