A nurse is assessing a patient who has a puncture wound on his foot.
Which of the following findings is a manifestation of acute osteomyelitis?

Choice A rationale

A pyloric obstruction is a blockage at the outlet of the stomach, preventing gastric contents from emptying into the duodenum. A nasogastric tube is inserted to decompress the stomach by removing accumulated fluids and gases, relieving pressure and distension.

Choice B rationale

While a nasogastric tube can be used for enteral feeding in some situations, it is not the primary rationale for its use in a pyloric obstruction. The obstruction would prevent the delivery of nutrients into the small intestine for absorption.

Choice C rationale

Medications can be administered through a nasogastric tube, but this is a secondary use in the context of a pyloric obstruction. The primary goal is to relieve the obstruction's effects by decompression.

Choice D rationale

Determining the pH of gastric secretions can be done via a nasogastric tube, but this is a diagnostic measure and not the primary therapeutic rationale for its use in treating a pyloric obstruction. Decompression is the priority.

Choice A rationale

While the partner's intention may be good, allowing someone other than the client to administer PCA medication bypasses the safety mechanisms built into the pump and disregards the client's ability to self-titrate based on their pain level. This could lead to over-sedation and respiratory depression.

Choice B rationale

Patient-controlled analgesia is designed to allow clients to manage their own pain by self-administering medication within prescribed limits. The client is the best judge of their pain intensity and medication needs. Allowing the partner to push the button undermines this principle of patient autonomy and safety.

Choice C rationale

The nurse should not administer PCA medication based on a third party's assessment of the client's needs. This still circumvents the client's control and the safety features of the pump. The nurse's role is to assess the client directly and educate the client and family on proper PCA use.

Choice D rationale

While it's important to understand the partner's reasoning, the immediate concern is the inappropriate administration of medication. Addressing the partner's actions directly and educating them on the proper use of the PCA pump is the priority.