When caring for a child with probable appendicitis, the nurse would be alert to recognize which condition or symptom is a sign of perforation?
Decreased abdominal distention
Anorexia
Bradycardia
Sudden relief from pain
The Correct Answer is D
Choice A reason:
Decreased abdominal distention is not typically a sign of appendicitis perforation. In fact, perforation often leads to increased abdominal distention due to the release of intestinal contents into the abdominal cavity, causing inflammation and swelling. Therefore, this choice is incorrect.
Choice B reason:
Anorexia, or loss of appetite, is a common symptom of appendicitis but not specifically indicative of perforation2. While anorexia can be present in cases of perforation, it is not a definitive sign. The sudden relief of pain is a more critical indicator of perforation, as it suggests the appendix has ruptured, temporarily relieving pressure.
Choice C reason:
Bradycardia, or a slow heart rate, is not a typical sign of appendicitis perforation. In fact, appendicitis and its complications, such as perforation, are more likely to cause tachycardia (an increased heart rate) due to pain and infection. Therefore, this choice is incorrect.
Choice D reason:
Sudden relief from pain is a classic sign of appendicitis perforation. When the appendix ruptures, the pressure inside the appendix is relieved, leading to a temporary decrease in pain. However, this is followed by a rapid onset of severe pain as the contents of the appendix spread throughout the abdominal cavity, causing peritonitis. This sudden change in pain is a critical indicator that the appendix has perforated and requires immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is d) Recurrent kidney infections.
Choice A reason:
Infarction of the renal vessels is not a common consequence of vesicoureteral reflux (VUR). Infarction refers to tissue death due to a lack of blood supply, which is not typically associated with VUR1. VUR primarily affects the urinary tract, leading to the backward flow of urine from the bladder into the ureters and kidneys. This condition can cause other complications, but infarction of the renal vessels is not one of them.
Choice B reason:
Renal calculi, or kidney stones, are not directly caused by vesicoureteral reflux. While VUR can lead to urinary tract infections (UTIs), which may increase the risk of developing kidney stones, it is not the primary outcome. Kidney stones are typically formed due to an imbalance of minerals and salts in the urine, leading to crystallization. VUR itself does not directly cause the formation of renal calculi.
Choice C reason:
Urinary obstruction is not a typical result of vesicoureteral reflux. VUR involves the backward flow of urine, but it does not usually cause a physical blockage in the urinary tract. Urinary obstruction can occur due to other conditions, such as congenital abnormalities, tumors, or kidney stones, but it is not a direct consequence of VUR.
Choice D reason:
Recurrent kidney infections are a common complication of vesicoureteral reflux. The backward flow of urine can carry bacteria from the bladder into the kidneys, leading to repeated episodes of pyelonephritis (kidney infection). These recurrent infections can cause kidney damage over time if not properly managed. Therefore, it is crucial to monitor and treat VUR to prevent recurrent kidney infections and preserve kidney function.
Correct Answer is B
Explanation
Choice A reason:
Removing the harness several times a day is not recommended. The Pavlik harness should be worn continuously as prescribed by the doctor to ensure proper hip development. Removing it frequently can disrupt the treatment and may lead to complications.
Choice B Reason:
Placing a superabsorbent disposable diaper over the harness is important to keep the harness clean and dry. This helps prevent skin irritation and maintains hygiene. It is essential to ensure that the diaper is properly positioned to avoid any interference with the harness.
Choice C Reason:
Returning to the clinic every 12 weeks for adjustment of the harness is not accurate. Typically, follow-up visits are more frequent, especially in the initial stages of treatment. Regular adjustments are necessary to ensure the harness is fitting correctly and effectively promoting hip development.
Choice D Reason:
Applying lotion or powder to minimize skin irritation is not recommended. Lotions and powders can accumulate and cause further irritation or infection. Instead, keeping the skin clean and dry is the best way to prevent irritation while using the Pavlik harness.
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