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Zorluk: OrtaPhysiological Adaptation

An older adult client is recovering in the surgical unit 4 hours after an exploratory laparotomy. The practical nurse (PN) reviews the client's current clinical status. Which of the following findings indicate an expected post-operative progression? Select all that apply.

  1. Scant amount of serosanguineous drainage on the surgical dressingCevap
  2. B
    Urine output of 15 mL over the past hour
  3. Incisional pain reported as 4 on a 0 to 10 scaleCevap
  4. D
    New onset of mild confusion and restlessness
  5. Hypoactive bowel sounds in all four quadrantsCevap
  6. F
    Oxygen saturation reading of 88% on room air

Cevap

The expected post-operative findings are scant serosanguineous drainage, an incisional pain level of 4 out of 10, and hypoactive bowel sounds.
In the immediate post-operative period following an exploratory laparotomy, the body undergoes expected physiological adaptation. Normal findings include hypoactive bowel sounds (due to anesthesia and surgical manipulation), mild to moderate incisional pain, and scant serosanguineous (pink/red) drainage on the dressing. These parameters indicate a normal recovery trajectory.

Adım Adım Çözüm

1
Evaluate the surgical dressing drainage.
Scant serosanguineous drainage is identified as normal.
Light pinkish-red drainage is typical in the first 24 to 48 hours after an abdominal procedure.
2
Assess the gastrointestinal and pain status.
Pain is 4/10 and bowel sounds are hypoactive.
Anesthesia and bowel manipulation temporarily slow peristalsis, and moderate localized pain is a standard post-operative outcome.
3
Identify findings that require immediate escalation.
Oliguria (15 mL/hr), new confusion, and hypoxia (88% oxygen saturation) are flagged as abnormal.
These findings indicate potential shock, impaired perfusion, or airway compromise, meaning they are unexpected and require urgent intervention.

Anahtar Kavram

Recognizing expected post-operative physiological adaptation versus early signs of acute clinical deterioration.
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Konular

Physiological Adaptation

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