A client with diverticular disease has just returned from a colonoscopy. While conducting an abdominal assessment, the nurse monitors for which of the following as an initial sign of a possible complication of the procedure?

Guarding and rebound tenderness

Nausea and vomiting

Diarrhea

Hyperactive bowel sounds

Answer and Explanation

The Correct Answer is A

Choice A reason: Guarding and rebound tenderness are signs of peritonitis, which is a serious complication of colonoscopy. Peritonitis is an inflammation of the peritoneum, the membrane that lines the abdominal cavity. It can be caused by perforation or puncture of the colon during the colonoscopy, which allows bacteria and fecal matter to enter the peritoneal space. The nurse should monitor the client for signs of peritonitis, such as abdominal pain, rigidity, fever, and leukocytosis.

Choice B reason: Nausea and vomiting are not specific signs of a complication of colonoscopy. They may be caused by other factors, such as the sedation, the bowel preparation, or the ingestion of food or fluids after the procedure. Nausea and vomiting may also be symptoms of other conditions, such as gastroenteritis, food poisoning, or pregnancy.

Choice C reason: Diarrhea is not a sign of a complication of colonoscopy. Diarrhea may be a normal consequence of the bowel preparation, which involves taking laxatives or enemas to clear the colon before the procedure. Diarrhea may also be caused by other factors, such as the ingestion of food or fluids after the procedure, or the presence of an underlying bowel disorder, such as irritable bowel syndrome or inflammatory bowel disease.

Choice D reason: Hyperactive bowel sounds are not a sign of a complication of colonoscopy. Hyperactive bowel sounds may indicate increased peristalsis, which is the movement of the digestive tract. Hyperactive bowel sounds may be a normal response to the bowel preparation, the ingestion of food or fluids after the procedure, or the stimulation of the colon during the colonoscopy. Hyperactive bowel sounds may also be present in conditions such as diarrhea, gastroenteritis, or intestinal obstruction.

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Correct Answer is B

Explanation

Choice A reason: This is not a correct result that the nurse should anticipate. RBC stands for red blood cells, which carry oxygen and carbon dioxide in the blood. The normal range for RBC is 4-5.5 /mm^3^, so a value of 4.2 /mm^3^ is within the normal range and does not indicate any abnormality.

Choice B reason: This is a correct result that the nurse should anticipate. WBC stands for white blood cells, which fight infections and inflammation in the body. The normal range for WBC is 5-10 /mm^3^, so a value of 17 /mm^3^ is above the normal range and indicates leukocytosis, which is an increase in the number of white blood cells. Leukocytosis can be caused by acute appendicitis, as the body tries to fight the infection and inflammation in the appendix.

Choice C reason: This is not a correct result that the nurse should anticipate. Neutrophils are a type of white blood cell that are the first to respond to bacterial infections. The normal range for neutrophils is 3-5.8 /mm^3^, so a value of 3.2 /mm^3^ is within the normal range and does not indicate any abnormality.

Choice D reason: This is not a correct result that the nurse should anticipate. Lymphocytes are a type of white blood cell that are involved in the immune response and the production of antibodies. The normal range for lymphocytes is 1-4 /mm^3^, so a value of 3 /mm^3^ is within the normal range and does not indicate any abnormality.

A. Drink a carbonated beverage before bed B. Increase fatty foods one at a time C. Elevate the head of the bed when sleeping D. Eat dinner late in the evening

Correct Answer is C

Explanation

Choice A reason: This is not a correct instruction because drinking a carbonated beverage before bed can worsen the reflux symptoms by increasing the gastric pressure and the production of gas.

Choice B reason: This is not a correct instruction because increasing fatty foods can worsen the reflux symptoms by delaying the gastric emptying and relaxing the lower esophageal sphincter (LES), which allows the stomach acid to flow back into the esophagus.

Choice C reason: This is a correct instruction because elevating the head of the bed when sleeping can help prevent the reflux symptoms by using gravity to keep the stomach contents from flowing back into the esophagus.

Choice D reason: This is not a correct instruction because eating dinner late in the evening can worsen the reflux symptoms by increasing the amount and acidity of the stomach contents, which can easily flow back into the esophagus when lying down. The client should avoid eating within 3 hours of bedtime.

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A client with diverticular disease has just returned from a colonoscopy. While conducting an abdominal assessment, the nurse monitors for which of the following as an initial sign of a possible complication of the procedure?

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