When a patient with splenomegaly is scheduled for splenectomy, which action will the nurse include in the preoperative plan of care?
a. Discourage deep breathing to reduce risk for splenic rupture.
b. Teach the patient to use ibuprofen (Advil) for left upper quadrant pain.
c. Schedule immunization with the pneumococcal vaccine (Pneumovax).
d. Avoid the use of acetaminophen (Tylenol) for 2 weeks prior to surgery.
ANS: C
Asplenic patients are at high risk for infection with Pneumococcus and immunization reduces this risk. There is no need to avoid acetaminophen use before surgery, but nonsteroidal antiinflammatory drugs (NSAIDs) may increase bleeding risk and should be avoided. The enlarged spleen may decrease respiratory depth and the patient should be encouraged to take deep breaths.
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