The nurse is caring for a client who presents with acute appendicitis:
Select all that apply?
Creatinine, 0.9 mg/dL
White blood cell count, 11,500 mm"
BUN 26 mg/dL.
Reports of pain increasing while coughing
Potassium 3.3 mEq/L
Nausea and vomiting
Correct Answer : B,C,D,E
Choice A rationale: This is a normal value, indicating normal renal function. The client does not have any signs of kidney damage or impairment.
Choice B rationale: This is an elevated value, indicating an infection or inflammation in the body. Acute appendicitis is a common cause of increased white blood cells, as the appendix becomes inflamed and infected. This finding requires immediate follow-up to monitor the client's condition and prevent complications such as perforation or peritonitis.
Choice C rationale: This is a high value, indicating impaired renal function or dehydration. The client may have decreased urine output due to vomiting and fluid loss, or may have underlying kidney problems. This finding requires immediate follow-up to assess the client's hydration status and renal function, and to provide appropriate fluid and electrolyte replacement.
Choice D rationale: This is a sign of peritoneal irritation, which may indicate that the appendix has ruptured or is close to rupturing. This is a medical emergency that requires immediate surgical intervention to remove the appendix and prevent sepsis and shock.
Choice E rationale: This is a low value, indicating hypokalemia or low potassium levels in the blood. The client may have lost potassium due to vomiting and fluid loss, or may have underlying electrolyte imbalances. This finding requires immediate follow-up to assess the client's cardiac function and muscle strength, and to provide appropriate potassium supplementation.
Choice F rationale: These are common symptoms of acute appendicitis, as the inflammation and infection of the appendix cause irritation of the gastrointestinal tract. These symptoms do not require immediate follow-up, but they should be managed with antiemetics and fluids to prevent dehydration and electrolyte imbalances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: Hypoglycemia (blood sugar less than 30 mg/dL) can lead to seizures due to inadequate glucose supply to the brain.
Choice B rationale: Anorexia (loss of appetite) is not directly associated with low blood sugar but can be a symptom of other conditions.
Choice C rationale: Anhidrosis refers to the inability to sweat and is not typically associated with low blood sugar.
Choice D rationale: Bradycardia (slow heart rate) can be a symptom of severe hypoglycemia but is not the primary complication expected at this blood sugar level.
Correct Answer is A
Explanation
Choice A rationale: this is the correct answer since the darkened spots in the uterus represent endometrial-like tissue growths within the muscular wall of the uterus (the myometrium).
Choice B rationale: This picture shows leiomyomas, also known as fibroids, which are benign tumors that develop from the smooth muscle cells of the uterus. They can vary in size, number, and location within or outside the uterus. They can cause symptoms such as heavy bleeding, pelvic pressure, pain, and infertility.
Choice C rationale: This is endometriosis which is a condition where tissue similar to the endometrium (the lining of the uterus) grows outside the uterus, such as on the ovaries, fallopian tubes, pelvic wall, or bowel. This tissue responds to hormonal changes and bleeds during the menstrual cycle, causing inflammation, pain, and sometimes infertility.
Choice D rationale: This image shows a normal uterus.
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