While in the postanesthesia care unit, a patient recovering from spinal surgery tells the nurse that he cannot feel his right hand and that his right shoulder is painful. The nurse's initial concern is in regard to which complication?
1. Thromboembolism in the brachial artery
2. Residual effects of spinal anesthesia
3. Infiltrated intravenous access site
4. Brachial plexus nerve injury
4
Rationale 1: Thromboembolism may have occurred but is not as likely as another complication.
Rationale 2: The patient is complaining of pain in a specific area, so this complication is not the most likely.
Rationale 3: Infiltration of the IV site is generally manifested by pain at the site. It also does not manifest with paresthesia.
Rationale 4: One complication due to patient positioning during a surgical procedure is injury to nerves. The patient's complaint of reduced sensation of the right hand with right shoulder pain would indicate an injury to the brachial plexus nerve region.
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