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The nurse is assisting with the care of a client.

Exhibits

For each finding, click to specify if the finding is consistent with small bowel obstruction or acute pancreatitis. Each finding may support more than 1 disease process.

A.

Pain level

B.

Social history

C.

Skin findings

D.

Lipase level

E.

WBC count

F.

Abdominal findings

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

Pain level:

  • Small bowel obstruction: The client reports mid-abdominal pain, which is characteristic of small bowel obstruction as the pain is often crampy and located around the abdomen.
  • Acute pancreatitis: Abdominal pain is also a common symptom of acute pancreatitis, typically described as severe and persistent.

Social history:

  • Small bowel obstruction: Alcohol consumption is not a typical cause of obstruction.
  • Acute pancreatitis: Chronic alcohol use is a major risk factor for acute pancreatitis.

Skin findings:

  • Small bowel obstruction: Skin findings are usually unaffected.
  • Acute pancreatitis: In severe cases, pancreatic enzymes can leak into the skin, leading to ecchymosis (e.g., Grey Turner's or Cullen's sign). While jaundice can occur in acute pancreatitis due to bile duct obstruction, its absence does not rule out the condition.

Lipase level:

  • Small bowel obstruction: Lipase is generally normal.
  • Acute pancreatitis: Elevated lipase levels are highly indicative of acute pancreatitis.

WBC count:

  • Small bowel obstruction: A mild increase in WBC may occur due to bowel distension. The client’s WBC count is 9,000/mm³, which is within the normal range.
  • Acute pancreatitis: WBC levels are often elevated due to inflammation.

Abdominal findings:

  • Small bowel obstruction: Tenderness and high-pitched bowel sounds are typical signs.
  • Acute pancreatitis: Abdominal tenderness can also be present in acute pancreatitis, but high-pitched bowel sounds are more specific to small bowel obstruction.


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Related Questions

Correct Answer is D

Explanation

A. "I am only contagious while the lesions are present.": Viral shedding can occur even when lesions are not visible.
B. "The virus cannot spread to areas other than the genital area.": The virus can spread to other areas through autoinoculation or sexual contact.
C. "I can have unprotected sex as long as I am taking acyclovir.": Acyclovir reduces outbreaks but does not eliminate the risk of transmission.
D. "The lesions may reoccur in times of stress.": Herpes simplex virus type 2 is latent between outbreaks, but stress and other factors can trigger recurrences.

Correct Answer is C

Explanation

A. Apply five drops of developer to each smear: Typically, two drops of developer are applied per sample, not five. Applying excess developer may dilute the reaction and yield unreliable results.
B. Use the same part of stool for each sample: Samples should be taken from different parts of the stool to ensure accuracy and detect localized bleeding.
C. Ensure the sample contains no urine: Urine contamination can interfere with test results, leading to inaccurate findings. The client should collect a clean stool sample.
D. Wait 10 min before applying the developing solution: The developing solution should be applied immediately after placing the stool sample on the test card to prevent errors in interpretation.

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