NCLEX-PN® ExaminationReduction of Risk PotentialMedium
An LPN is assisting with the care of a client who underwent abdominal surgery 2 days ago. The client reports severe pain (8/10), is restless, and has a respiratory rate of 24 breaths/min and shallow breathing. The client's abdomen is distended and firm to palpation, and no bowel sounds are audible. Which complication should the LPN suspect?
- APneumonia
- BDeep vein thrombosis (DVT)
- CParalytic ileus
- DWound dehiscence
Show answer & explanationAnswer & explanation
Correct answer: C. Paralytic ileus
Severe abdominal pain, distention, firmness, absent bowel sounds, and shallow breathing (due to pain and distention) after abdominal surgery are classic signs of a paralytic ileus, a common postoperative complication where peristalsis temporarily ceases.
Why the other options are wrong
- A. Pneumonia would present with fever, productive cough, and abnormal lung sounds, not primarily abdominal symptoms.
- B. DVT presents with leg pain, swelling, redness, and warmth, unrelated to abdominal symptoms.
- D. Wound dehiscence involves separation of wound edges, often with serosanguinous drainage, not typically severe abdominal distention and absent bowel sounds.
Paralytic Ileus
A temporary cessation of intestinal peristalsis, often occurring after abdominal surgery, leading to bowel obstruction symptoms without a physical blockage.
- Causes: abdominal surgery, opioids, electrolyte imbalances, inflammation
- Symptoms: abdominal distention, nausea, vomiting, absent bowel sounds, pain
- Management: NPO, NGT decompression, IV fluids, ambulation, avoiding opioids if possible
Memory trick: Post-Op Problems: Don't Get Paralyzed by Pain!