A nurse is assessing a client who is postoperative following orthopedic surgery. Which of the following findings should the nurse identify as an indication of paralytic ileus?

Paralytic ileus is the cessation of bowel motility following surgery, particularly abdominal or orthopedic procedures, due to the effects of anesthesia, opioid analgesics, and surgical manipulation. The hallmark assessment findings of paralytic ileus include absent or hypoactive bowel sounds, nausea, vomiting, inability to pass flatus or stool, and abdominal distention caused by the accumulation of gas and fluid in the non-moving bowel. Abdominal distention is therefore the correct answer. Oliguria refers to decreased urine output and is associated with fluid imbalances, acute kidney injury, or shock — not paralytic ileus specifically. Watery stool would suggest an intact, hyperactive bowel or infectious diarrhea, which is the opposite of ileus. Dizziness is a non-specific finding associated with orthostatic hypotension, blood loss, or medication effects, but is not characteristic of paralytic ileus. Recognizing abdominal distention as a key sign of ileus is important because early identification allows for interventions such as keeping the client NPO, initiating nasogastric decompression if needed, encouraging ambulation, and managing contributing factors like opioid use, all of which promote return of bowel function.