A client who had colon surgery 3 days ago is anxious and requesting assistance to reposition. While the nurse is turning the client, the wound dehisces and eviscerates. The nurse moistens an available sterile dressing and places it over the wound. Which intervention should the nurse implement next?
Obtain a sample of the drainage to send to the laboratory.
Auscultate the abdomen for bowel sound activity.
Prepare the client to return to the operating room.
Bring additional sterile dressing supplies to the room.
The Correct Answer is C
A. Obtaining a sample of the drainage is not an immediate priority after evisceration; the patient's safety and stabilization come first.
B. Auscultating the abdomen for bowel sounds is important but secondary to addressing the immediate crisis of evisceration.
C. Preparing the client to return to the operating room is the priority action because evisceration indicates a surgical emergency that requires prompt intervention to repair the abdominal wall and prevent complications.
D. While additional sterile dressing supplies may be needed, addressing the evisceration takes precedence to prevent further injury and manage the patient’s condition.
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Correct Answer is B
Explanation
A. Latent hepatitis C is not an absolute contraindication for peritoneal dialysis, and patients with this condition can often undergo dialysis with appropriate precautions.
B. Crohn's disease with a history of colectomy poses a risk for peritoneal dialysis due to potential intra-abdominal adhesions and infection, which can complicate the procedure and increase the risk of peritonitis.
C. A history of nephrotic syndrome does not contraindicate peritoneal dialysis; patients with nephrotic syndrome may still be candidates depending on their overall kidney function and health status.
D. Type 2 diabetes mellitus is a common condition among patients needing dialysis and does not preclude the use of peritoneal dialysis, as long as blood sugar levels are managed effectively.
Correct Answer is D
Explanation
A. While bowel sounds can indicate gastrointestinal activity, they do not directly correlate with pain management or the underlying cause of abdominal discomfort in chronic pancreatitis.
B. The level and amount of physical activity may impact overall well-being but are less directly related to the management of abdominal pain from pancreatitis.
C. The color and consistency of feces can provide some information regarding pancreatic function and fat absorption but is not the most immediate factor affecting pain management.
D. Understanding the client’s eating patterns, including food triggers and timing, is crucial because certain foods can exacerbate abdominal pain in chronic pancreatitis. Dietary adjustments can significantly help manage symptoms and improve quality of life.