A nurse is collecting data from a client who has peptic ulcer disease. Which of the following findings is a manifestation of gastrointestinal perforation?

Choice A: Bradycardia. This is not a manifestation of gastrointestinal perforation, but rather a sign of vagal stimulation, which can occur in response to gastric distension, vomiting, or suctioning. Vagal stimulation can slow down the heart rate and lower the blood pressure.

Choice B: Hyperactive bowel sounds. This is not a manifestation of gastrointestinal perforation, but rather a sign of increased intestinal motility, which can occur in response to inflammation, infection, or irritation of the gastrointestinal tract. Hyperactive bowel sounds are loud, high-pitched, and frequent.

Choice C: Report of epigastric fullness. This is not a manifestation of gastrointestinal perforation, but rather a sign of delayed gastric emptying, which can occur in response to gastric outlet obstruction, gastroparesis, or pyloric stenosis. Epigastric fullness is a feeling of pressure or discomfort in the upper abdomen after eating.

Choice D: Severe upper abdominal pain. This is a manifestation of gastrointestinal perforation, which is a life-threatening complication of peptic ulcer disease. Peptic ulcer disease is a condition that causes erosion and ulceration of the mucosal lining of the stomach or duodenum. If the ulcer penetrates through the wall of the gastrointestinal tract, it can cause perforation, which is a hole that allows gastric contents to leak into the peritoneal cavity. This can cause peritonitis, which is an inflammation and infection of the peritoneum. Peritonitis can cause severe upper abdominal pain, which may radiate to the shoulder or back. The pain may be sudden, sharp, and constant.

Choice A: Rapid pulse. This is not a finding that indicates that the client is experiencing DKA, but rather a sign of hypoglycemia, which is a low level of glucose in the blood. Hypoglycemia can cause rapid pulse due to increased sympathetic nervous system activity and decreased cardiac output.

Choice B: Clammy skin. This is not a finding that indicates that the client is experiencing DKA, but rather a sign of hypoglycemia. Hypoglycemia can cause clammy skin due to increased sweating and vasoconstriction.

Choice C: Choice C: Confusion is commonly found in HHS rather than DKA.

Choice D: Polydipsia. This is a finding that indicates that the client is experiencing DKA due to the high level of glucose in the blood. Hyperglycemia in DKA can cause polydipsia, which is excessive thirst, due to osmotic diuresis and dehydration.