Which of the following laboratory results would be expected in a client with peritonitis?

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: 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.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Metabolic alkalosis with hypokalemia. When a client vomits frequently, they lose hydrochloric acid from the stomach, leading to metabolic alkalosis. The loss of gastric contents also results in the loss of potassium, causing hypokalemia. Option A) Metabolic acidosis with hyperkalemia is incorrect because vomiting leads to the loss of acid, not an excess, and potassium is lost, not retained. Option B) Metabolic acidosis with hypokalemia is incorrect because vomiting causes metabolic alkalosis due to acid loss, not acidosis. Option C) Metabolic alkalosis with hyperkalemia is incorrect because vomiting results in hypokalemia due to potassium loss, not hyperkalemia. Educationally, understanding the electrolyte imbalances and acid-base disturbances that can result from vomiting is crucial in the care of patients with gastrointestinal issues. Recognizing these imbalances helps nurses provide appropriate interventions and prevent further complications. It also highlights the importance of monitoring electrolyte levels in patients with vomiting to prevent adverse outcomes.

Correct Answer: C

Rationale: The priority nursing diagnosis in this scenario is "Deficient fluid volume" (Option C). This is because a small-bowel obstruction can lead to significant fluid loss and dehydration due to the inability of fluid and contents to pass through the intestines. The insertion of a Miller-Abbott tube is aimed at decompressing the bowel and relieving the obstruction, which can result in further fluid loss. Therefore, addressing the deficient fluid volume is crucial to prevent complications such as hypovolemic shock and electrolyte imbalances. Option A, "Imbalanced nutrition: Less than body requirements," is not the priority in this situation as fluid volume deficit poses a more immediate threat to the client's physiological stability. While nutrition is important for recovery, addressing fluid volume deficit takes precedence. Option B, "Acute pain," is also important to address, but in the context of a small-bowel obstruction and the need for bowel decompression, fluid volume deficit poses a greater risk to the client's immediate well-being. Option D, "Excess fluid volume," is incorrect as there is no indication of fluid overload in this scenario. In fact, the client is more likely experiencing fluid volume deficit due to the obstruction. Educationally, understanding the priority nursing diagnosis in a specific clinical situation is crucial for providing safe and effective care to patients. This rationale highlights the importance of prioritizing interventions based on the client's immediate needs and the potential risks associated with the condition.