A 57-year-old client was admitted to the emergency room with severe abdominal pain, anorexia, chills, skin pallor, a weak and thready pulse of 118, a blood pressure of 70/40, rebound tenderness, and rigidity of the abdomen
The nurse's initial action is focused on: A)
treatment for shock.
B)
diagnostic testing with barium studies and endoscopy.
C)
administration of antibiotic.
D)
preparation for an exploratory laparoscopy.
A
Explanation:
A)
The assessment findings suggest a perforated appendix with peritonitis. Stabilization of the shock will be necessary before surgery is performed. Barium studies would be contraindicated. Antibiotics would be administered after shock is treated.
Application
Implementation
Physiological Integrity: Reduction of Risk Potential
B)
The assessment findings suggest a perforated appendix with peritonitis. Stabilization of the shock will be necessary before surgery is performed. Barium studies would be contraindicated. Antibiotics would be administered after shock is treated.
Application
Implementation
Physiological Integrity: Reduction of Risk Potential
C)
The assessment findings suggest a perforated appendix with peritonitis. Stabilization of the shock will be necessary before surgery is performed. Barium studies would be contraindicated. Antibiotics would be administered after shock is treated.
Application
Implementation
Physiological Integrity: Reduction of Risk Potential
D)
The assessment findings suggest a perforated appendix with peritonitis. Stabilization of the shock will be necessary before surgery is performed. Barium studies would be contraindicated. Antibiotics would be administered after shock is treated.
Application
Implementation
Physiological Integrity: Reduction of Risk Potential
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