A nurse is reviewing the provider's prescriptions for a client experiencing a paralytic ileus following an appendectomy.
Which of the following actions should the nurse expect to take?
Insert nasogastric tube.
Provide a bulk-forming agent.
Administer an antacid.
Apply a truss.
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Pruritus following scabies treatment is often due to residual irritation from the mites and the inflammatory response. Mittens can prevent scratching, which can exacerbate the itching, lead to skin breakdown, and increase the risk of secondary infections.
Choice B rationale
Rubbing the affected area, even gently, can further irritate the skin and intensify the itching sensation. This can prolong discomfort and potentially cause skin damage.
Choice C rationale
Applying additional scabicide after the prescribed treatment is completed is generally not recommended and can cause skin irritation or even systemic toxicity if overused. Pruritus after treatment is usually due to the body's reaction to dead mites and their products, not ongoing infestation.
Choice D rationale
Hot showers can dry out the skin and worsen pruritus. Warm or cool showers are generally recommended for individuals experiencing itching, as they are less likely to cause further irritation.
Correct Answer is B
Explanation
Choice A rationale
Pediculosis refers to an infestation of lice, which typically presents with intense itching and the presence of nits (lice eggs) attached to hair shafts. While there may be redness and irritation from scratching, oozing lesions are not a primary characteristic of pediculosis.
Choice B rationale
Contact dermatitis is an inflammatory skin condition caused by direct contact with an allergen or irritant. It often manifests as pruritus (itching), redness (erythema), and oozing lesions (vesiculation and weeping) at the site of contact. The client's report of pruritus and reddened, oozing lesions on her lower leg is consistent with contact dermatitis.
Choice C rationale
Alopecia refers to hair loss, which can be localized or widespread. It does not typically involve pruritus or oozing lesions on the skin.
Choice D rationale
Tinea pedis, also known as athlete's foot, is a fungal infection of the feet. It commonly presents with scaling, itching, redness, and sometimes blistering, but oozing lesions are less typical unless there is a secondary bacterial infection. The location on the lower leg is also less common for tinea pedis, which primarily affects the feet. .
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