The nurse is rounding on a client who is 12 hours postoperative. Upon assessment, the client becomes tachycardic, hypotensive, and restless and complains of sudden chest pain. Which postoperative complication should the nurse conclude that the client most likely experienced?

Pulmonary embolism

Pneumonia

Hemorrhage

Myocardial infarction

Answer and Explanation

The Correct Answer is A

A. Pulmonary embolism: Pulmonary embolism presents with sudden onset of chest pain, tachycardia, hypotension, and restlessness, which aligns with the client's symptoms. It is a common postoperative complication due to immobility and potential hypercoagulability.
B. Pneumonia: Pneumonia typically develops more gradually and presents with fever, productive cough, and respiratory distress rather than sudden chest pain and hemodynamic instability. It is less likely in the immediate postoperative period.
C. Hemorrhage: Hemorrhage would also cause tachycardia and hypotension, but it would typically present with symptoms such as excessive bleeding, swelling at the surgical site, and pallor rather than chest pain.
D. Myocardial infarction: While myocardial infarction can cause chest pain, tachycardia, and hypotension, it is less likely in this scenario compared to a pulmonary embolism, given the timing and nature of the symptoms in the immediate postoperative period.

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Correct Answer is C

Explanation

A. Abdomen soft, surgical dressing has scant amount of old drainage: A soft abdomen and minimal old drainage from the surgical dressing are expected findings postoperatively. They do not indicate an immediate concern that requires prompt action.
B. Client ambulating with minimal assistance, complaints of occasional nausea: Ambulation and occasional nausea are common and generally expected postoperatively. These findings do not require urgent collaboration with the healthcare provider.
C. Crackles bilaterally in bases of lungs, has incisional pain: Crackles in the lungs can indicate fluid accumulation or atelectasis, which may lead to pneumonia or other respiratory complications. This finding, especially combined with recent surgery, requires prompt evaluation and intervention.
D. Temperature 99.4°F (37.4°C), pulse 100 bpm, bowel sounds present: A slightly elevated temperature and increased pulse are common after surgery. The presence of bowel sounds is a positive sign indicating the return of gastrointestinal function. These findings are not immediately concerning.

A. Intraosseous line B. Intrathecal catheter C. Peripheral intravenous line D. Subcutaneous implantable port E. Subcutaneous implantable port

Correct Answer is D

Explanation

A. Intraosseous line: Intraosseous lines are used for emergency situations when peripheral access is not available, and are not suitable for long-term chemotherapy administration due to the risk of complications and discomfort.
B. Intrathecal catheter: Intrathecal catheters are used for delivering medication directly into the spinal canal. They are not suitable for systemic chemotherapy administration, which requires vascular access.
C. Peripheral intravenous line: Peripheral intravenous lines are typically used for short-term treatments. They are not ideal for long-term chemotherapy because they need frequent replacement, and the veins can become damaged from prolonged use of chemotherapeutic agents.
D. Subcutaneous implantable port: A subcutaneous implantable port is the best option for long-term chemotherapy. It is implanted under the skin, reducing the risk of infection, and provides a stable and reliable access point for repeated treatments over several months.

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The nurse is rounding on a client who is 12 hours postoperative. Upon assessment, the client becomes tachycardic, hypotensive, and restless and complains of sudden chest pain. Which postoperative complication should the nurse conclude that the client most likely experienced?

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