In reviewing the medical record for a patient admitted with acute pancreatitis, the nurse sees that the patient has a positive Cullen's sign. Indicate the area in the accompanying figure where the nurse will assess for this change.
Epigastrium
Umbilical
Flank
Subumbilical
The Correct Answer is B
Rationale:
A. Epigastrium refers to the upper central region of the abdomen, just below the sternum; Cullen’s sign does not appear here.
B. Umbilical region (around the navel) is where Cullen’s sign appears as a bluish discoloration due to subcutaneous fat necrosis or retroperitoneal bleeding associated with acute pancreatitis. This is the correct site.
C. Flank discoloration is known as Grey Turner’s sign, another indicator of retroperitoneal bleeding, but distinct from Cullen’s sign.
D. Subumbilical refers to the area below the umbilicus, not the typical site for Cullen’s sign.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. RBC count is not typically affected by acute pancreatitis unless there is bleeding, which is uncommon.
B. Serum amylase is elevated in acute pancreatitis because pancreatic inflammation leads to the release of digestive enzymes into the bloodstream. Amylase levels usually rise within 6–12 hours of symptom onset and remain elevated for 3–5 days.
C. Calcium levels often decrease in acute pancreatitis due to fat saponification, not increase.
D. Magnesium levels are usually normal or decreased, but elevation is not a typical finding in pancreatitis.
Correct Answer is []
Explanation
Rationale:
- Potential Condition: The client presents with jaundice, ascites, abdominal distention, confusion, and abnormal liver function tests (elevated AST, ALT, and bilirubin, with low albumin), consistent with cirrhosis and fluid volume excess.
- Actions to Take:
- Administer diuretics (such as spironolactone or furosemide) to reduce fluid retention and help manage ascites.
- Monitor fluid intake and output to evaluate fluid balance and effectiveness of diuretic therapy.
- Parameters to Monitor:
- Blood pressure is important because hypotension is present and can worsen with fluid shifts and diuretic therapy.
- Abdominal girth is monitored to track the progression or reduction of ascites.
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