Which signs and symptoms would the nurse expect to find in the history of a patient that is going for a Nissen Fundoplication surgery?

A. Sudden and severe abdominal pain is a classic sign of gastrointestinal perforation. When an ulcer perforates, it allows gastric contents to spill into the abdominal cavity, leading to irritation and inflammation of the peritoneum (peritonitis). This can cause acute, intense pain that often starts suddenly and is typically localized to the area of the perforation.
B. Hyperactive bowel sounds may occur due to irritation or inflammation in the gastrointestinal tract but are not a definitive indicator of perforation. In fact, with perforation, bowel sounds may be diminished or absent due to the associated peritonitis and ileus that can occur after a perforation.
C. Bradycardia (a slow heart rate) is not a typical finding associated with gastrointestinal perforation. In fact, perforation often leads to tachycardia (increased heart rate) as a compensatory response to pain, shock, or blood loss. Bradycardia may indicate other issues but is not directly linked to perforation.
D. Increased blood pressure is also not typically associated with gastrointestinal perforation. Patients may experience hypotension due to shock from blood loss and infection resulting from perforation.

A. Distended neck veins are typically associated with conditions that lead to increased central venous pressure, such as heart failure or fluid overload, not pyloric stenosis. Therefore, this option is not relevant to pyloric stenosis.
B. Projectile vomiting is a classic symptom of pyloric stenosis. This occurs due to the obstruction caused by the thickened pylorus, which prevents food from passing into the duodenum. The vomiting is forceful and occurs shortly after feeding, making this option a hallmark of the condition.
C. A ridged (or rigid) abdomen can indicate underlying issues, such as peritonitis or other abdominal emergencies, but it is not a typical finding associated specifically with pyloric stenosis. Pyloric stenosis may lead to some degree of abdominal distension, but not necessarily to a ridged abdomen.

D. Red currant jelly stools are associated with intussusception, not pyloric stenosis. This type of stool appears when there is a mix of blood and mucus due to bowel obstruction or ischemia, but it is not a symptom of pyloric stenosis.