A nurse is caring for a client on the medical-surgical unit. Exhibits Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Rationale for Correct Answers: Paralytic Ileus: The patient's symptoms, such as abdominal pain, nausea, vomiting, hypoactive bowel sounds, absence of gas in the colon, and the CT scan results (fluid and gas in the small intestine), are consistent with paralytic ileus. This condition is often caused by a lack of peristalsis after abdominal surgery, resulting in a functional obstruction. Prepare to insert a nasogastric tube: A nasogastric tube can help decompress the stomach, remove excess fluids and gases, and prevent further vomiting and distention, which are common in paralytic ileus. Make the client NPO: Keeping the patient NPO (nothing by mouth) prevents the gastrointestinal system from being further stressed and allows it to rest, reducing the risk of worsening the ileus or causing aspiration. Serum sodium and potassium: Monitoring electrolytes is essential in paralytic ileus due to the potential for dehydration and electrolyte imbalances from vomiting and the inability to properly absorb fluids and nutrients. Pain: Abdominal pain is a key symptom of paralytic ileus, and monitoring pain levels helps assess the severity and effectiveness of the management plan. Rationale for Incorrect Choices: Peptic Ulcer Disease: Peptic ulcers cause upper abdominal pain and may lead to complications like bleeding or perforation. However, the symptoms, combined with CT scan results showing small intestine issues, are more consistent with paralytic ileus than with peptic ulcer disease. Cholecystitis: Cholecystitis is characterized by right upper quadrant pain, often related to gallstones, and is usually associated with a positive Murphy's sign. The CT scan did not show gallbladder inflammation, making this diagnosis unlikely. Gastroenteritis: Gastroenteritis typically involves symptoms like vomiting and diarrhea, but the lack of bowel movements and the absence of gas in the colon point toward a paralytic ileus rather than an infection like gastroenteritis. Administer a proton pump inhibitor: A proton pump inhibitor is used for conditions such as GERD or peptic ulcers, not for paralytic ileus. It doesn't address the underlying issue of bowel motility in this case. Administer an NSAID: NSAIDs can worsen gastrointestinal issues by increasing the risk of bleeding, especially after abdominal surgery. They should not be used in paralytic ileus as they may exacerbate the condition. Offer the client fluid oral rehydration therapy: Oral rehydration is not appropriate in paralytic ileus, as the digestive system is not functioning properly. Intravenous fluids are more appropriate to prevent dehydration in this condition. Yellow skin and mucous membranes: This indicates jaundice, typically associated with liver dysfunction or biliary obstruction. There are no signs in the client's notes or labs to suggest this. Hemoglobin and hematocrit: Although important for monitoring bleeding or dehydration, these values are less specific for paralytic ileus and do not directly assess the effectiveness of treatment for this condition. Skin: Monitoring the skin for signs of pressure ulcers or other conditions may be important in hospitalized patients, but it is not directly related to managing paralytic ileus, where the priority is gastrointestinal and pain management.