sandra
Forum Guru
Topics: 199
Posts: 455
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A 37-year-old woman comes to the emergency
department because of
a 3-day history of increasingly severe abdominal pain,
nausea, and
vomiting. Twelve years ago, she had a hysterectomy
because of severe
dysfunctional uterine bleeding. Her temperature is 37
C (98.6 F), blood
pressure is 106/70 mm Hg, pulse is 110/min, and
respirations are 12/min.
Examination shows a distended, tympanic abdomen with
diffuse tenderness
but no guarding; bowel sounds are hypoactive. Her
leukocyte count is
10,000/mm3, and hematocrit is 44%. An x-ray film of
the abdomen is
shown. Which of the following is the most appropriate
initial step in
management?
A
) CT scan of the abdomen
B
) Intravenous neostigmine therapy
C
) Esophagogastroduodenoscopy
D
) Nasogastric intubation
E
) Laparotomy
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| nyimalay
Forum Elite
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D
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| guangyu
Forum Elite
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B
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| farnsworth
Forum Newbie
Topics: 0
Posts: 165
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D
if the pt is nauseous and vomits incessantly, inserting a NG tube provides immediate relief (and keeps your office clean). Then it is advisable to treat the post-operative bowel atony (neostigmine/prostigmine, in combination w/ metoclopramide)
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| shahnaz.r
Forum Junior
Topics: 7
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D
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| dr ruman
Forum Elite
Topics: 29
Posts: 412
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yup D as conservative management for intestinal obstruction with nasogastric decompression
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