The nurse is reviewing the laboratory findings for a 34-year-old woman who is scheduled for a Schilling's test for B12 deficiency anemia. Which result should the nurse report immediately to the primary care provider?

Choice A Reason:
Abdominal distention is a common finding in large bowel obstruction due to the accumulation of intestinal contents, gas, and fluid proximal to the obstruction site. This can lead to a visibly swollen abdomen and is often accompanied by discomfort or pain.

Choice B Reason:
Hypoactive bowel sounds are expected in large bowel obstruction as the peristaltic activity decreases below the point of obstruction. Initially, bowel sounds may be high-pitched or tinkling due to the intestine's attempt to move contents past the obstruction, but as the condition progresses, the sounds become less frequent or even absent.

Choice C Reason:
Diarrhea is not typically associated with large bowel obstruction. In fact, constipation or cessation of stool is a more common symptom. If diarrhea occurs, it may be due to a partial obstruction or the presence of liquid stool that can pass around the blockage.

Choice D Reason:
Fever may indicate a complication of large bowel obstruction, such as ischemia or perforation, leading to infection and inflammation. However, fever is not a primary symptom of uncomplicated large bowel obstruction and should prompt immediate further investigation.

Choice A reason:
Allowing the client some time alone could be beneficial in certain situations where the client prefers solitude to process their emotions. However, in the context of intimate partner abuse, leaving the client alone when they are visibly distressed may not provide the immediate support and safety they need.

Choice B reason:
Remaining with the client is crucial in providing emotional support and ensuring their safety. Victims of intimate partner abuse often feel isolated and scared; having a compassionate presence can offer comfort and reassurance. The nurse's presence can also help in assessing the client's immediate needs and risks, and in facilitating access to further support and resources.

Choice C reason:
Making an audio recording without the client's consent could be a violation of privacy and trust. It is essential to respect the client's autonomy and confidentiality, especially in sensitive situations involving abuse. The priority should be to address the client's emotional state and safety, not to gather evidence.

Choice D reason:
Encouraging the client to write down their thoughts can be a therapeutic tool and may be suggested as part of ongoing therapy or coping strategies. However, it should not be the first action taken when the client is in acute distress. Immediate emotional support and safety planning are more pressing concerns.