Surgical Procedures & Postoperative Care Flashcards

When assessing a postoperative patient's surgical wound on day 2, the nurse observes wound edges that are approximated with mild serous drainage. This finding is:

Answer: A normal finding for primary intention healing

Approximated wound edges with mild serous drainage on postoperative day 2 are expected findings for primary intention healing.

A patient receiving epidural analgesia postoperatively develops a blood pressure of 85/50 mmHg and heart rate of 55 bpm. The nurse's priority action is to:

Answer: Discontinue the epidural and notify the anesthesiologist

Hypotension and bradycardia with epidural analgesia suggest sympathetic blockade; the epidural must be stopped and the anesthesiologist notified immediately.

Following a colostomy, a patient's stoma appears pale and dusky 12 hours postoperatively. The nurse should:

Answer: Notify the surgeon immediately as this indicates ischemia

A pale or dusky stoma indicates compromised vascular supply (ischemia), which requires immediate surgical notification.

A postoperative patient uses a PCA pump and reports uncontrolled pain at level 8/10. The nurse assesses that the patient is not pressing the button correctly. The appropriate intervention is:

Answer: Educate the patient on proper PCA use and assess for barriers

Patient education on correct PCA use addresses the root cause of underutilization before escalating to other analgesic routes.

Which laboratory finding is most concerning in a patient 24 hours post-bowel resection?

Answer: Serum lactate 6 mmol/L

An elevated serum lactate of 6 mmol/L signals anaerobic metabolism, suggesting tissue hypoperfusion or septic shock requiring urgent intervention.

A patient who underwent repair of a perforated duodenal ulcer develops fever, board-like abdomen rigidity, and rebound tenderness on postoperative day 3. The nurse suspects:

Answer: Peritonitis from anastomotic leak

Board-like rigidity and rebound tenderness with fever post-bowel surgery strongly suggest peritonitis, often from an anastomotic leak.

To prevent aspiration pneumonia in a postoperative patient who is semiconscious, the nurse should:

Answer: Position in lateral recovery position until fully alert

The lateral (recovery) position allows secretions to drain and prevents aspiration in a semiconscious patient.