A nurse is caring for a client with cholecystitis who is experiencing severe abdominal pain. Which of the following actions should the nurse take first?
Administer pain medication as prescribed.
Assess the client's vital signs and pain level.
Place the client in a semi-Fowler's position.
Offer the client a cup of herbal tea for relaxation.
The Correct Answer is B
Choice A reason:
Administering pain medication is important, but assessing the client's vital signs and pain level takes priority to determine the severity of the pain and the appropriate intervention.
Choice B reason:
This statement is correct. Assessing the client's vital signs and pain level is the first action the nurse should take to evaluate the client's condition and determine the appropriate intervention.
Choice C reason:
Placing the client in a semi-Fowler's position may provide some comfort, but it does not address the underlying pain or assist in determining the severity of the situation.
Choice D reason:
Offering herbal tea for relaxation is a non-pharmacological intervention that can be helpful, but it is not the first action the nurse should take when the client is experiencing severe abdominal pain.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason:
While chronic cholecystitis can lead to complications, such as gallbladder inflammation and gallstones, it is not a typical cause of gallbladder cancer.
Choice B reason:
This statement is correct. Complications of chronic cholecystitis may include pancreatitis, which is inflammation of the pancreas, and cholangitis, which is inflammation of the bile ducts. These complications can occur if gallstones migrate from the gallbladder and obstruct the pancreatic or bile ducts.
Choice C reason:
This statement is incorrect. Chronic cholecystitis is inflammation of the gallbladder, not the pancreas. However, complications of chronic cholecystitis, such as gallstone migration, can cause acute inflammation of the pancreas (pancreatitis).
Choice D reason:
Complications of chronic cholecystitis do not typically include lung infections. The primary complications are related to the gallbladder, pancreas, and bile ducts.
Correct Answer is B
Explanation
Choice A reason:
Itching is not typically associated with an allergic reaction and is more likely related to cholecystitis itself or complications such as cholangitis or bile duct obstruction.
Choice B reason:
This statement is correct. Cholecystitis can cause bile salts to accumulate in the skin, leading to pruritus (itching). When the bile flow is obstructed or altered, bile salts may not be properly eliminated from the body, leading to their accumulation in the skin and causing itching.
Choice C reason:
Dehydration may occur in some cases of cholecystitis due to nausea, vomiting, or reduced fluid intake, but it is not the primary cause of pruritus.
Choice D reason:
Cholecystitis does not typically cause elevated blood sugar levels. However, certain conditions like diabetes mellitus may increase the risk of cholecystitis.
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