The nurse is caring for an adolescent with a ruptured appendix. What assessment findings would support the diagnosis of peritonitis?
Hyperactive bowel sounds
Profuse diarrhea
A hard, rigid abdomen
Abdominal cramping
The Correct Answer is C
A. This finding is generally not associated with peritonitis. Instead, hyperactive bowel sounds may indicate early gastrointestinal irritation or obstruction. In the case of peritonitis, bowel sounds are often diminished or absent due to the inflammation and irritation of the peritoneum.
B. Profuse diarrhea is not a typical sign of peritonitis. While gastrointestinal disturbances can occur, diarrhea is more commonly associated with infections or irritations of the intestines rather than with peritonitis itself. Peritonitis typically presents with symptoms related to abdominal rigidity and pain.
C. A hard, rigid abdomen is a classic sign of peritonitis. It indicates involuntary guarding, which occurs as a response to inflammation and irritation of the peritoneum. The rigidity reflects the body's protective mechanism against pain and is a significant assessment finding.
D. While abdominal cramping can occur in various gastrointestinal conditions, it is not a specific indicator of peritonitis. In cases of peritonitis, the pain is often more severe and localized rather than cramping. The patient may experience sharp, steady pain that worsens with movement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Ondansetron is not indicated for treating diarrhea. While nausea can accompany diarrhea, ondansetron specifically targets nausea and vomiting rather than the underlying causes of diarrhea.
B. Ondansetron is primarily used to prevent and treat nausea and vomiting, particularly those associated with chemotherapy, radiation therapy, and postoperative recovery. If a patient is experiencing nausea and vomiting, ondansetron would be the appropriate medication to administer.
C. Ondansetron is not indicated for managing pain. Incisional pain is typically treated with analgesics, not antiemetics. While postoperative patients may experience nausea, ondansetron would not be used solely for pain relief.
D. Paralytic ileus is a condition characterized by the lack of movement in the intestines, leading to a blockage. While nausea and vomiting can occur in this condition, ondansetron is not a treatment for the underlying issue of ileus. The focus would be on managing the ileus and any complications that arise.
Correct Answer is B
Explanation
A. Fluoroquinolones, such as ciprofloxacin and levofloxacin, do not have a known significant interaction with neuromuscular blockers. They can generally be used safely in patients receiving neuromuscular blockade.
B. Aminoglycosides (such as gentamicin, tobramycin, and amikacin) can potentiate the effects of neuromuscular blockers and may lead to increased neuromuscular blockade. This can result in respiratory depression or paralysis, making them contraindicated in patients receiving neuromuscular blockers.
C. Carbapenems (such as meropenem and imipenem) do not typically have a significant interaction with neuromuscular blockers. They can generally be used safely, although careful monitoring is always recommended in patients with neuromuscular blockade.
D. Macrolides (such as azithromycin and erythromycin) do not have a major contraindication with neuromuscular blockers. While they can affect certain neuromuscular transmission processes, they are not typically contraindicated in this context.
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