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. The nurse is caring for a client in the immediate postoperative period following a pancreatoduodenectomy (Whipple) procedure. The nurse is assessing for decreased fluid volume in the client. What would the nurse assess first?

A.

Bowel sounds, abdominal girth, and NG tube output

B.

Vital signs, cardiac rhythm, and peripheral pulses

C.

Blood Urea Nitrogen, Creatinine, and daily weight

D.

Respiratory rate, respiratory depth, and pulse oximetry

Answer and Explanation

The Correct Answer is B

A. Bowel sounds, abdominal girth, and NG tube output provide important information about gastrointestinal function and the potential for complications like ileus or obstruction. However, they do not provide direct information regarding fluid volume status.  

 

B. Vital signs (including blood pressure and heart rate), cardiac rhythm, and peripheral pulses are the first indicators to assess for decreased fluid volume. Hypovolemia often manifests as tachycardia, hypotension, and weak peripheral pulses, which are critical early signs of fluid depletion.  

 

C. Blood Urea Nitrogen (BUN), creatinine, and daily weight are useful in assessing kidney function and long-term fluid status, but they may not be as immediate indicators of acute fluid volume changes in the immediate postoperative period.  

 

D. Respiratory rate, depth, and pulse oximetry are important for assessing respiratory function and oxygenation. While fluid volume imbalances can impact respiratory function, these parameters are not the most direct indicators of fluid volume status.


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Correct Answer is C

Explanation

A. Limiting visits by family members and friends is not necessary for managing ascites and could hinder the client's emotional support.

B. While amylase and lipase are important in assessing pancreatic function, they are not directly relevant to ascites management or liver cancer.

C. An abdominal assessment including abdominal girth is crucial for monitoring ascites, as changes in girth can indicate fluid accumulation or changes in the client's condition.

D. Continuous cardiac monitoring is not typically indicated for clients with liver cancer experiencing ascites unless there are specific cardiac concerns.

Correct Answer is B

Explanation

A. Bowel sounds, abdominal girth, and NG tube output provide important information about gastrointestinal function and the potential for complications like ileus or obstruction. However, they do not provide direct information regarding fluid volume status.

B. Vital signs (including blood pressure and heart rate), cardiac rhythm, and peripheral pulses are the first indicators to assess for decreased fluid volume. Hypovolemia often manifests as tachycardia, hypotension, and weak peripheral pulses, which are critical early signs of fluid depletion.

C. Blood Urea Nitrogen (BUN), creatinine, and daily weight are useful in assessing kidney function and long-term fluid status, but they may not be as immediate indicators of acute fluid volume changes in the immediate postoperative period.

D. Respiratory rate, depth, and pulse oximetry are important for assessing respiratory function and oxygenation. While fluid volume imbalances can impact respiratory function, these parameters are not the most direct indicators of fluid volume status.

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