The nurse is caring for a patient following abdominal surgery. The patient asks the nurse when he ...

The answer to question 1  D
Although the diet order originates with the physician, the nurse must ensure that bowel sounds are present and the patient is able to pass flatus before any type of diet can be given to the pa-tient. Most surgeons will write an order to advance the diet as tolerated once these findings oc-cur. Every patient responds differently based upon their body and the type of surgery, so stating that most patients eat regular foods within 2 to 3 days is inaccurate.

The answer to question 2  B
Abdominal pain with dry, hot skin, fruity breath, and deep respirations is characteristic of ketoa-cidosis. Manifestations of an insulin reaction, or hypoglycemia, include tremulousness, hunger, headache, pallor, sweating, palpitations, blurred vision, and weakness. Rebound hyperglycemia, or the Somogyi effect, follows a period of hypoglycemia, often during sleep. When hypoglyce-mia occurs, the body secretes glucagon, epinephrine, growth hormone, and cortisol to counteract the effects of low blood sugar. The patient may report nightmares and night sweats along with morning elevated serum glucose; if the patient increases the insulin dose, it worsens the problem.

The answer to question 3  D
The appearance of hives (urticaria) or swelling beneath the skin (angioedema) may signal the onset of an anaphylactic episode. Wheezing, shortness of breath, and difficulty swallowing are later signs of anaphylaxis.

The answer to question 4  B
A data entry specialist spends large amounts of time entering data in the computer. Ptosis, dys-phagia, and aphasia are all symptoms associated with myasthenia gravis, but diplopia, or double vision, will cause the patient the most difficulty with using a computer.

The answer to question 5  C
The external device for fracture reduction allows greater freedom of movement, decreasing the problems of immobility. Healing time and pain are the same as with any other fracture reduction method.

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