Exhibits

Which of the day 2 lab values would alert the RN that Mary might be experiencing systemic inflammatory response syndrome (SIRS)? (Select All that Apply.)

A. Cimetidine: Cimetidine is an H2 receptor antagonist, not a proton pump inhibitor (PPI). While H2 blockers like cimetidine reduce stomach acid, they are not classified as PPIs.

B. Pantoprazole: Pantoprazole is a proton pump inhibitor (PPI) and is commonly used to treat peptic ulcers. PPIs work by inhibiting the proton pump in the stomach, thereby reducing gastric acid production, which helps in healing peptic ulcers.

C. Famotidine: Famotidine is an H2 receptor antagonist, similar to cimetidine, and works by reducing acid secretion in the stomach. While effective for ulcers, it is not a proton pump inhibitor.

D. Ranitidine: Ranitidine is also an H2 receptor antagonist, which works by reducing stomach acid but does not have the same mechanism as a proton pump inhibitor like pantoprazole.

Rationale for Correct Answer:

• Improve circulation: Ambulating post-operatively helps to promote blood circulation throughout the body. This is important for preventing complications like blood clots and ensuring effective recovery from surgery. Improved circulation supports overall healing and reduces the risk of cardiovascular issues.
• Deep vein thrombosis (DVT): After surgery, especially bariatric surgery, the risk of developing blood clots (DVT) increases due to reduced mobility. Ambulation helps keep blood circulating, preventing the stasis that can lead to clot formation in the veins, particularly in the legs.

Rationale for Incorrect Choices:

• Reduce pain: While ambulation may help with post-operative discomfort by promoting circulation, the primary goal is to reduce the risk of complications like DVT, not necessarily to reduce pain. Pain management strategies like medications are more directly focused on managing pain.
• Increase appetite: Ambulating post-op is important for physical recovery, but it is not aimed at increasing appetite. Appetite can be influenced by other factors like gastrointestinal recovery and the body’s metabolic state after surgery, not by walking.
• Infection: Although ambulation is important for overall recovery, it doesn't directly prevent infection. Infection prevention typically involves good hygiene, wound care, and possibly antibiotics, rather than just physical activity.
• Pressure ulcers: Pressure ulcers are more commonly prevented through repositioning and using pressure-relieving devices, not primarily through ambulation. While moving helps circulation, preventing pressure ulcers involves more targeted interventions like avoiding prolonged pressure on specific body parts.
• Dehydration: Dehydration is prevented through fluid management and proper hydration, not by walking. Dehydration is more directly influenced by fluid intake and output than by physical activity.