A patient who has undergone an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea when a full liquid diet is started postoperatively. The nurse recognizes that these symptoms are most indicative of:
An intolerance to the feedings
Esophageal perforation with fistula formation into the lung
Extension of the tumor into the aorta
Leakage of fluids into the mediastinum
The Correct Answer is B
A. An intolerance to the feedings might cause discomfort, but it would not typically cause increasing pain, fever, and dyspnea. These symptoms are more indicative of a serious complication.
B. Esophageal perforation with fistula formation into the lung is the most likely cause of these symptoms. A perforation can lead to leakage of gastric contents into the pleural space or mediastinum, causing fever, pain, and respiratory distress. The formation of a fistula between the esophagus and the lung would lead to dyspnea.
C. Extension of the tumor into the aorta is a rare complication that would typically manifest with symptoms related to cardiovascular issues, not gastrointestinal symptoms like fever and dyspnea.
D. Leakage of fluids into the mediastinum is a possible cause of the symptoms, but esophageal perforation with a fistula into the lung is more directly linked to these specific symptoms, especially dyspnea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Epigastric discomfort is a common symptom of peptic ulcer disease, but it is not the priority finding. This symptom is usually manageable with appropriate treatment, such as antacids or proton pump inhibitors.
B. Hematemesis (vomiting blood) is a critical finding and indicates active bleeding, which can be life-threatening. This requires immediate attention as it suggests a potential complication, such as ulcer perforation or severe gastric bleeding, that can lead to hypovolemic shock. It is the priority finding because it indicates the need for urgent medical intervention.
C. Constipation is not a priority concern in a patient with peptic ulcer disease unless it is severe and related to medication (such as opioids). While it may be uncomfortable, it does not pose the immediate risk that hematemesis does.
D. Dyspepsia, or indigestion, is another common symptom of peptic ulcer disease. While it can be bothersome, it does not represent an acute, life-threatening issue like hematemesis does.
Correct Answer is ["28"]
Explanation
Total volume (mL) Drop factor (gtt/mL) = Total drops
1000 mL 10 gtt/mL = 10,000 drops
Next, we need to determine the total number of minutes in 6 hours:
6 hours 60 minutes/hour = 360 minutes
Finally, we can calculate the drip rate:
Drip rate (gtt/min) = Total drops / Total minutes
Drip rate = 10,000 drops / 360 minutes ≈ 28 gtt/min
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