A patient with a gastric outlet obstruction has been treated with NG decompression. After the first 24 hours, the patient develops nausea and increased upper abdominal bowel sounds. What is the best action by the nurse?
Check the patency of the NG tube.
Place the patient in a recumbent position.
Encourage the patient to deep breathe and consciously relax.
Assess the patient's vital signs and circulatory status.
The Correct Answer is D
The development of nausea and increased upper abdominal bowel sounds after 24 hours of NG decompression in a patient with gastric outlet obstruction raises concerns for possible complications or changes in the patient's condition. Assessing the patient's vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, can provide important information about their circulatory status and overall stability.
While checking the patency of the NG tube is important, it is not the best immediate action in this situation. The nurse should first assess the patient's vital signs to ensure their stability before proceeding with further interventions.
Placing the patient in a recumbent position (lying down) or encouraging deep breathing and conscious relaxation may not address the underlying issue and could potentially exacerbate the symptoms. It is essential to assess the patient's vital signs and circulatory status to determine the appropriate course of action.
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Correct Answer is D
Explanation
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of medications commonly used to relieve pain, reduce inflammation, and lower fever. They work by inhibiting the production of prostaglandins, which are substances in the body that play a role in pain and inflammation. Celecoxib specifically belongs to the subclass of NSAIDs known as selective COX-2 inhibitors, which target the enzyme cyclooxygenase-2 (COX-2). By selectively inhibiting COX-2, celecoxib helps to reduce inflammation and pain while potentially minimizing the gastrointestinal side effects associated with traditional non-selective NSAIDs.
Correct Answer is B
Explanation
Rhinoplasty is a surgical procedure performed on the nose, and it often involves the placement of nasal packing to control bleeding, support the nasal structures, and promote healing. Nasal packing can cause mouth breathing and oral dryness, which can lead to increased swallowing as the patient tries to alleviate the discomfort.
While bleeding posterior to the nasal packing is a potential complication of rhinoplasty, it typically presents with other symptoms such as active bleeding, nasal discharge, or changes in vital signs. Without additional information or signs of active bleeding, it is less likely to be the cause of the patient's frequent swallowing in this scenario.
An adverse reaction to the analgesic is possible, but it would typically present with other symptoms such as allergic reactions (rash, swelling, difficulty breathing) or gastrointestinal symptoms (nausea, vomiting). In the absence of these symptoms, an adverse reaction to the analgesic is less likely.
Lastly, a normal response to the analgesic and surgery would not typically manifest as frequent swallowing. While pain medication can cause side effects, such as drowsiness or nausea, increased swallowing is not a common response.
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