The nurse cares for a client who has had a left-sided intracerebral hemorrhage. The client is unable to detect light and pain touch on the right arm. Which explanation best describes these observations?

Choice A reason: Appendicitis and peritonitis are not the most common cause of small bowel obstruction in adults because they are conditions that affect the appendix and the peritoneum, which are parts of the large intestine, not the small intestine. The appendix is a small pouch that is attached to the cecum, which is the first part of the large intestine. The peritoneum is a membrane that covers the abdominal organs and the abdominal wall. Appendicitis is a condition where the appendix becomes inflamed, causing symptoms such as pain, fever, or nausea. Peritonitis is a condition where the peritoneum becomes inflamed, usually due to an infection or a perforation of the abdominal organs, causing symptoms such as pain, fever, or shock.

Choice B reason: Sigmoid colon cancer is not the most common cause of small bowel obstruction in adults because it is a condition that affects the sigmoid colon, which is the last part of the large intestine, not the small intestine. The sigmoid colon is a curved segment that connects the descending colon to the rectum, which is the final part of the digestive tract. Sigmoid colon cancer is a type of cancer that develops from the cells that line the inner wall of the sigmoid colon, causing symptoms such as bleeding, change in bowel habits, or weight loss.

Choice C reason: Cirrhosis and ascites are not the most common cause of small bowel obstruction in adults because they are conditions that affect the liver and the abdomen, not the small intestine. The liver is a large organ that performs various functions, such as detoxifying the blood, producing bile, and metabolizing nutrients. The abdomen is the cavity that contains the digestive organs, such as the stomach, the small intestine, and the large intestine. Cirrhosis is a condition where the liver becomes scarred and damaged, usually due to chronic alcohol abuse, viral hepatitis, or fatty liver disease, causing symptoms such as jaundice, fatigue, or bleeding. Ascites is a condition where fluid accumulates in the abdomen, usually due to portal hypertension, which is a high blood pressure in the vein that carries blood from the digestive organs to the liver. Portal hypertension can be a complication of cirrhosis, and can cause symptoms such as abdominal distension, shortness of breath, or infection.

Choice D reason: Adhesions of the small intestine are the most common cause of small bowel obstruction in adults because they are bands of scar tissue that form between the loops of the small intestine, which is the part of the digestive tract that extends from the stomach to the large intestine, and is responsible for digesting and absorbing nutrients. Adhesions of the small intestine can block or twist the passage of food and fluid, causing symptoms such as pain, vomiting, or constipation. Adhesions of the small intestine can be caused by various factors, such as surgery, infection, or inflammation.

Choice A reason: Uric acid is the most common type of renal calculi in clients with gout because it is a condition where the blood has a high level of uric acid, which is a waste product that results from the breakdown of purines, which are substances found in some foods and drinks, such as meat, seafood, and beer. Uric acid can form crystals in the joints, causing inflammation and pain, which is known as gout. Uric acid can also form crystals in the urine, causing kidney stones, which are hard deposits of minerals and salts that can block the urinary tract and cause symptoms such as severe pain, blood in the urine, nausea, and fever.

Choice B reason: Struvite is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of ammonia, which is a chemical that results from the breakdown of urea, which is a waste product that is produced by the liver and excreted by the kidneys. Ammonia can form crystals in the urine, along with magnesium, phosphate, and carbonate, creating struvite stones, which are large and staghorn-shaped stones that can fill the entire kidney or the ureter. Struvite stones are usually associated with urinary tract infections, which are caused by bacteria that produce enzymes that increase the urine pH and the ammonia level.

Choice C reason: Cystine is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of cystine, which is an amino acid that is a building block of proteins. Cystine can form crystals in the urine, causing kidney stones, which are rare and hereditary. Cystine stones are caused by a genetic disorder that affects the transport of cystine and other amino acids in the kidneys, resulting in excessive excretion of cystine in the urine.

Choice D reason: Calcium oxalate is not the most common type of renal calculi in clients with gout because it is a condition where the urine has a high level of calcium and oxalate, which are substances that are normally present in the diet and the body. Calcium and oxalate can form crystals in the urine, causing kidney stones, which are the most common type of kidney stones in the general population, but not in clients with gout. Calcium oxalate stones can be caused by various factors, such as dehydration, high intake of animal protein, low intake of fluids, and certain medications.