A nurse plans care for a patient with acute pancreatitis. Which intervention would the nurse include in this patient's plan of care to reduce discomfort?

Maintain nothing by mouth (NPO) and administer intravenous fluids.

Provide small, frequent feedings with no concentrated sweets.

Administer morphine sulfate intramuscularly every 4 hours as needed.

Position the patient in a flat, supine position to decrease discomfort.

Answer and Explanation

The Correct Answer is A

Choice A reason: Maintaining nothing by mouth (NPO) and administering intravenous fluids is the best intervention to reduce discomfort in a patient with acute pancreatitis. NPO status helps to rest the pancreas by preventing the secretion of pancreatic enzymes that can exacerbate inflammation and pain. Intravenous fluids are essential to maintain hydration and electrolyte balance while the patient is not eating or drinking.

Choice B reason: Providing small, frequent feedings with no concentrated sweets is not appropriate for a patient with acute pancreatitis. The priority is to keep the patient NPO to rest the pancreas. Introducing any food can stimulate the pancreas and worsen the condition.

Choice C reason: Administering morphine sulfate intramuscularly every 4 hours as needed can help manage pain, but the preferred route for pain medication in acute pancreatitis is intravenous, as it provides quicker relief and avoids the discomfort of intramuscular injections. Pain management is important, but it should be part of a broader plan that includes NPO status and IV fluids.

Choice D reason: Positioning the patient in a flat, supine position is not recommended for reducing discomfort in acute pancreatitis. Patients often find relief in a semi-Fowler's position (head elevated) or by leaning forward, which can help reduce abdominal pain and pressure on the inflamed pancreas.

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Correct Answer is A

Explanation

Choice A reason: Blood clots form more easily in mechanical replacement valves due to the artificial surface of the valve, which can cause the blood to clot more readily. This increases the risk of thromboembolic events, such as stroke or valve obstruction. Therefore, patients with mechanical valves need to take anticoagulants for life to prevent clot formation and ensure the valve functions effectively.

Choice B reason: The statement that the vein taken from the leg reduces circulation in the leg is incorrect in this context. Vein grafts from the leg are typically used in coronary artery bypass grafting (CABG) surgery, not in valve replacement surgery. Therefore, this explanation does not apply to the patient's situation of needing anticoagulants after valve replacement surgery.

Choice C reason: The idea that the valve replacement surgery left a lot of small clots in the heart and lungs is not accurate. The surgery itself does not leave clots; rather, the ongoing risk of clot formation is due to the presence of the mechanical valve. This risk necessitates lifelong anticoagulation.

Choice D reason: The mechanical valve does not place the patient at a greater risk for a heart attack specifically. The concern with mechanical valves is the increased risk of blood clot formation, which is why anticoagulants are prescribed. Heart attacks are typically caused by blockages in the coronary arteries, which is a different issue.

A. pH 7.50, pO2 85, pCO2 35, HCO3 30 mEq/L B. pH 7.30, pO2 90, pCO2 35, HCO3 20 mEq/L C. pH 7.50, pO2 95, pCO2 25, HCO3 22 mEq/L D. pH 7.30, pO2 80, pCO2 55, HCO3 22 mEq/L

Correct Answer is D

Explanation

Choice A reason: The values pH 7.50, pO2 85, pCO2 35, HCO3 30 mEq/L indicate alkalosis with a high bicarbonate level, which is not consistent with the patient’s slow respiratory rate that would typically lead to respiratory acidosis.

Choice B reason: The values pH 7.30, pO2 90, pCO2 35, HCO3 20 mEq/L indicate metabolic acidosis with normal pCO2, which does not align with the respiratory issue described (hypoventilation).

Choice C reason: The values pH 7.50, pO2 95, pCO2 25, HCO3 22 mEq/L indicate respiratory alkalosis, which is characterized by a low pCO2. This is not consistent with the patient’s hypoventilation, which would lead to elevated pCO2 levels.

Choice D reason: The values pH 7.30, pO2 80, pCO2 55, HCO3 22 mEq/L indicate respiratory acidosis, which aligns with the patient’s hypoventilation due to anesthesia effects and incisional pain. The elevated pCO2 and decreased pH are consistent with reduced respiratory rate and shallow breathing.

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A nurse plans care for a patient with acute pancreatitis. Which intervention would the nurse include in this patient's plan of care to reduce discomfort?

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