Author Question: The nurse is conducting an assessment on a client who is 36 hours postoperative following an ... (Read 89 times)

plus1 · **on:** Jun 25, 2018

The nurse is conducting an assessment on a client who is 36 hours postoperative following an appendectomy. During the assessment, the nurse is unable to hear any bowel sounds. The client denies passing flatus. Which action is most appropriate by the nurse

A) Withholding food and fluid intake until intestinal motility has returned
B) Encouraging the client to increase fluid intake to promote peristalsis
C) Encouraging the client to increase solid food intake to promote peristalsis
D) Encouraging the client to decrease the amount of oral intake

Question 2

A nurse checking for tenderness at McBurney's point for a client with suspected appendicitis will palpate which area?

A) A
B) B
C) C
D) D

JYan · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Answer: A

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

Answer: C

McBurney's point, located midway between the umbilicus and the anterior iliac crest in the right lower quadrant, is the usual side for localized pain and rebound tenderness due to appendicitis.