The nurse is caring for a patient diagnosed with small bowel obstruction. A nasogastric tube with low continuous suction has been in place for 72 hours. Upon reviewing the blood work, which lab results will the nurse expect to see?

pH 7.46, PaCO2 30, HCO3 24

pH 7.48, PaCO2 42, HCO3 29

pH 7.31, PaCO2 34, HCO3 18

Answer and Explanation

The Correct Answer is B

Choice A reason: The lab results pH 7.46, PaCO2 30, HCO3 24 suggest a slightly alkaline state with normal bicarbonate levels, which could indicate respiratory alkalosis with compensation. However, for a patient with a small bowel obstruction and nasogastric suction, this is less likely.

Choice B reason: The lab results pH 7.48, PaCO2 42, HCO3 29 indicate metabolic alkalosis. This is a common finding in patients with small bowel obstruction who have been on nasogastric suction, which removes stomach acids and leads to an increase in bicarbonate levels. The elevated pH and bicarbonate levels are consistent with this condition.

Choice C reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis. This finding is inconsistent with the expected results for a patient with small bowel obstruction and nasogastric suction, which typically leads to metabolic alkalosis due to loss of gastric acid.

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Correct Answer is A

Explanation

Choice A reason:

Ondansetron on a PRN basis is used to manage nausea and vomiting. In patients with inflammatory bowel disease, especially during an inpatient stay, controlling nausea is important to maintain comfort and prevent dehydration. This makes it an appropriate symptomatic treatment.

Choice B reason:

Vitamin B12 injections may be indicated in patients with Crohn’s disease who have malabsorption issues, particularly if the terminal ileum is involved. However, they are not routinely given to all patients with inflammatory bowel disease solely for the prevention of pernicious anemia.

Choice C reason:

Antidiarrheal medications are generally contraindicated in inflammatory bowel disease, as they can mask important symptoms and may increase the risk of complications like toxic megacolon, especially if administered before meals.

Choice D reason:

Beta adrenergic blockers are not used to reduce bowel motility. Their primary use is in cardiovascular conditions, and they do not address the gastrointestinal symptoms associated with inflammatory bowel disease.

A. Implement a fluid restriction of 1500 mL in 24 hours B. Provide a bland, low-residue diet C. Establish a bowel routine with daily stool softeners D. Consult surgeon to discuss colostomy creation

Correct Answer is C

Explanation

Choice A reason: Implementing a fluid restriction could worsen constipation and bowel function in patients with multiple sclerosis.

Choice B reason: Providing a bland, low-residue diet is less effective in managing bowel function compared to establishing a regular bowel routine.

Choice C reason: Establishing a bowel routine with daily stool softeners helps maintain regular bowel movements and prevents constipation, which is important for patients with multiple sclerosis.

Choice D reason: Consulting a surgeon for colostomy creation is a more invasive intervention that is not the first line of treatment for changes in bowel function in multiple sclerosis patients.

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The nurse is caring for a patient diagnosed with small bowel obstruction. A nasogastric tube with low continuous suction has been in place for 72 hours. Upon reviewing the blood work, which lab results will the nurse expect to see?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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