Nursing management for a patient with a bowel obstruction includes which of the following interventions?

Choice A rationale

Checking blood pressure does not directly address the faint pulses and cool foot. While hypotension could contribute to peripheral perfusion issues, the signs described more likely indicate compartment syndrome, which requires urgent action.

Choice B rationale

Repositioning the leg might provide some comfort but does not alleviate the potential compartment syndrome. Elevation could worsen ischemia by reducing arterial blood flow.

Choice C rationale

Compartment syndrome is a medical emergency caused by increased pressure within a muscle compartment. This pressure compromises circulation and tissue viability. The nurse must notify the health care provider immediately to prevent permanent damage.

Choice D rationale

Assessing the incision for redness delays addressing the critical signs of potential compartment syndrome. Redness indicates infection, but faint pulses and a cool extremity necessitate more urgent evaluation.

Choice A rationale

While alcohol is a known irritant to the gastric lining, it is not the primary cause of peptic ulcer disease. Excessive alcohol consumption contributes to mucosal damage but lacks the direct causative action of Helicobacter pylori, which colonizes the stomach lining and interferes with protective mechanisms, leading to ulcer formation. Alcohol merely exacerbates existing risk factors rather than initiating disease.

Choice B rationale

Helicobacter pylori is the most common cause of peptic ulcer disease globally. Its mechanism involves producing urease, neutralizing stomach acid and enabling bacterial survival. It induces inflammation and mucosal damage, compromising the stomach's protective lining. Persistent infection leads to ulcer formation. This bacterial colonization is implicated in up to 90% of duodenal ulcers, making it the key pathogenic factor in PUD.

Choice C rationale

Smoking is a risk factor for peptic ulcer disease but functions more as an aggravating agent than the primary cause. Tobacco use increases gastric acid secretion and decreases bicarbonate production, weakening mucosal defenses. It also reduces the efficacy of Helicobacter pylori eradication therapy, prolonging ulcer disease. However, it does not directly induce the condition independently, highlighting its secondary role in PUD pathology.

Choice D rationale

Stress is associated with peptic ulcer disease but is not a primary causative factor. Psychological stress can lead to hypersecretion of gastric acid, aggravating mucosal vulnerability in susceptible individuals. However, its role is predominantly indirect, amplifying existing risk factors like Helicobacter pylori infection. Stress-induced ulcers are typically seen in critical illnesses or severe physiological stress conditions, differing from PUD pathogenesis.