Three days after a cholecystectomy for cholelithiasis, a female client reports having persistent upper abdominal pain that radiates to her back. She has vomited three times in the last 12 hours and has a temperature of 101.8° F. (38.7° C). Serum amylase and lipase are twice the normal value. Based on these findings, the nurse should observe the client for which pathophysiological condition?
Acute pancreatitis.
Biliary duct obstruction.
Surgical site infection.
Hepatorenal failure.
The Correct Answer is A
A. The symptoms of persistent upper abdominal pain radiating to the back, elevated serum amylase and lipase levels, vomiting, and fever suggest acute pancreatitis, which can occur after cholecystectomy due to potential injury to the pancreas or bile duct obstruction.
B. While biliary duct obstruction can occur postoperatively, the significantly elevated amylase and lipase levels, along with the described symptoms, more strongly indicate pancreatitis.
C. Surgical site infection typically presents with localized symptoms rather than systemic symptoms like elevated amylase and lipase.
D. Hepatorenal failure is unlikely to present with these specific gastrointestinal symptoms and enzyme elevations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. A positive sputum smear and culture would indicate that the tuberculosis infection is still active, which is not an expected outcome of effective treatment with isoniazid.
B. Vertigo and tinnitus are not expected outcomes of isoniazid therapy; they may indicate side effects or adverse reactions, not effectiveness.
C. Decreased cough and sputum would demonstrate the effectiveness of isoniazid in treating active tuberculosis, as the medication should lead to symptomatic improvement and reduced bacterial load.
D. Decreased appetite and weight loss can be associated with tuberculosis but are not direct indicators of medication effectiveness.
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}
Explanation
- Hypoxia is a condition in which there is a deficiency of oxygen in the tissues, which is consistent with the client’s low oxygen saturation of 89% on room air and 97% on supplemental oxygen.
- The diminished concentration of inhaled oxygen refers to the inadequate oxygen availability, which is a significant concern in pneumonia as it affects gas exchange in the lungs, leading to hypoxia.
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