Author Question: During the postoperative assessment of a client who had an appendectomy 36 hours ago, the nurse is ... (Read 69 times)

HCHenry · **on:** Jul 22, 2018

During the postoperative assessment of a client who had an appendectomy 36 hours ago, the nurse is unable to hear any bowel sounds. The client denies passing flatus. What action by the nurse is indicated?

1. Encourage the client to increase fluid intake to promote peristalsis
2. Encourage the client to increase solid food intake to promote peristalsis
3. Withhold food and fluid intake until intestinal motility has returned
4. Encourage the client to slow the amount of oral intake

Question 2

A client is admitted to the hospital with sudden, severe abdominal pain. Which of the following values in the arterial blood gas would the nurse expect?

1. pH is 7.33
2. PaCO2 is 28
3. H2CO3- is 30
4. PaO2 is 88

kristenb95 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

3. Withhold food and fluid intake until intestinal motility has returned

Rationale:
After abdominal surgery, the risk of a paralytic ileus exists. An ileus results when the bowel is not experiencing peristalsis. Oral intake must be withheld during this time.

Answer to Question 2

2. PaCO2 is 28

Rationale:
Acute pain usually causes hyperventilation, which causes the CO2 to drop and the client to experience respiratory alkalosis. The pH would denote alkalosis and would be higher than 7.45. H2CO3- would trend downwards as the kidneys begin to compensate for the alkalosis by excreting H2CO3. The PaO2 is likely to be normal unless the client has been hyperventilating for a long time and is beginning to tire.