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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 A

Explanation

A. Chewing food on the unaffected side helps to prevent triggering pain episodes in the affected side of the face, which is critical for managing trigeminal neuralgia effectively.

B. While maintaining oral hygiene is important, the timing of brushing teeth is less critical than managing pain during eating. Brushing teeth should be done gently to avoid pain but is not specifically prioritized over other interventions.

C. Avoiding an electric razor is not relevant to managing trigeminal neuralgia pain; it relates more to safety and comfort in shaving rather than pain management.

D. Food should not be served hot or cold as extreme temperatures can trigger pain in trigeminal neuralgia patients; it's better to serve food at a moderate temperature.

Correct Answer is C

Explanation

A. Large tumors with distant metastasis may not respond well to radiation therapy, as the effectiveness diminishes when cancer spreads beyond the primary site.

B. While radiation can be effective for superficial cancers, it is most impactful when the cancer is localized.

C. Radiation therapy is most effective for localized cancers, where the treatment can target the tumor directly without affecting surrounding healthy tissues extensively.

D. Cancer spread to multiple sites in one organ complicates treatment and may reduce the efficacy of radiation therapy, as multiple targets may require different approaches.

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