The emergency room nurse is caring for a client just diagnosed with a bowel obstruction secondary to adhesions. Which of the following orders should the nurse complete first?

Hang IV fluids of CSNS with 20 mEq of potassium chloride at 125 ml/hr

Insert a nasogastric tube

Draw a basic metabolic panel

Ambulate in the hallway

Answer and Explanation

The Correct Answer is B

A. Hang IV fluids of CSNS with 20 mEq of potassium chloride at 125 ml/hr: Fluid resuscitation is important, but potassium should not be administered until electrolyte levels are assessed. Also, potassium administration in a client with a bowel obstruction requires caution due to the risk of hyperkalemia if renal function is impaired.

B. Insert a nasogastric tube: A nasogastric (NG) tube is essential in managing bowel obstruction as it helps decompress the stomach, relieve pressure, and prevent aspiration. This should be done first to stabilize the client.

C. Draw a basic metabolic panel: Checking electrolyte imbalances is important but should be done after stabilizing the client with NG tube insertion.

D. Ambulate in the hallway: Ambulation is contraindicated in acute bowel obstruction due to the risk of worsening symptoms such as nausea, vomiting, and severe pain.

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Correct Answer is B

Explanation

A. Both require frequent surgery: While surgery may be required for complications of UC or CD, not all cases require frequent surgery. UC is more likely to be treated with total colectomy, while Crohn’s often requires surgery for strictures, fistulas, or bowel obstruction.

B. Both are inflammatory: Both ulcerative colitis (UC) and Crohn’s disease (CD) are types of inflammatory bowel disease (IBD) characterized by chronic inflammation of the gastrointestinal tract.

C. Both begin in the rectum: Ulcerative colitis starts in the rectum and progresses proximally, while Crohn’s disease can occur anywhere along the gastrointestinal tract (mouth to anus) but most commonly affects the ileum and colon.

D. Both manifest fistula formation: Fistulas (abnormal connections between organs) are common in Crohn’s disease but not in ulcerative colitis.

A. "You can donate blood as long as your symptoms have resolved.”" B. " It is safe to consume alcohol in moderation.” C. "You should inform your sexual partners about your diagnosis." D. "You do not need to follow up with your healthcare provider once you feel better."

Correct Answer is C

Explanation

A. "You can donate blood as long as your symptoms have resolved.": Clients with a history of hepatitis B can never donate blood, even if symptoms have resolved, due to the risk of latent infection and transmission.

B. "It is safe to consume alcohol in moderation.": Alcohol should be avoided because it worsens liver inflammation and damage in hepatitis B.

C. "You should inform your sexual partners about your diagnosis.": Hepatitis B (HBV) is a bloodborne virus transmitted through sexual contact, blood, and bodily fluids. Clients should inform sexual partners and practice safe sex to prevent transmission.

D. "You do not need to follow up with your healthcare provider once you feel better.": Follow-up is essential to monitor liver function, prevent complications, and check for chronic hepatitis B, which may lead to cirrhosis or liver cancer.

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The emergency room nurse is caring for a client just diagnosed with a bowel obstruction secondary to adhesions. Which of the following orders should the nurse complete first?

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