The nurse provides care for a client diagnosed with non-Hodgkin lymphoma. Which observation does the nurse expect to find during assessment of the client?

Choice A reason: Fewer numbers of parietal cells in the gastric mucosa is not the best explanation because it is a condition that affects the production of gastric acid, not the development of duodenal ulcers. Parietal cells are the cells that secrete hydrochloric acid and intrinsic factor in the stomach. Hydrochloric acid helps to digest food and kill bacteria, while intrinsic factor helps to absorb vitamin B12. Fewer numbers of parietal cells can cause hypochlorhydria, which is a low level of gastric acid, or pernicious anemia, which is a deficiency of vitamin B12. Hypochlorhydria can increase the risk of bacterial overgrowth and infections, while pernicious anemia can cause symptoms such as fatigue, weakness, and neurological problems.

Choice B reason: Helicobacter pylori infection is the best explanation because it is the most common cause of duodenal ulcers, which are sores that form in the lining of the first part of the small intestine, called the duodenum. Helicobacter pylori is a type of bacteria that can survive in the acidic environment of the stomach and the duodenum. It can damage the protective layer of mucus that covers the lining of the digestive tract, exposing it to the gastric acid and causing inflammation and ulceration. Helicobacter pylori infection can also increase the production of gastrin, which is a hormone that stimulates the secretion of gastric acid, and decrease the production of somatostatin, which is a hormone that inhibits the secretion of gastric acid.

Choice C reason: Slowed gastric emptying is not the best explanation because it is a condition that affects the movement of food from the stomach to the small intestine, not the development of duodenal ulcers. Gastric emptying is the process of passing the food that has been partially digested in the stomach to the duodenum, where it is further broken down and absorbed. Slowed gastric emptying can be caused by various factors, such as diabetes, medications, or nerve damage, and can result in symptoms such as nausea, vomiting, bloating, or fullness.

Choice D reason: Frequent use of acetaminophen is not the best explanation because it is a factor that affects the development of gastric ulcers, not duodenal ulcers. Acetaminophen is a type of medication that is used to relieve pain and fever. It can cause gastric ulcers by inhibiting the synthesis of prostaglandins, which are substances that protect the lining of the stomach from the gastric acid and promote healing. Acetaminophen can also cause liver damage if taken in high doses or for a long time.

Choice A reason: Shallow respirations and a smooth, beefy red tongue are not the expected findings because they are signs of pernicious anemia, not acute blood loss. Pernicious anemia is a condition where the body cannot produce enough red blood cells due to a lack of vitamin B12, which is needed for DNA synthesis and cell division. Pernicious anemia can cause shallow respirations due to hypoxia, which is a low level of oxygen in the tissues, and a smooth, beefy red tongue due to atrophy of the tongue papillae, which are the small projections that give the tongue its rough texture.

Choice B reason: Facial flushing with distended neck veins are not the expected findings because they are signs of polycythemia, not acute blood loss. Polycythemia is a condition where the body produces too many red blood cells, which increases the blood volume and the blood viscosity, making the blood thicker and harder to flow. Polycythemia can cause facial flushing due to increased blood flow to the skin, and distended neck veins due to increased pressure in the venous system.

Choice C reason: Bilateral numbness and tingling of the extremities are not the expected findings because they are signs of peripheral neuropathy, not acute blood loss. Peripheral neuropathy is a condition where the nerves that carry signals from the brain and spinal cord to the rest of the body are damaged or impaired, causing sensory and motor disturbances. Peripheral neuropathy can cause bilateral numbness and tingling of the extremities due to reduced nerve conduction and sensation.

Choice D reason: Increased heart rate and decreased mental alertness are the expected findings because they are signs of acute blood loss. Acute blood loss is a condition where the body loses a large amount of blood in a short period of time, which reduces the oxygen-carrying capacity of the blood and the tissue perfusion. Acute blood loss can cause increased heart rate due to the compensatory mechanism of the body to increase the cardiac output and maintain the blood pressure, and decreased mental alertness due to the reduced oxygen delivery to the brain.