A 70-year-old female has been admitted to the hospital. The client has had nausea and vomiting for the past three days. Upon admission the client is slightly confused and weak. Her vital signs are: 99 F (37.2 C), respirations 20 breaths/minute, pulse 102 beats/minute, BP 96/66 mm Hg, and her pain level is an "8"on a scale of 0-10. Breath sounds are clear bilaterally upon auscultation. Pulse oximetry is 95% on room air. Bowel sounds are absent in the right and left lower quadrants and in the left upper quadrant. Abdomen is hard and distended. When questioned as to her last bowel movement, the client responds, "I have not moved my bowels in over one week." Mucous membranes dry; skin turgor poor. 11. What would be a priority nursing diagnosis for this client? List one short-term goal. List three interventions for your priority nursing diagnosis.

Respuesta :

What is a protein that is waterproof?

Priority nursing diagnosis for this client is intestinal narrowing.

What can cause bowel narrowing?

Bowel obstruction can be caused by fibrous scarring bands of tissue inside your abdomen (adhesions) that form after

  • Surgery
  • Inflamed or infected "bags" in your intestines (diverticulitis)
  • Hernias
  • or Even tumors.

The interventions made could be

  1. Abdominal X-ray, which can find blockages in the small and large intestines
  2. CT scan of the abdomen, which helps identify whether the blockage is partial or complete, or if you have a tumor in your abdomen
  3. Bloodtests.

Whit this information, we can conclude that Priority nursing diagnosis for this client is intestinal narrowing.

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