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The nurse is assisting with the care of a client.

Exhibits

For each finding, click to specify if the finding is consistent with small bowel obstruction or acute pancreatitis. Each finding may support more than 1 disease process.

A.

Pain level

B.

Social history

C.

Skin findings

D.

Lipase level

E.

WBC count

F.

Abdominal findings

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

Pain level:

  • Small bowel obstruction: The client reports mid-abdominal pain, which is characteristic of small bowel obstruction as the pain is often crampy and located around the abdomen.
  • Acute pancreatitis: Abdominal pain is also a common symptom of acute pancreatitis, typically described as severe and persistent.

Social history:

  • Small bowel obstruction: Alcohol consumption is not a typical cause of obstruction.
  • Acute pancreatitis: Chronic alcohol use is a major risk factor for acute pancreatitis.

Skin findings:

  • Small bowel obstruction: Skin findings are usually unaffected.
  • Acute pancreatitis: In severe cases, pancreatic enzymes can leak into the skin, leading to ecchymosis (e.g., Grey Turner's or Cullen's sign). While jaundice can occur in acute pancreatitis due to bile duct obstruction, its absence does not rule out the condition.

Lipase level:

  • Small bowel obstruction: Lipase is generally normal.
  • Acute pancreatitis: Elevated lipase levels are highly indicative of acute pancreatitis.

WBC count:

  • Small bowel obstruction: A mild increase in WBC may occur due to bowel distension. The client’s WBC count is 9,000/mm³, which is within the normal range.
  • Acute pancreatitis: WBC levels are often elevated due to inflammation.

Abdominal findings:

  • Small bowel obstruction: Tenderness and high-pitched bowel sounds are typical signs.
  • Acute pancreatitis: Abdominal tenderness can also be present in acute pancreatitis, but high-pitched bowel sounds are more specific to small bowel obstruction.


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Related Questions

Correct Answer is ["119"]

Explanation

Convert weight to kg:

175lb÷2.2=79.54kg

Multiply weight by dosage:

1.5mg/kg×79.54=119.31mg

Round to the nearest whole number: 119 mg

Correct answer: 119mg

Correct Answer is D

Explanation

A. "You will need to fast for 2 hours before the procedure." Bone marrow aspiration typically does not require fasting. If the procedure involves sedation, the client may be instructed to fast for a certain period, but fasting is not a standard requirement for bone marrow aspiration.
B. "You will have the bone marrow taken from your femur." While the femur (thigh bone) can be a site for bone marrow aspiration, the most common site is the posterior iliac crest (the back of the pelvis). The nurse should clarify the exact site with the healthcare provider.
C. "You will not receive a local anesthetic agent for this procedure." Bone marrow aspiration is typically performed under local anesthesia to minimize discomfort at the site. The client will feel pressure during the procedure but should not experience pain due to the anesthesia.
D. "I will hold pressure on the site after the procedure." After a bone marrow aspiration, the nurse will apply pressure to the site to control any bleeding and help prevent hematoma formation. This is an important part of post-procedure care.

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