The nurse continues to care for the client.

Select 1 condition and 1 client finding to fill in each blank in the following sentence.

The client is most likely experiencing

_____

as evidenced by the client's

_____

.

A. A 25-gauge needle: Small-gauge needles like a 25-gauge are not suitable for accessing implanted venous ports because they may not provide sufficient flow for infusion and can increase the risk of needle bending or damage.

B. A noncoring needle: Noncoring needles, such as a Huber needle, are specifically designed for accessing implanted ports. They prevent coring of the septum, preserving the integrity of the port and reducing the risk of damage or infection while allowing safe infusion of medications and fluids.

C. A butterfly needle: Butterfly needles are designed for peripheral venous access and are not appropriate for implanted ports. Using them could damage the port septum and compromise long-term functionality.

D. An angiocatheter: Angiocatheters are intended for peripheral or central line insertion and are not designed for repeated access of the septum in implanted ports. Their use could increase the risk of leakage, infection, or port damage.

Rationale for correct choices

• Laxative: The client is postoperative day 3 and reports not having had a bowel movement, which is common after abdominal surgery due to anesthesia, opioid use, and decreased mobility. The return of flatus indicates partial return of bowel function, making a laxative appropriate to stimulate bowel evacuation. Early management helps prevent postoperative ileus and discomfort.

• Bowel movements: Absence of bowel movements by postoperative day 3 signals delayed gastrointestinal motility. This finding indicates the need for intervention to promote normal elimination. Monitoring bowel movement patterns helps guide appropriate pharmacologic and nonpharmacologic interventions.

• Bowel sounds: The client has hypoactive bowel sounds, suggesting slowed intestinal activity following surgery. Hypoactive sounds combined with lack of bowel movement indicate decreased peristalsis rather than obstruction. This assessment finding supports the use of a laxative once flatus is present.

Rationale for incorrect choices

• Antiemetic: The client is not currently reporting nausea or vomiting. Gastrointestinal symptoms are related to decreased motility rather than upper GI upset. An antiemetic would not address constipation or delayed bowel function.

• Antidiarrheal: The client does not have diarrhea and has not had any bowel movements. Using an antidiarrheal would further slow intestinal motility and worsen constipation. This intervention would be inappropriate in the current postoperative context.

• Findings at incision site: Although purulent drainage and swelling suggest possible infection, these findings do not indicate the need for a laxative. Incisional findings are more relevant to antibiotic therapy or wound management. They do not explain delayed bowel elimination.

• Abdominal distention: The abdomen is soft and nondistended on assessment. Distention would suggest gas or obstruction, which is not present. The primary indicators remain bowel sounds and bowel movement status.

• Incisional tenderness: Incisional tenderness is expected after abdominal surgery and reflects tissue healing or inflammation. It does not directly influence bowel motility or elimination. Pain alone does not justify laxative use. This finding is unrelated to gastrointestinal function.