The nurse is caring for a client on the third day following abdominal surgery and assesses the absence of bowel sounds, abdominal distention, and the client passing no flatus. These findings indicate the client is experiencing which of the following postoperative complications?

Fecal impaction

Incisional infection

Health care-associated Clostridium difficile

Paralytic ileus

Answer and Explanation

The Correct Answer is D

Choice A reason: Fecal impaction typically presents with the inability to pass stool and may not be associated with the absence of bowel sounds.

Choice B reason: Incisional infection is usually indicated by localized redness, warmth, and possible discharge, not necessarily by the absence of bowel sounds or flatus.

Choice C reason: Health care-associated Clostridium difficile often presents with diarrhea, not the absence of bowel sounds or flatus.

Choice D reason: Paralytic ileus is characterized by impaired intestinal motility and transit, absence of the passage of flatus, diminished bowel sounds, abdominal distension, and intestinal dilatation, fitting the symptoms described.

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Correct Answer is A

Explanation

Choice A reason: Emptying the drain device every shift is important to prevent infection and accumulation of fluid, which can impede healing.

Choice B reason: Minimizing use of the affected arm is not recommended; rather, gentle exercises to promote circulation and prevent lymphedema are usually encouraged.

Choice C reason: Measuring the circumference of both arms can be part of monitoring for lymphedema, but it is not the priority in immediate post-mastectomy care.

Choice D reason: Placing the affected arm below the level of the heart is not recommended as it can increase swelling; elevation is usually advised.

A. Positive pregnancy test B. Family history of hypertension C. Signed advance directive D. Medical history of diabetes

Correct Answer is A

Explanation

Choice A reason: A positive pregnancy test is a significant concern for a patient preparing for surgery as it can affect the type of anesthesia used and the surgical approach, due to the potential impact on the fetus.

Choice B reason: While a family history of hypertension is important, it is not as immediately concerning as a positive pregnancy test in a patient preparing for surgery.

Choice C reason: A signed advance directive is a document that outlines a patient's wishes regarding medical treatment and is not a concern but rather a part of preoperative preparation.

Choice D reason: A medical history of diabetes is important to consider in surgical patients due to potential complications with wound healing and blood glucose control, but it is not as urgent as confirming pregnancy status before surgery.

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The nurse is caring for a client on the third day following abdominal surgery and assesses the absence of bowel sounds, abdominal distention, and the client passing no flatus. These findings indicate the client is experiencing which of the following postoperative complications?

Nursing Test Bank

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