A nurse is caring for a client with peritonitis who developed sepsis. Which nursing intervention is the highest priority in managing this complication?
Administering pain medication as prescribed
Monitoring vital signs every 4 hours
Initiating broad-spectrum antibiotic therapy
Providing deep breathing exercises
The Correct Answer is C
Choice A reason:
Administering pain medication is important for the client's comfort, but it is not the highest priority in managing sepsis, a life-threatening complication of peritonitis. Addressing the underlying infection with antibiotics takes precedence.
Choice B reason:
Monitoring vital signs is essential for assessing the client's condition, but initiating broad-spectrum antibiotic therapy is more critical in managing sepsis.
Choice C reason:
Initiating broad-spectrum antibiotic therapy is the highest priority in managing sepsis. Prompt administration of antibiotics is crucial to treat the bacterial infection and prevent its spread.
Choice D reason:
Providing deep breathing exercises is important for preventing respiratory complications, but it is not the highest priority compared to addressing sepsis with antibiotics.
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Correct Answer is C
Explanation
Choice A reason:
Lying flat in bed may provide some comfort for the client and is not likely to exacerbate the abdominal pain associated with peritonitis.
Choice B reason:
Using a heating pad on the abdomen may provide some relief for the client and is not likely to exacerbate the abdominal pain associated with peritonitis.
Choice C reason:
Deep breathing and coughing exercises may worsen the client's abdominal pain due to the stretching and movement of the peritoneum during these activities.
Choice D reason:
Administering prescribed analgesics is essential for managing the client's pain and providing comfort during the treatment of peritonitis.
Correct Answer is D
Explanation
Choice A reason:
Monitoring blood glucose levels is important for clients with various conditions, but it is not directly related to the management of acute kidney injury (AKI) in peritonitis.
Choice B reason:
Administering pain medication is essential for managing the client's pain and providing comfort during treatment, but it is not directly related to the management of acute kidney injury.
Choice C reason:
Encouraging fluid intake is important for clients with peritonitis, but the specific recommendation of 3 liters per day is not universally applicable and may vary based on individual client needs and medical status.
Choice D reason:
Maintaining fluid and electrolyte balance is crucial in managing acute kidney injury in peritonitis. The nurse should closely monitor the client's fluid intake, output, and electrolyte levels and collaborate with the healthcare team to adjust the fluid therapy as needed.
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