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:
no bowel sounds noted during the assessment.
an SPO2 which registers 90% while the client is asleep.
increasing abdominal distention.
a small amount of green-tinged fluid from the nasogastric tube.
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. Switching from regular to decaffeinated coffee does not significantly impact gastric cancer risk. The main dietary risk factors include high intake of salted, smoked, and processed foods, not caffeine consumption.
B. Consuming large amounts of salted, smoked, and processed foods has been shown to increase the risk of gastric cancer. These foods contain nitrates and nitrites, which can be converted into cancer-causing compounds in the stomach.
C. High-fiber diets are generally protective against gastrointestinal cancers, including gastric cancer, rather than increasing the risk. A reduction in fiber intake could contribute to other gastrointestinal problems.
D. Lactose intolerance is not a known risk factor for gastric cancer. Regular testing for gastric cancer is not necessary for people who are lactose-intolerant unless they have additional risk factors, such as a family history of gastric cancer.
Correct Answer is C
Explanation
A. Applying pressure to injection sites helps reduce bleeding but does not directly prevent tumor lysis syndrome.
B. Monitoring telemetry is important for patients with potential cardiac issues but is not specifically related to preventing complications from tumor lysis syndrome.
C. Ensuring a high fluid intake of 3000 to 5000 mL/day helps dilute electrolytes and reduce the risk of acute kidney injury and other complications associated with tumor lysis syndrome, making this the most crucial intervention.
D. Assisting the client in ambulatory activities may support their overall well-being but does not address the prevention of tumor lysis syndrome.