Which statement accurately represents a recommended guideline when providing postoperative care for the following clients?
A) Force fluids for an adult client who has a urine output of less that 30 mL per hour.
B) If client is febrile within 12 hours of surgery, notify the physician immediately.
C) If the dressing was clean but now has a large amount of fresh blood, remove the dressing and reapply it.
D) If vital signs are progressively increasing or decreasing from baseline, notify the physician of possible internal bleeding.
Ans: D
A continued decrease in blood pressure or an increase in heart rate could indicate internal bleeding, and the physician should be notified. If an adult client has a urine output of less than 30 mL per hour, the physician should be notified, unless this is expected. If the client is febrile within 12 hours of surgery, the nurse should assist the client with coughing and deep-breathing exercises. When large amounts of fresh blood are present, the dressing should be reinforced with more bandages and the physician notified.
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