A nurse is planning care for a client who has acute appendicitis.
Which of the following actions should the nurse plan to take?
Administer a laxative to the client.
Keep the client on NPO status.
Place the client's head of bed flat.
Apply heat to the client's abdomen.
The Correct Answer is B
Choice A rationale:
Administering a laxative to a client with acute appendicitis is contraindicated. Laxatives can increase bowel motility, which may aggravate the inflamed appendix and lead to rupture. Rupture of the appendix can result in a life-threatening condition known as peritonitis.
Choice B rationale:
Keeping the client on NPO (nothing by mouth) status is the correct choice. NPO status is essential in the management of acute appendicitis. It helps to rest the bowel, prevents stimulation of the appendix, and decreases the risk of rupture. Oral intake, including food and fluids, is usually restricted until the client undergoes surgery to remove the inflamed appendix (appendectomy).
Choice C rationale:
Placing the client's head of bed flat is not the optimal position for a client with acute appendicitis. Elevating the head of the bed slightly (semi-Fowler's position) can help reduce discomfort and minimize pressure on the abdomen. This position is more comfortable for the client and can aid in pain management.
Choice D rationale:
Applying heat to the client's abdomen is not recommended in acute appendicitis. Heat application can increase blood flow to the area, potentially worsening inflammation and exacerbating pain. Cold packs or ice packs are sometimes used to provide comfort, but their application should be done cautiously to avoid skin damage. However, in many cases, healthcare providers prefer to avoid temperature applications to prevent masking symptoms and signs of worsening appendicitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
An angiocatheter is not appropriate for accessing an implanted venous access port. Angiocatheters are large-bore catheters designed for rapid fluid administration and are typically used for peripheral venous access. They are not suitable for accessing the small, specialized ports used for central venous access.
Choice B rationale:
A 25-gauge needle is too small for accessing an implanted venous access port. While smaller gauge needles are suitable for delicate procedures and patients with fragile veins, they might not provide adequate flow for certain therapies or blood draws. Accessing a port with a needle that is too small can lead to increased pressure, potentially damaging the port or causing discomfort to the patient.
Choice C rationale:
A butterfly needle is also not the best choice for accessing an implanted venous access port. Butterfly needles, also known as winged infusion sets, are commonly used for short-term peripheral venous access. They are not designed for accessing implanted ports, which require a noncoring needle for precise and safe access without damaging the port membrane.
Choice D rationale:
(Correct Choice) A noncoring needle, also known as a Huber needle, is the correct choice for accessing an implanted venous access port. Noncoring needles have a specially designed tip that creates a smaller puncture hole, reducing damage to the port membrane and minimizing patient discomfort. They are specifically designed for accessing ports and are the standard choice for this procedure.
Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"B"}}
Explanation
The assessment findings that are consistent with mastitis are: Chills Temperature Painful, tender breast The assessment findings that are consistent with endometritis are: Chills Temperature Foulsmelling lochia Mastitis is an inflammation of the breast tissue that can lead to infection. It is usually caused by a blocked milk duct or bacteria entering the breast through a cracked nipple. Mastitis can cause symptoms such as fever, chills, headache, body aches, and redness, swelling, and pain in the affected breast. Mastitis is usually treated with antibiotics and pain relievers. It is important to continue breastfeeding or pumping to empty the breast and prevent further engorgement. Endometritis is an inflammation of the inner lining of the uterus (endometrium) that can lead to infection. It is usually caused by bacteria entering the uterus during childbirth, miscarriage, abortion, or insertion of an intrauterine device (IUD). Endometritis can cause symptoms such as fever, chills, lower abdominal pain, foul-smelling vaginal discharge (lochia), and uterine tenderness. Endometritis is usually treated with antibiotics and pain relievers. It is important to seek medical attention if symptoms persist or worsen .
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