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 B
Explanation
A. While deep breathing exercises are important after surgery, they are not specific to cataract extraction recovery; the focus should be on eye care.
B. Observing the pupil response of the right eye can help detect any issues with the right eye post-surgery, ensuring the patient monitors both eyes' health effectively.
C. Clients are generally advised to avoid sleeping flat and may be instructed to sleep in a specific position to prevent pressure on the operated eye, often in a semi-reclined position.
D. Administering a stool softener can be important for some postoperative patients, but it is not a primary concern following cataract surgery unless specifically indicated for that client.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"},"F":{"answers":"B"}}
Explanation
- Oxygen saturation greater than 94% indicates improved oxygenation, showing the treatment's effectiveness.
- PaCO2 55 mm Hg per arterial blood gas indicates hypercapnia, suggesting ineffective treatment as normal levels should be lower.
- Symmetric chest expansion suggests effective treatment as it reflects improved lung function.
- Rhonchi in the right lung may indicate retained secretions, suggesting ineffective treatment.
- Client ambulates without shortness of breath demonstrates effective treatment, as the patient can move without respiratory distress.
- Diminished breath sounds in the right lung could indicate ongoing consolidation or fluid, suggesting ineffective treatment.
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