Mr. Moreno has had a surgical procedure that necessitated a thoracic incision. The nurse anticipates that he will have a higher risk for postoperative complications involving which body system?

Preoperative anxiety is common; patients need empathy and a safe space to express fears. The nurse’s best immediate response acknowledges the feeling and opens a conversation so underlying concerns (fear of death, anesthesia, pain, loss of control) can be explored, corrected, and managed. Therapeutic communication (open-ended invitation, active listening) improves trust.

Rationale for correct answer:

2. “Let’s talk about how you are feeling.” Invites the patient to express concerns, shows empathy, and lets the nurse assess the intensity and content of the fear.

Rationale for incorrect answers:

1. “You have a wonderful doctor.” Diverts attention from the patient’s feelings and gives a vague reassurance rather than exploring fear.

3. “Everyone wakes up from surgery!” False reassurance; minimizes the patient’s worry and may undermine trust.

4. “Don’t worry, you will be just fine.” Dismissive; it shuts down emotional expression instead of addressing it.

Take home points:

• Use open-ended, empathetic statements that invite expression rather than offering premature reassurance.
• Exploring fears lets you assess need for teaching, more explanation from anesthesia, or anxiolytic interventions-don’t dismiss or minimize.

Certain chronic conditions (diabetes, obesity, respiratory impairment) predispose clients to complications such as infection, poor healing, and respiratory compromise. Identifying these risks allows the nurse to implement preventive measures.

Rationale for correct answers:

1. Obesity increases surgical risk because excess adipose tissue reduces blood supply to tissues, impairs wound healing, and increases strain on the respiratory and cardiovascular systems. It also makes positioning and anesthesia management more difficult.

3. Delayed wound healing: Diabetes interferes with tissue perfusion and impairs immune response, increasing the risk of delayed wound healing and postoperative infections.

4. Ineffective vital capacity: Obesity can restrict chest expansion, reduce lung volume, and impair effective ventilation. This puts the client at higher risk for atelectasis and hypoxemia postoperatively.

Rationale for incorrect answers:

2. Prolonged bleeding time: There’s no evidence in the scenario that this client has a bleeding disorder. Prolonged bleeding time is a concern with anticoagulant therapy or platelet dysfunction, not specifically linked to this patient.

5. Immobility secondary to height: Height alone is not a risk factor for immobility or surgical complications. Immobility is more commonly associated with obesity, fractures, or neurologic impairment.

Take home points:

• Obesity and diabetes significantly increase surgical risks due to poor wound healing, infection risk, and respiratory limitations.
• Risk assessment guides pre- and post-op nursing care e.g., strict glucose control, pulmonary hygiene, infection prevention.