Question

a nurse is checking a client who was admitted with a bowel obstruction. the client reports severe abdominal pain. which of the following findings should indicate to the nurse that a possible bowel perforation has occurred?

• elevated blood pressure

• bowel sounds increased in frequency and pitch

• rigid abdomen

• emesis of undigested food

Explanation:

To determine the sign of bowel perforation:

• Elevated blood pressure is not typical for perforation (shock from perforation may cause hypotension).
• Increased bowel sounds (like in obstruction) are not a sign of perforation; perforation often leads to decreased or absent bowel sounds.
• A rigid abdomen occurs due to peritonitis from leaked intestinal contents (a key sign of bowel perforation).
• Emesis of undigested food is more related to obstruction, not perforation.

Answer:

C. Rigid abdomen