The nurse assesses a client admitted 4 hours ago with a diagnosis of diverticulitis. Which assessment finding must be reported immediately to the healthcare provider?

Choice D rationale

Sudden, sharp abdominal pain is a key indicator of gastrointestinal perforation. This severe symptom results from the leakage of gastrointestinal contents into the abdominal cavity, causing intense pain and requiring urgent medical attention.

Choice A rationale

Elevated blood pressure is not a specific indicator of gastrointestinal perforation. While stress or pain might cause temporary increases in blood pressure, it is not a reliable diagnostic sign for perforation.

Choice B rationale

Low heart rate is not typically associated with gastrointestinal perforation. Instead, tachycardia or increased heart rate might occur due to pain and the body's response to infection or sepsis from a perforation.

Choice C rationale

Hyperactive bowel sounds do not indicate gastrointestinal perforation. In fact, bowel sounds may be absent if a perforation occurs due to the body's response to abdominal infection and inflammation. Hyperactive sounds are more related to increased intestinal activity, not perforation.

Choice A rationale

Shortness of breath while lying flat, known as orthopnea, can indicate worsening heart failure or other serious cardiac conditions. This symptom may suggest fluid buildup in the lungs due to inadequate heart function, requiring immediate medical evaluation.

Choice B rationale

Night sweats and excessive sweating can be associated with cardiac issues such as myocardial infarction or heart failure. These symptoms can indicate that the heart is not effectively pumping blood, leading to increased stress on the body.

Choice C rationale

Burning chest pain at night can be indicative of angina or even a myocardial infarction. Angina often worsens at night due to changes in heart rate and blood pressure during sleep. This symptom warrants prompt cardiac assessment to rule out severe cardiac events.

Choice D rationale

Headaches after eating are not typically associated with cardiac conditions. This symptom is more likely related to gastrointestinal or metabolic issues rather than cardiac problems.

Choice E rationale

Feeling sleepy after eating is usually due to normal postprandial somnolence and is not directly related to cardiac issues. This symptom does not require urgent cardiac evaluation.