Which of the following conditions is most likely to directly cause peritonitis?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Perforated ulcer. Peritonitis is the inflammation of the peritoneum, the lining of the abdominal cavity, usually caused by contamination from a perforated viscus. A perforated ulcer is a breach in the wall of the stomach or intestines, allowing gastric or intestinal contents to leak into the peritoneal cavity, leading to peritonitis. Option A) Cholelithiasis refers to the presence of gallstones in the gallbladder and does not directly cause peritonitis. Option B) Gastritis is inflammation of the stomach lining and does not involve perforation or leakage of contents. Option D) Incarcerated hernia involves a trapped segment of the intestine in the hernia sac but does not necessarily lead to perforation and peritonitis. Educationally, understanding the direct causes of peritonitis is crucial in medical-surgical nursing. Recognizing conditions like perforated ulcers that can lead to this serious complication is essential for prompt intervention and preventing further complications for the patient. Nurses need to be able to differentiate between various abdominal pathologies to provide appropriate care and ensure positive patient outcomes.

Correct Answer: D

Rationale: In a client with peritonitis, the correct laboratory result that would be expected is a white blood cell count above 15,000 (Option D). Peritonitis is an inflammatory process involving the peritoneum, often caused by infection. This leads to an increased white blood cell count as the body tries to fight off the infection. Option A, partial thromboplastin time above 100 seconds, is not typically associated with peritonitis. Peritonitis is more likely to affect the white blood cell count rather than clotting factors. Option B, hemoglobin level below 10 mg/dL, is not a direct result of peritonitis. Hemoglobin levels may be affected by bleeding or anemia but are not a specific marker for peritonitis. Option C, potassium level above 5.5 mEq/L, is not a common finding in peritonitis. Elevated potassium levels are more commonly seen in conditions like renal failure or severe tissue damage. Understanding the specific laboratory findings associated with peritonitis is crucial for nurses caring for patients with this condition. Recognizing these abnormalities can help in early identification and prompt treatment of peritonitis, which is essential in preventing complications and improving patient outcomes.

Correct Answer: D

Rationale: In the medical management of a client with peritonitis, the therapy that is not included is a regular diet (Option D). Peritonitis is a serious condition characterized by inflammation of the peritoneum, often caused by infection. In this context, providing a regular diet could exacerbate symptoms and lead to complications such as bowel obstruction or perforation. Broad-spectrum antibiotics (Option A) are essential in treating peritonitis as they target the infection causing the inflammation. Electrolyte replacement (Option B) is crucial because peritonitis can lead to fluid and electrolyte imbalances due to vomiting, diarrhea, and sequestration of fluids in the peritoneal cavity. Intravenous (IV) fluids (Option C) are necessary to maintain hydration, support organ function, and help manage the systemic effects of peritonitis. Educationally, understanding the rationale behind each option reinforces the importance of tailored interventions in managing peritonitis. By grasping the significance of specific therapies, nursing students can enhance their clinical decision-making skills and provide effective care for clients with peritonitis. It also underscores the critical role nurses play in the multidisciplinary approach to treating complex conditions like peritonitis.

Correct Answer: A

Rationale: In the context of a client with peritonitis, the priority focus of nursing management is maintaining fluid and electrolyte balance (Option A). Peritonitis is a serious condition characterized by inflammation of the peritoneum, which can lead to fluid shifts, dehydration, and electrolyte imbalances. Addressing fluid and electrolyte balance is crucial in stabilizing the client's condition and preventing complications such as hypovolemic shock. Gastric irrigation (Option B) is not a priority in the management of peritonitis as it may exacerbate the inflammatory process and lead to further complications. Pain management (Option C) is important in providing comfort to the client but is secondary to addressing the physiological imbalances caused by peritonitis. Psychosocial issues (Option D) should also be addressed but are not the immediate priority in the acute phase of peritonitis. In an educational context, understanding the prioritization of nursing interventions based on the client's condition is essential for providing safe and effective care. By focusing on the underlying pathophysiology and immediate needs of the client, nurses can optimize outcomes and promote recovery in clients with complex medical conditions like peritonitis.

Correct Answer: B

Rationale: In the case of irritable bowel syndrome (IBS), the correct meal plan for a client being discharged would be option B) High fiber, low-fat. This choice is based on the understanding of IBS management principles. High fiber helps regulate bowel movements and prevent constipation, a common issue in IBS patients. Additionally, a low-fat diet is recommended to reduce the risk of triggering IBS symptoms such as abdominal pain and diarrhea. Option A) Low fiber, low-fat would not be ideal as low fiber intake can exacerbate constipation, a common symptom in some IBS patients. Option C) Low fiber, high-fat is also not recommended as high-fat foods can worsen IBS symptoms like diarrhea and discomfort. Option D) High-fiber, high-fat is not suitable as high-fat intake can trigger symptoms, while high-fiber foods may be beneficial in moderation but not when combined with high-fat content. In an educational context, understanding the rationale behind dietary recommendations for specific conditions like IBS is crucial for nursing students. It helps in providing holistic care to patients and tailoring interventions based on individual needs. By grasping the impact of different dietary components on gastrointestinal health, nurses can effectively support patients in managing their conditions and promoting overall well-being.