A nurse is assessing a school-age child immediately postoperative following a perforated appendix. Which of the following finding should the nurse expect?

A WBC of 6,000/mm3

Purulent nasogastric drainage

Passage of dark red stool with mucus

Absence of peristalsis

Answer and Explanation

The Correct Answer is D

A. A WBC of 6,000/mm³ is within the normal range (4,500-11,000/mm³), and a postoperative infection is more likely to result in an elevated WBC count.

B. Purulent nasogastric drainage is more suggestive of a gastrointestinal issue unrelated to a perforated appendix and is not a common finding post-surgery.

C. Passage of dark red stool with mucus could suggest gastrointestinal bleeding or infection, but it is not typical postoperatively after a perforated appendix.

D. After surgery for a perforated appendix, peristalsis may be absent initially due to the effects of anesthesia, bowel manipulation, or inflammation from the infection. This is a normal postoperative finding.

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Correct Answer is D

Explanation

A. While methicillin resistance is a concern, it does not pose an immediate threat to the child’s life compared to the risk of sepsis.
B. Redness in the affected area is a typical symptom of cellulitis and, while it should be monitored, it is not the most urgent concern.
C. The risk for recurrence is important for long-term management but is not the primary concern in the acute phase of cellulitis.
D. Sepsis is the most immediate concern in cellulitis because the infection can rapidly spread into the bloodstream, leading to systemic infection and potential life-threatening complications.

A. Urinary output 100 mL/hr B. Temperature 39.1C (102.4° F) C. Blood pressure 130/90 mm Hg D. Heart ráte 60/min

Correct Answer is B

Explanation

A. A urinary output of 100 mL/hr is within the expected range for a 10-year-old and does not indicate septic shock. In early septic shock, urinary output is often preserved or mildly decreased.

B. An elevated temperature (fever) is a hallmark of early septic shock as the body mounts an inflammatory response to infection. Fever often accompanies early sepsis in pediatric patients.

C. Blood pressure may remain normal or slightly elevated in early septic shock due to compensatory mechanisms. A BP of 130/90 mm Hg is not a defining feature.

D. A heart rate of 60/min is abnormally low for a 10-year-old and could indicate late-stage shock or other complications. In early septic shock, tachycardia (elevated heart rate) is typically observed.

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A nurse is assessing a school-age child immediately postoperative following a perforated appendix. Which of the following finding should the nurse expect?

Nursing Test Bank

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