The patient is having a gastroduodenostomy (Billroth I operation) for stomach cancer. Which complication is occurring when the patient reports generalized weakness, sweating, palpitations, and dizziness 15 minutes after eating?

Choice A reason: Neutrophils at 3,000/mm might indicate an infection, but for acute appendicitis, one would expect to see a significant increase in the overall white blood cell count rather than just the neutrophils.
Choice B reason: Lymphocytes at 3,000/mm do not specifically indicate acute appendicitis. Lymphocyte counts are more commonly elevated in viral infections rather than bacterial ones like appendicitis.
Choice C reason: A WBC count of 17,000/mm is indicative of an acute bacterial infection like appendicitis. The elevated WBC count shows the body’s response to the infection, making this the most accurate indicator among the options provided.
Choice D reason: RBC at 4.2 million/mm is within the normal range and does not provide specific information related to acute appendicitis. This value is unrelated to the acute inflammatory process expected in appendicitis.

Choice A reason: Securing the drain to the client's bed sheet is not appropriate as it does not ensure proper positioning and can lead to accidental dislodgement.
Choice B reason: Measuring the drainage every hour for the first 8 hours is excessive unless there are specific clinical concerns. Typically, drainage is measured at regular intervals but not every hour unless warranted by the client's condition.
Choice C reason: Removing the JP drain should be done according to medical orders, and not by the nurse independently deciding when to remove it. The JP drain is typically removed when the output decreases to a minimal level.
Choice D reason: Expelling the air from the JP bulb after emptying is crucial to re-establish the suction, which is necessary for the drain to function effectively. This action helps to ensure continuous drainage and prevent fluid accumulation.