A nurse is receiving postoperative report for a school-age child following surgery for a ruptured appendix. Which of the following prescriptions should the nurse expect?

Place the client in a supine position for the first 12 hr postoperative.

Pack the open wound with a dry gauze dressing.

Administer naproxen orally for pain 30 min prior to ambulation.

Maintain an NG tube on low intermittent suction until bowel sounds return.

Answer and Explanation

The Correct Answer is D

A) Place the client in a supine position for the first 12 hr postoperative: Following surgery for a ruptured appendix, placing the child in a supine position for the first 12 hours can be inappropriate. It may be more beneficial to position the child in a semi-Fowler's position to promote drainage of any remaining infection and reduce the risk of respiratory complications.

B) Pack the open wound with a dry gauze dressing: For a postoperative wound following a ruptured appendix, using a dry gauze dressing might not be the best practice. A moist dressing can promote better healing and reduce the risk of infection. Wet-to-dry or other appropriate dressings are typically recommended based on the surgeon's instructions.

C) Administer naproxen orally for pain 30 min prior to ambulation: While managing pain is important, naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that is typically not the first choice for postoperative pain management in children. Additionally, oral medication might not be recommended immediately post-surgery, especially if the child has an NG tube or other contraindications for oral intake.

D) Maintain an NG tube on low intermittent suction until bowel sounds return: This is a standard postoperative practice for children who have had surgery for a ruptured appendix. The NG tube helps to decompress the stomach, preventing vomiting and aspiration, and helps manage bowel function until normal activity resumes, which is crucial for postoperative recovery.

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Correct Answer is ["B","C","E"]

Explanation

A) Urticaria:
Urticaria, or hives, is a skin reaction characterized by itchy, raised welts. It is not typically associated with a small bowel obstruction, which primarily affects the gastrointestinal system rather than the skin.

B) Vomiting:
Vomiting is a common symptom of a complete small bowel obstruction. It occurs due to the blockage in the intestines, which prevents the passage of contents, leading to nausea and vomiting as the body tries to expel the obstruction.

C) Distended abdomen:
A distended abdomen is expected in cases of small bowel obstruction. The blockage causes a buildup of gas and fluids, leading to abdominal swelling and distention as the normal passage of intestinal contents is impeded.

D) Fluid overload:
Fluid overload is not a typical manifestation of a small bowel obstruction. Instead, dehydration and electrolyte imbalances are more likely due to vomiting and the inability to absorb fluids and nutrients properly.

E) Obstipation:
Obstipation, or severe constipation with an inability to pass stool or gas, is a key sign of a complete small bowel obstruction. The obstruction prevents the normal movement of intestinal contents, leading to a cessation of bowel movements.

A. Offer the client a small meal if she is not nauseated. B. Administer 1 mg of glucagon intramuscularly to the client. C. Contact the client's provider for further instructions D. Transport the client to an emergency department for treatment.

Correct Answer is B

Explanation

A) Offer the client a small meal if she is not nauseated:
While eating a small meal can help raise blood glucose levels, it is not the immediate priority in a severe hypoglycemia situation. The client might be unconscious or unable to swallow safely, making this action inappropriate as a first step.

B) Administer 1 mg of glucagon intramuscularly to the client:
Administering glucagon intramuscularly is the most crucial initial action. Glucagon rapidly increases blood glucose levels by stimulating glycogen breakdown in the liver. This is vital for quickly reversing severe hypoglycemia, especially if the client is unconscious or unable to ingest carbohydrates orally.

C) Contact the client's provider for further instructions:
Contacting the provider is essential, but it should occur after addressing the immediate hypoglycemic episode. Once the client's condition stabilizes, further guidance can be sought from the healthcare provider.

D) Transport the client to an emergency department for treatment:
Transporting the client to the emergency department is necessary if the hypoglycemia does not improve after administering glucagon or if the client remains unresponsive. However, it is not the first action; immediate glucagon administration takes precedence to stabilize the client's condition before considering transportation.

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A nurse is receiving postoperative report for a school-age child following surgery for a ruptured appendix. Which of the following prescriptions should the nurse expect?

Nursing Test Bank

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