A nurse is assessing a client who has a complete small bowel obstruction. Which of the following manifestations should the nurse expect? (Select all that apply.)

Urticaria

Vomiting

Distended abdomen

Fluid overload

Obstipation

Answer and Explanation

Correct Answer : B,C,E

A) Urticaria:
Urticaria, or hives, is a skin reaction characterized by itchy, raised welts. It is not typically associated with a small bowel obstruction, which primarily affects the gastrointestinal system rather than the skin.

B) Vomiting:
Vomiting is a common symptom of a complete small bowel obstruction. It occurs due to the blockage in the intestines, which prevents the passage of contents, leading to nausea and vomiting as the body tries to expel the obstruction.

C) Distended abdomen:
A distended abdomen is expected in cases of small bowel obstruction. The blockage causes a buildup of gas and fluids, leading to abdominal swelling and distention as the normal passage of intestinal contents is impeded.

D) Fluid overload:
Fluid overload is not a typical manifestation of a small bowel obstruction. Instead, dehydration and electrolyte imbalances are more likely due to vomiting and the inability to absorb fluids and nutrients properly.

E) Obstipation:
Obstipation, or severe constipation with an inability to pass stool or gas, is a key sign of a complete small bowel obstruction. The obstruction prevents the normal movement of intestinal contents, leading to a cessation of bowel movements.

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Correct Answer is B

Explanation

A) Ibuprofen: While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation, it is not the best choice for a client with a history of peptic ulcer disease. NSAIDs can exacerbate gastrointestinal issues and increase the risk of ulcer complications.

B) Tramadol: Tramadol is a moderate pain reliever that is not an NSAID and does not have the gastrointestinal side effects associated with NSAIDs. It is a suitable choice for short-term pain management in clients with a history of peptic ulcer disease, as it does not increase the risk of ulcer complications.

C) Ketorolac: Ketorolac is a potent NSAID used for short-term pain management. It is not recommended for clients with a history of peptic ulcer disease due to its high risk of causing gastrointestinal bleeding and exacerbating ulcer conditions.

D) Aspirin: Aspirin is an NSAID and has a high potential to irritate the gastrointestinal tract, which can worsen peptic ulcer disease and lead to complications such as bleeding. It is generally avoided in clients with a history of peptic ulcers.

A. Drink 8 oz of milk when hypoglycemia develops. B. Initiate a 1,400-calorie diet daily. C. Rotate the insulin injection site to a different area of the body with every other injection. D. Keep unopened insulin refrigerated at 4.44° C (40° F).

Correct Answer is D

Explanation

A) Drink 8 oz of milk when hypoglycemia develops:
While consuming a fast-acting carbohydrate is important during hypoglycemia, 8 oz of milk may not be the most effective choice. Typically, glucose tablets or juice are recommended as they provide a quicker absorption of sugar into the bloodstream.

B) Initiate a 1,400-calorie diet daily:
Caloric needs should be individualized based on the adolescent’s age, weight, activity level, and overall health. A fixed 1,400-calorie diet might not be appropriate for every adolescent and could lead to insufficient energy intake or excessive restriction.

C) Rotate the insulin injection site to a different area of the body with every other injection:
While rotating injection sites is important to prevent lipodystrophy, it is generally recommended to use different sites within the same area (such as different spots on the abdomen) rather than entirely different areas of the body with each injection. This ensures consistent absorption of insulin.

D) Keep unopened insulin refrigerated at 4.44° C (40° F):
Unopened insulin should be stored in the refrigerator to maintain its potency until it is ready to be used. This temperature range ensures the insulin remains stable and effective for use.

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A nurse is assessing a client who has a complete small bowel obstruction. Which of the following manifestations should the nurse expect? (Select all that apply.)

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