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The nurse is caring for a client who had a bowel resection 2 hours ago for adenocarcinoma removal. It would be necessary for the nurse to immediately notify the surgeon if the client's assessment revealed:

A.

no bowel sounds noted during the assessment.

B.

an SPO2 which registers 90% while the client is asleep.

C.

increasing abdominal distention.

D.

a small amount of green-tinged fluid from the nasogastric tube.

Answer and Explanation

The Correct Answer is C

A. The absence of bowel sounds shortly after surgery is not uncommon, especially within the first few hours, and does not necessarily indicate a complication at this time.  

 

B. An SPO2 of 90% while the client is asleep may warrant attention, but it is not as critical as signs of a potential surgical complication. The nurse should assess the patient's respiratory status and consider interventions, but immediate notification to the surgeon is not required.

  

C. Increasing abdominal distention is a concerning sign that may indicate complications such as an anastomotic leak or bowel obstruction, which requires immediate evaluation and possible intervention by the surgeon.  

 

D. A small amount of green-tinged fluid from the nasogastric tube is generally expected postoperatively and does not necessarily indicate a problem, thus does not require immediate notification of the surgeon.


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Correct Answer is B

Explanation

A. While a diet of soft foods and liquid protein may be beneficial for a client undergoing chemotherapy, it is not the most critical intervention related to thrombocytopenia. Nutritional needs can be managed but do not address the immediate risk of bleeding or injury.

B. Teaching safety in the home to reduce injury and falls is the most important intervention. Clients with thrombocytopenia have a significantly increased risk of bleeding and bruising, making it essential to prevent falls and injuries that could lead to serious complications.

C. Spacing activities throughout the day can help manage fatigue, but it is not as urgent as ensuring the client is safe from injuries related to low platelet counts.

D. Frequent hand hygiene is important to prevent infections, especially in immunocompromised patients, but it does not directly address the primary concern of preventing injuries related to thrombocytopenia.

Correct Answer is A

Explanation

A. A profound feeling of tiredness is a common side effect of radiation therapy due to fatigue caused by the treatment itself and the body's response to cancer.

B. Renal impairment is not a typical direct side effect of radiation therapy for esophageal cancer; it is more commonly associated with treatments targeting the kidneys or systemic therapies.

C. Expectoration of frothy sputum may indicate pulmonary issues or fluid overload but is not a common side effect specifically related to radiation therapy for esophageal cancer.

D. Development of bone marrow suppression is possible but less common specifically with radiation therapy compared to chemotherapy, which is more directly associated with this side effect.

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