A nurse is collecting data from a client who has peritonitis. Which of the following findings should the nurse expect?
Polyuria
Peripheral edema
Decreased respirations
Absent bowel sounds
The Correct Answer is D
Choice A Reason:
Polyuria is incorrect. Peritonitis doesn’t directly influence urine output. Polyuria (increased urine production) is more commonly associated with conditions affecting the kidneys or diabetes mellitus rather than peritonitis.
Choice B Reason:
Peripheral edema is incorrect. Peritonitis typically involves abdominal symptoms and signs rather than peripheral issues like edema. Edema can be related to heart, kidney, or circulatory system problems, but it's not a typical manifestation of peritonitis.
Choice C Reason:
Decreased respirations is incorrect. Peritonitis can cause pain and discomfort, which might affect the depth of breathing or result in shallow breathing due to guarding against abdominal pain. However, decreased respirations as a specific finding wouldn't commonly be expected in peritonitis. Pain might cause shallow breathing, but it wouldn't lead to a consistent decrease in respiratory rate.
Choice D Reason:
Absent bowel sounds is correct. Peritonitis is an inflammation of the peritoneum, the lining of the abdominal cavity. This condition often leads to the loss or significant reduction of bowel sounds due to the irritation and inflammation of the abdominal structures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
"I'll make sure I stay away from microwave ovens." This statement is incorrect . While there were concerns about interference in the past, modern pacemakers are generally not affected by household appliances like microwave ovens.
Choice B Reason:
"I should have an MRI, rather than a CAT scan, if necessary." This statement is incorrect. Both MRI and CAT scans have considerations when a person has a pacemaker. An MRI might be contraindicated due to the magnetic field, while a CAT scan might be a safer imaging choice.
Choice C Reason:
"I'll hold my cell phone against the ear on the opposite side of my body." This statement reflects an understanding of the precaution to avoid holding a cell phone directly over the implanted pacemaker. Keeping the phone on the opposite side helps minimize the potential interference with the pacemaker's function.
Choice D Reason:
"I shouldn't travel by plane because of airport security." This statement is incorrect. Airport security systems generally don't affect pacemakers, so traveling by plane is usually safe. However, informing security personnel about the presence of a pacemaker is a good practice.
Correct Answer is C
Explanation
Choice A Reason:
Experiences nocturia is incorrect. Nocturia (waking up at night to urinate) is a common symptom and, while it's important to address for the client's comfort and potential underlying causes, it doesn't pose an immediate risk to the client's roommate or necessitate urgent intervention in a shared room setting.
Choice B Reason:
History of generalized anxiety disorder is incorrect. A history of generalized anxiety disorder is relevant to the client's mental health and overall care. However, in the context of a shared room, it might not require immediate attention or interventions that directly impact the roommate's health or safety.
Choice C Reason:
Recent exposure to tuberculosis is correct. Tuberculosis (TB) is an infectious disease that spreads through the air when an infected person coughs or sneezes. In a shared room, a history of recent exposure to TB is a significant concern as it poses a potential risk to both the client and the roommate. Immediate measures to prevent transmission and ensure proper isolation protocols are necessary to protect the health of both individuals in the shared space.
Choice D Reason:
Reports periodic migraine headaches is correct.
Periodic migraine headaches are a health concern for the client experiencing them, but they typically do not pose an immediate risk or concern for the client's roommate. While addressing pain management is important, it might not require immediate action in the shared room environment.
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