A patient presents with acute onset severe abdominal pain, tachycardia, and hypotension. On examination, the abdomen is rigid and tympanic. A chest X-ray reveals free air under the diaphragm. Which intervention should the nurse prioritize to align most closely with the current standards of care for this patient?
Administer broad-spectrum antibiotics
Administer IV analgesics and antipyretics
Obtain an abdominal computed tomography (CT) scan
Prepare the patient for surgery and notify the surgical team immediately
The presence of free air under the diaphragm on a chest X-ray in a patient presenting with signs and symptoms of acute abdomen typically indicates a bowel perforation. This is a surgical emergency, and the most appropriate initial intervention is to prepare the patient for surgery while managing acute symptoms. While antibiotics and fluid resuscitation are important supportive measures, the primary action after stabilizing the patient is to expedite surgical consultation and preparation for the definitive treatment—surgery. Administering analgesics or antipyretics and obtaining a CT scan are less immediate priorities compared to the urgency of surgical intervention.
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Why is free air under the diaphragm on a chest X-ray significant?
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BCEN CEN
Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
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