A nurse is caring for a client who had IV fluids initiated at 0330.

The IV fluids are infusing at 120 mL/hr. The nurse should record how many mL of IV fluids on the intake record at 0600?

Choice A rationale

Ulcerative colitis is a chronic inflammatory bowel disease characterized by inflammation and ulceration of the colon mucosa, usually presenting with frequent bloody diarrhea and abdominal pain. While it can cause abdominal discomfort, it does not typically present as a sudden, acute absence of bowel sounds and flatus in a postoperative context. The clinical manifestations described in the scenario are more indicative of a mechanical or functional obstruction rather than an underlying chronic inflammatory autoimmune condition.

Choice B rationale

A paralytic ileus is a common postoperative complication where intestinal peristalsis stops, often due to abdominal surgery, handling of the intestines, or the effects of anesthesia and opioids. The lack of movement leads to the accumulation of gas and secretions, resulting in an absence of bowel sounds, abdominal distention, and the inability to pass flatus. This functional obstruction is the most likely cause given the timing of three days post-surgery and the specific clinical symptoms provided.

Choice C rationale

Wound dehiscence refers to the partial or total separation of the layers of a surgical wound. While it is a serious postoperative complication, it is characterized by the visible opening of the incision site or the drainage of serosanguineous fluid. It does not directly cause the cessation of bowel sounds or the systemic absence of flatus. Although a severe dehiscence could lead to evisceration and secondary bowel issues, it is not the primary cause of the symptoms described.

Choice D rationale

Cholecystitis is the inflammation of the gallbladder, usually caused by gallstones obstructing the cystic duct. It typically presents with sharp pain in the right upper quadrant of the abdomen, fever, and nausea, often triggered by fatty meals. While abdominal pain occurs, cholecystitis does not cause a generalized cessation of bowel sounds and flatus across the entire intestinal tract. The signs of distention and lack of flatus specifically point toward a functional motility issue in the intestines.

Step 1 is 0600 - 0330 = 2 hours and 30 minutes.

Step 2 is 2.5 hours × 120 mL ÷ hour = 300 mL. The final calculated answer is 300 mL.