A nurse is monitoring the urinary output of an adult client who had a colon resection.
Which of the following 24-hr output totals indicates oliguria?

Choice A rationale

Insertion of a nasogastric tube is expected in a client with paralytic ileus to decompress the bowel by removing accumulated fluids and gas. Paralytic ileus is a non-mechanical obstruction of the bowel characterized by a lack of peristalsis, often occurring after abdominal surgery like an appendectomy. This decompression helps relieve abdominal distension, pain, and nausea, facilitating the return of bowel function.

Choice B rationale

Providing a bulk-forming agent, such as psyllium, is contraindicated in paralytic ileus. Bulk-forming agents work by increasing the volume of stool, which would exacerbate the obstruction and potentially cause further discomfort and complications in the absence of peristalsis. These agents are typically used to treat constipation by adding fiber to the diet and promoting bowel movements.

Choice C rationale

Administering an antacid, such as aluminum hydroxide or calcium carbonate, is not a primary intervention for paralytic ileus. Antacids work by neutralizing stomach acid and are used to treat conditions like heartburn and acid reflux. While a client with paralytic ileus might experience some gastric upset, the underlying issue is the lack of bowel motility, which antacids do not address.

Choice D rationale

Applying a truss is used to provide support for hernias, a condition unrelated to paralytic ileus following an appendectomy. A truss helps to keep the protruding tissue in place and reduce discomfort associated with the hernia. It does not address the underlying lack of bowel motility characteristic of paralytic ileus.

Choice A rationale

Migraine headaches are a common comorbidity associated with fibromyalgia. Studies suggest a shared pathophysiology involving central sensitization and altered pain processing mechanisms in the central nervous system that contribute to both conditions.

Choice B rationale

Weather changes, particularly fluctuations in barometric pressure, temperature, and humidity, are frequently reported by individuals with fibromyalgia as triggers for increased pain and other symptoms like stiffness and fatigue. The exact mechanisms are not fully understood but may involve changes in tissue pressure and nerve sensitivity.

Choice C rationale

Chest pain, specifically non-cardiac chest pain, is a recognized symptom in some individuals with fibromyalgia. This pain is often musculoskeletal in origin, arising from tender points in the chest wall and surrounding muscles, and is not related to cardiac issues.

Choice D rationale

Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive issues. Unlike rheumatoid arthritis or osteoarthritis, fibromyalgia does not involve joint inflammation or structural damage to the joints. The pain is believed to originate from amplified pain signals in the brain and spinal cord.