Nokea
Mr. Novello is an 81-year old male patient who presents with crampy abdominal pain in the hypogastrum and a vague history as to his last normal bowel movement. Physical examination reveals distention and high-pitched bowel sounds. The patient says he has never has this kind of problem before and denies any history of abdominal surgery. Abdominal radiographs reveal a frame pattern of colonic distention. The AGACNP considers
Correct Answer: B
Rationale: The most appropriate step for the AGACNP to take in this scenario is to decompress the colon with a rectal tube. The patient's presentation, including crampy abdominal pain, distention, lack of bowel movements, and a frame pattern of colonic distention on radiographs, are suggestive of acute colonic pseudo-obstruction, also known as Ogilvie's syndrome. This condition is characterized by colonic distention without a mechanical obstruction, which can lead to significant complications such as perforation.