A nurse on the oncology unit is evaluating a client's response after receiving a dose of aprepitant. Which of the following therapeutic effects should the nurse expect?

Choice A reason: This finding does not need to be reported because it is within the normal range of temperature for adults (36.5° C to 37.5° C or 97.7° F to 99.5° F). A mild elevation in temperature may occur after surgery due to inflammation or dehydration and does not indicate infection unless it exceeds 38° C (100.4° F).

Choice B reason: This finding does not need to be reported because it is expected after abdominal surgery due to anesthesia, pain medication, or decreased mobility that can slow down bowel motility. Hypoactive bowel sounds are defined as less than five sounds per minute. The nurse should encourage the client to ambulate, drink fluids, and eat high-fiber foods to stimulate bowel function.

Choice C reason: This finding needs to be reported because it indicates a possible infection at the surgical site. Red streaks along the incision are a sign of cellulitis, which is a bacterial infection of the skin and underlying tissue that can spread rapidly and cause serious complications. The nurse should also check for other signs of infection such as warmth, swelling, pain, pus, or foul odor at the incision site.

Choice D reason: This finding does not need to be reported because it is normal during the first few days after surgery. Serosanguineous drainage is a mixture of blood and clear fluid that leaks from the wound as part of the healing process. The nurse should monitor the amount, color, and consistency of the drainage and change the dressing as needed.

Choice A reason: This is not an appropriate intervention for this client because offering oral fluids every 4 hours can interfere with the IV fluid replacement and cause fluid overload or electrolyte imbalance. The nurse should follow the provider's orders regarding oral fluid intake and monitor the client's fluid balance status.

Choice B reason: This is an appropriate intervention for this client because monitoring pulse pressure every 6 hours can assess the effectiveness of IV fluid replacement and detect signs of hypovolemia or hypervolemia. Pulse pressure is the difference between systolic and diastolic blood pressure and reflects stroke volume and arterial compliance. The normal range of pulse pressure is 30 to 50 mm Hg.

Choice C reason: This is not an appropriate intervention for this client because checking for neck vein distention can indicate fluid overload or right-sided heart failure, but not dehydration. The nurse should check for other signs of dehydration, such as dry mucous membranes, poor skin turgor, decreased urine output, or increased hematocrit.

Choice D reason: This is not an appropriate intervention for this client because limiting oral fluids prior to bedtime can worsen dehydration and cause nocturia or thirst. The nurse should follow the provider's orders regarding oral fluid intake and monitor the client's fluid balance status.