On the second postoperative day, a client reports increasing abdominal pain. Assessment findings include a distended abdomen with absent bowel sounds. Which intervention should the nurse anticipate implementing?

Choice A reason: Measuring glucose monitors corticosteroid-induced hyperglycemia, but a rigid abdomen with rebound tenderness suggests peritonitis, possibly from IBD-related perforation. Vital signs detect systemic effects like sepsis (e.g., tachycardia), more urgent than glucose, as perforation is a life-threatening emergency requiring immediate intervention to prevent shock.

Choice B reason: Monitoring bloody diarrhea is relevant in IBD, but a rigid abdomen with rebound tenderness indicates peritonitis, likely from perforation. Vital signs assess systemic stability (e.g., fever, hypotension), critical for detecting life-threatening complications like sepsis, making this more urgent than tracking expected IBD symptoms.

Choice C reason: A rigid abdomen with rebound tenderness suggests peritonitis from bowel perforation in IBD, causing peritoneal irritation. Vital signs (e.g., heart rate, BP, temperature) detect shock or infection, guiding urgent interventions like surgery or antibiotics. This assessment prioritizes rapid response to a potentially fatal surgical emergency.

Choice D reason: Encouraging ambulation is contraindicated with a rigid abdomen and rebound tenderness, indicating peritonitis. Movement may worsen peritoneal irritation or infection spread. Vital signs assess systemic compromise, critical for managing perforation, ensuring timely intervention to prevent sepsis or shock, making ambulation inappropriate.

Choice A reason: Depression involves social withdrawal, driven by low serotonin or dopamine. Encouraging the client to leave the room and engage socially stimulates oxytocin release and cognitive behavioral benefits, counteracting isolation. This therapeutic approach enhances mood and aligns with depression management goals, making it the most effective response.

Choice B reason: Calling TV a passive activity is partially true but less therapeutic, as it doesn’t directly promote social engagement. Depression treatment prioritizes interpersonal interaction to boost neurotransmitters like serotonin. This response misses the opportunity to encourage social therapy, critical for alleviating depressive symptoms in a mental health setting.

Choice C reason: Suggesting TV sends messages is inappropriate without psychotic symptoms, not indicated in this client’s depression. Depression involves low mood, not delusions. This could confuse or stigmatize, failing to promote social engagement, which is essential for improving mood via neurochemical and behavioral pathways in depression management.

Choice D reason: Allowing unlimited TV outside the room does not address depression’s social isolation. Excessive TV may reinforce withdrawal, reducing therapeutic group activities that enhance serotonin. This lacks focus on active engagement, critical for recovery, making it less effective than encouraging social interaction to improve mental health outcomes.