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Three days after a cholecystectomy for cholelithiasis, a female client reports having persistent upper abdominal pain that radiates to her back. Based on these findings, the nurse should observe the client for which pathophysiological condition?

A.

Acute pancreatitis.

B.

Biliary duct obstruction.

C.

Surgical site infection.

D.

Hepatorenal failure.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

Acute pancreatitis is a potential complication after cholecystectomy. The persistent upper abdominal pain radiating to the back is a classic symptom of acute pancreatitis. This condition can occur due to the migration of gallstones or other factors affecting the pancreas.

 

Choice B rationale

 

Biliary duct obstruction can cause upper abdominal pain, but it is less likely to present with pain radiating to the back. This condition typically presents with jaundice and other symptoms.

 

Choice C rationale

 

Surgical site infection can cause abdominal pain, but it is usually localized to the surgical site and does not typically radiate to the back. Other signs of infection, such as fever and redness, would also be present.

 

Choice D rationale

 

Hepatorenal failure is a severe condition that can occur in patients with liver disease, but it is not commonly associated with pain radiating to the back. It typically presents with symptoms of liver and kidney dysfunction.

 


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Correct Answer is C

Explanation

Choice A rationale

Anxiety and grieving are important issues but are not the priority when the client is at risk for aspiration.

Choice B rationale

Chronic pain is significant, but the immediate risk of aspiration due to dysphagia takes precedence.

Choice C rationale

Risk for aspiration related to difficulty swallowing is the priority nursing problem. Aspiration can lead to serious complications such as pneumonia.

Choice D rationale

Imbalanced nutrition is important but is secondary to the immediate risk of aspiration.

Correct Answer is A

Explanation

Choice A rationale

Respiratory acidosis is characterized by elevated levels of carbon dioxide (CO2) in the blood due to impaired ventilation. This accumulation of CO2 leads to a decrease in blood pH, making it more acidic.

Choice B rationale

Hyperventilation leads to a rapid elimination of CO2, which would result in respiratory alkalosis, not acidosis. Therefore, this choice does not support the pathophysiological process of respiratory acidosis.

Choice C rationale

Blood oxygen levels stimulating the respiratory rate is a compensatory mechanism for hypoxemia but does not directly cause respiratory acidosis. This process is more related to respiratory alkalosis.

Choice D rationale

The kidneys do play a role in acid-base balance, but they primarily eliminate acids other than CO2. They do not significantly convert CO2 for elimination, making this choice incorrect.

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