A patient is in an urgent care center with an acute asthma attack.
The nurse expects a medication from which class will be used as the initial treatment?

This question addresses safe medication administration in patients with mechanical bowel obstruction. It requires applying knowledge of gastrointestinal motility to identify agents that are strictly contraindicated, as stimulating peristalsis against a physical blockage can cause severe bowel distension, pain, or potentially life-threatening perforation.

Choice A rationale

Non-steroidal anti-inflammatory drugs like ibuprofen may cause gastric irritation or ulcers, but they do not actively stimulate intestinal peristalsis. While used with caution in some patients, they are not strictly contraindicated in the same way as motility-enhancing agents during obstruction.

Choice B rationale

Zolpidem is a hypnotic agent that works on the central nervous system to induce sleep. It does not have a pharmacological effect on intestinal motility and is not contraindicated in patients diagnosed with a small bowel obstruction during their hospital stay.

Choice C rationale

Omeprazole is a proton pump inhibitor used to decrease gastric acid secretion. It does not influence the motility of the intestinal tract and is not contraindicated in the management of a patient diagnosed with a mechanical small bowel obstruction.

Choice D rationale

Bisacodyl is a stimulant laxative that works by directly increasing peristalsis in the colon and small intestine. Administering a stimulant laxative to a patient with a mechanical bowel obstruction is contraindicated because it can cause perforation, severe pain, and emergency complications.

This question tests the application of the nursing process phases. It requires identifying the specific stage where the nurse compares the patient's current status and clinical outcomes against the established goals to determine the success of the implemented interventions and the need for plan modifications.

Choice A rationale

The evaluation phase involves comparing the patient’s health status with the goals and outcomes defined in the care plan. Monitoring progress after a new medication regimen is a classic example of evaluating the effectiveness of a planned clinical intervention.

Choice B rationale

The planning phase involves setting measurable goals, outcomes, and nursing interventions based on the assessment data. While the nurse plans for the future, the action of monitoring ongoing progress is an evaluative step, not the creation of the initial care plan.

Choice C rationale

The assessment phase is the collection of patient data, including health history, physical examination, and diagnostic results. Monitoring progress happens after interventions have been initiated, whereas assessment occurs before and during the continuous data collection process to identify patient needs.

Choice D rationale

The implementation phase is the actual execution of nursing interventions and actions. While the nurse performs the monitoring, the cognitive process of determining how well the medication is working by comparing patient status to outcomes is defined as the evaluation phase.