It is possible that this patient is suffering from a Clostridium difficile infection caused by bacteria. The presence of an underlying condition, increasing age, and antibiotic use are all risk factors for contracting Clostridium difficile. A stool sample is commonly used to test for the bacteria. Until the results are available, Carrie should place the patient under proper C. difficile contact precautions.

Portal hypertension causes proteins to move from the bloodstream into the lymphatics which cannot handle the excess and they leak into to abdominal cavity. The proteins causes an osmotic pressure pulling fluid into the space leading to ascites. Hypoalbuminemia will lead to decreased colloid oncotic pressure as well, also contributing to ascites.  

Helicobacter pylori or H. pylori is the bacterial cause of peptic ulcers. Staphylococcus aureus is a bacteria that frequently causes skin infections along with other conditions such as toxic shock syndrome. Streptococcus faecalis is responsible for many urinary tract infections and contracting Viridans streptococci may result in endocarditis. Treponema pallidum bacteria cause syphilis.

Several foods can cause relaxation or irritation of the lower-esophageal sphincter. Alcohol, carbonated beverages, and chocolate are a few examples. Advise the patient to remain upright after meals, to utilize antacids when appropriate, and to practice a balanced diet.

Magnesium hydroxide is a strong base. It works by neutralizing the acid in the stomach, forming water and magnesium chloride. All other listed medications work to prevent the stomach from over-producing acid, rather than neutralizing the existing acid in the stomach.

Advanced age, female sex, obesity, alcohol use, frequent heavy lifting, pregnancy, gastrointestinal tumors, and smoking may increase an individual's risk for the development of a hiatal hernia. The correct scenario represents four risk factors.

Fowler’s position (head of bed (HOB) elevated 45 degrees) increases comfort, ventilation, circulation, and relieves pressure from the thorax. It would be best for this patient due to the pain experienced by the patient in the abdomen. Sims’ position (halfway between lateral and prone, upper arm flex, lower arm behind patient) is used when a patient is receiving an enema or an examination in the perineal area. Trendelenburg (HOB lowered, feet elevated) is used for patients with hypotension, as it promotes venous return. Reverse Trendelenburg (HOB elevated, feet lowered) is used to promote gastrointestinal problems by minimizing esophageal reflux. Side-lying (patient on side with top leg in front of bottom leg and hip/knee flexed) is used to relieve pressure from the sacrum and is often rotated with patients who are on bedrest.

To prevent pain during a bowel movement post operatively, pain medication is often indicated to help make it more tolerable. Pain medications will need to be given post op and may contribute to constipation, but oral stool softeners and and a high fiber diet can help to avoid the constipation. Rectal suppositories and daily enemas are not needed. Bowel movements should not be delayed nor avoided in the post operative period. 

This client is to be on contact precautions, the wearing of a mask is consistent with airborne precautions which is not necessary for C-diff. All other choices are appropriate for contact precautions. 

Acetaminophen causes more liver failure in the United States than viral hepatitis, making it one of the most common causes of liver-related emergency room visits. It causes approximately 78,000 emergency room visits and 150 deaths due to liver failure each year. None of the other medications listed are associated with liver failure.