Postoperative and Emergency Care Flashcards

Which of the following interventions is the primary treatment for postoperative urinary retention (POUR) after spinal anesthesia?

Answer: Urinary catheterization

Urinary catheterization is the primary treatment for POUR when the bladder is significantly distended and the patient cannot void spontaneously.

A surgical patient returning from the OR has a temperature of 38.9°C on day 2 postoperatively. What is the most common cause of fever at this time point?

Answer: Pulmonary atelectasis

Fever within the first 48 hours postoperatively is most commonly caused by atelectasis due to shallow breathing and mucus plugging.

During a postoperative assessment, the surgical first assistant notes that a patient's wound has separated with visible bowel loops protruding through the incision. This complication is called:

Answer: Evisceration

Evisceration is the protrusion of abdominal viscera through an open wound, which is a surgical emergency requiring immediate sterile saline-moistened dressing and urgent return to the OR.

What is the correct initial management of evisceration discovered postoperatively at the bedside?

Answer: Cover the exposed viscera with a sterile saline-moistened dressing and call the surgeon immediately

Covering the bowel with moist sterile dressings prevents desiccation and further contamination while the surgeon is urgently notified for operative repair.

A patient on the surgical floor three days postoperatively develops a fever of 39.2°C, dysuria, and a urinalysis positive for nitrites and leukocyte esterase. What is the most likely source of infection?

Answer: Catheter-associated urinary tract infection (CAUTI)

Fever with urinary symptoms and a positive UA on postoperative day 3 in a patient who likely had an indwelling catheter is consistent with CAUTI.

A patient recovering from a hip arthroplasty suddenly develops pleuritic chest pain, dyspnea, and tachycardia on postoperative day 3. The most likely diagnosis is:

Answer: Pulmonary embolism

Pulmonary embolism classically presents with sudden pleuritic chest pain, dyspnea, and tachycardia following major orthopedic surgery, a high-risk period for DVT.

Which parameter is monitored using a pulse oximeter?

Answer: Peripheral arterial oxygen saturation (SpO2)

Pulse oximetry measures peripheral arterial oxygen saturation (SpO2) using photoplethysmography based on light absorption differences between oxyhemoglobin and deoxyhemoglobin.