The nurse is caring for a client with intestinal obstruction who presents with severe, colicky abdominal pain, nausea, vomiting, and abdominal distention. Which pathophysiologic mechanism supports the client's clinical presentation?
Nerve degeneration due to chronic gastric reflux.
Volvulus that occurred during an appendectomy.
Esophagitis due to reflux of gastric contents.
A history of having Helicobacter pylori infection.
The Correct Answer is B
A) Nerve degeneration due to chronic gastric reflux:
Nerve degeneration due to chronic gastric reflux may lead to conditions such as gastroesophageal reflux disease (GERD) or esophagitis, but it is not directly related to the clinical presentation of intestinal obstruction. Symptoms of GERD or esophagitis typically include heartburn, regurgitation, and dysphagia rather than severe, colicky abdominal pain, nausea, vomiting, and abdominal distention.
B) Volvulus that occurred during an appendectomy:
Correct. Volvulus refers to the twisting of a segment of the intestine around its mesentery, leading to obstruction of the bowel lumen and compromising blood flow to the affected area. In this scenario, the client's clinical presentation of severe, colicky abdominal pain, nausea, vomiting, and abdominal distention is consistent with symptoms of intestinal obstruction, which can occur secondary to volvulus. Volvulus may result from various factors, including prior abdominal surgeries, such as an appendectomy, leading to abnormal positioning or adhesions within the abdomen.
C) Esophagitis due to reflux of gastric contents:
Esophagitis due to reflux of gastric contents can cause symptoms such as heartburn, chest pain, and difficulty swallowing, but it is not typically associated with severe, colicky abdominal pain, nausea, vomiting, and abdominal distention characteristic of intestinal obstruction.
D) A history of having Helicobacter pylori infection:
Helicobacter pylori infection is associated with conditions such as peptic ulcer disease and gastritis, but it is not directly related to the clinical presentation of intestinal obstruction. Symptoms of H. pylori infection may include abdominal pain, nausea, and vomiting, but they are not typically colicky and severe as those seen in intestinal obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A,D,C,E,B
Explanation
This sequence starts with an injury to the arterial endothelium, leading to inflammation. Macrophages then consume LDL, forming foam cells. These foam cells release growth factors that stimulate the growth of smooth muscle cells. The smooth muscle cells grow over the fatty streaks, creating fibrous plaques. Finally, as these plaques grow, they narrow the vessel, which can result in ischemia. This is a simplified explanation of a complex process that involves many other factors and steps. It’s also important to note that this process can take many years to develop.
Correct Answer is A
Explanation
A. Provide pressure over the biopsy site:
Positioning the client on the right side after a liver biopsy is aimed at providing pressure over the biopsy site. This pressure helps in promoting hemostasis by compressing the blood vessels at the biopsy site, thus reducing the risk of bleeding or hematoma formation. The liver is located on the right side of the body, so positioning the client on the right side applies pressure directly over the liver, aiding in the prevention of bleeding complications.
B. Keep the client from aspirating:
Positioning the client on the right side after a liver biopsy is not primarily aimed at preventing aspiration. Aspiration precautions are typically implemented during procedures where there is a risk of regurgitation or vomiting, such as during anesthesia induction or recovery, rather than specifically after a liver biopsy.
C. Lessen the amount of post-procedure pain:
While positioning can play a role in managing post-procedure pain, the primary reason for positioning the client on the right side after a liver biopsy is to provide pressure over the biopsy site to promote hemostasis. Pain management strategies such as administering analgesics may be utilized to address any discomfort experienced by the client post-procedure.
D. Facilitate pulmonary expansion:
Positioning the client on the right side after a liver biopsy does not directly facilitate pulmonary expansion. Facilitating pulmonary expansion is typically achieved through interventions such as deep breathing exercises, incentive spirometry, and early ambulation rather than positioning alone.
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