The nurse suspects that a patient with 40% total body surface area burned is developing gastrointestinal problems. What did the nurse assess to make this clinical determination? Select all that apply.

Question

Quizplus · Accepted Answer

1. The systemic vasoconstriction caused by burn shock often results in the development of paralytic ileus and mucosal edema. The patient with paralytic ileus is at risk for hematemesis.
2. Abdominal pain is not a usual gastrointestinal symptom associated with a burn injury.
3. A board-like abdomen is not a usual gastrointestinal disorder associated with a burn injury.
4. Absent bowel sounds indicates a paralytic ileus.
5. The systemic vasoconstriction caused by burn shock often results in the development of paralytic ileus and mucosal edema. The patient with paralytic ileus is at risk for abdominal distention.

The Nurse Suspects That a Patient with 40% Total Body