A patient with suspected appendicitis is being prepared for surgery. Which of the following preoperative interventions should the nurse prioritize?
Apply a heating pad to the abdomen
Administer a cleansing enema
Administer oral analgesics as needed
Place the patient on NPO status
The Correct Answer is D
A. Apply a heating pad to the abdomen: This is incorrect and potentially harmful, as applying heat to the abdomen can increase blood flow and worsen inflammation or risk rupture of the appendix.
B. Administer a cleansing enema: Enemas should not be administered for suspected appendicitis as they may cause irritation and increase the risk of perforation.
C. Administer oral analgesics as needed: Oral analgesics are contraindicated since the patient should be NPO, and strong pain relief might mask the symptoms of a ruptured appendix.
D. Place the patient on NPO status: The highest priority preoperative intervention is to place the patient on NPO (nothing by mouth) status to prevent aspiration during anesthesia, a standard preoperative practice, especially for abdominal surgeries.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Prednisone: Prednisone, a corticosteroid, is often used to reduce inflammation and suppress the immune response during exacerbations of ulcerative colitis. It helps manage the symptoms and prevent further complications.
B. Metronidazole: While used in some gastrointestinal conditions, it is more commonly prescribed for infections related to Crohn’s disease or infections caused by anaerobic bacteria, not for ulcerative colitis exacerbations.
C. Omeprazole: Omeprazole is a proton pump inhibitor used to reduce stomach acid and is typically indicated for gastroesophageal reflux disease (GERD) or peptic ulcers, not ulcerative colitis.
D. Loperamide: This antidiarrheal medication should be used with caution in ulcerative colitis, as it can increase the risk of toxic megacolon.
Correct Answer is A
Explanation
A. Laxatives are contraindicated in clients who have a small bowel obstruction. Laxatives such as senna are contraindicated in bowel obstructions because they can increase peristalsis and exacerbate the blockage, leading to complications like bowel perforation or ischemia.
B. Bulk-forming laxatives such as psyllium should be substituted for this client: Bulk-forming laxatives like psyllium would not be appropriate either because they rely on bowel movement for efficacy. They could worsen the obstruction by adding bulk.
C. An osmotic laxative, such as magnesium citrate, should be substituted in this client: Osmotic laxatives, like magnesium citrate, are also contraindicated in bowel obstruction because they draw water into the bowel, which can worsen distension and pressure on the obstructed area.
D. The prescribed medication should be administered via NG route rather than the oral route for this client: While NG tubes may be used to decompress the bowel in cases of obstruction, administering a laxative through an NG tube would still be contraindicated, as laxatives increase the risk of further complications in bowel obstruction.
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