A nurse is contributing to the care plan for a patient who has acute pancreatitis.
Which of the following interventions should the nurse include?

Monitor peripheral pulses every 8 hours

Measure urine output every 4 hours

Maintain NPO status

Ambulate the patient three times daily

Answer and Explanation

The Correct Answer is C

Choice A rationale
Monitoring peripheral pulses every 8 hours is not typically a priority in the care plan for a patient with acute pancreatitis. While cardiovascular monitoring is important in all patients, it is not specifically related to the management of acute pancreatitis.
Choice B rationale
Measuring urine output every 4 hours can be important in assessing fluid balance and kidney function, but it is not the primary intervention in the care plan for a patient with acute pancreatitis.
Choice C rationale
Maintaining NPO (nothing by mouth) status is a key intervention in the management of acute pancreatitis. This helps to rest the pancreas and reduce the production of digestive enzymes.
Choice D rationale
Ambulating the patient three times daily is generally a good practice for postoperative recovery, but it is not specific to the care of a patient with acute pancreatitis. In the acute phase of pancreatitis, rest is often recommended.

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Correct Answer is A

Explanation

Choice A rationale
Dumping syndrome is a condition that occurs when food moves too fast from the stomach to the duodenum, usually after a surgery to the stomach. Early signs of dumping syndrome include abdominal cramps, diarrhea, nausea, vomiting, flushing, dizziness, and rapid heart rate. One of the late symptoms of dumping syndrome is sweating. Therefore, sweating and pallor can indicate the occurrence of dumping syndrome.
Choice B rationale
Bradycardia and indigestion are not typically associated with dumping syndrome. While digestive issues can occur, they usually manifest as nausea, vomiting, and diarrhea rather than indigestion.
Choice C rationale
Dry skin and stomach pain are not typically associated with dumping syndrome. The primary symptoms of dumping syndrome are related to the digestive system and the body’s response to rapid changes in blood sugar levels.
Choice D rationale
Double vision and chest pain are not typically associated with dumping syndrome. These symptoms may be indicative of other medical conditions and should be evaluated separately

A. Position A B. Position B C. Position C D. Position D

Correct Answer is A

Explanation

Choice A rationale
The most common position for administering an enema is the left lateral position, where the patient lies on their left side with their right leg flexed toward their chest. This position allows for the best flow of the enema solution by gravity along the natural curves of the sigmoid colon and rectum.
Choice B rationale
Position B is not typically recommended for enema administration.
Choice C rationale
Position C is not typically recommended for enema administration.
Choice D rationale
Position D is not typically recommended for enema administration

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A nurse is contributing to the care plan for a patient who has acute pancreatitis. Which of the following interventions should the nurse include?

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A nurse is contributing to the care plan for a patient who has acute pancreatitis.
Which of the following interventions should the nurse include?