Postoperative 

Patient Profile

C.H. is a very active 64-year-old white woman. She volunteers several days a week at the local senior center. She has recently developed increasing abdominal pain, accompanied by a 25-pound weight loss. A magnetic resonance image (MRI) scan showed a large mass in the fundal area of the stomach. A subtotal gastrectomy was performed. She is now day 1 into her postoperative recovery.

Subjective Data

• States her abdominal pain is a level 8, on a 1 to 10 scale

Objective Data

Physical Examination

• Blood pressure 155/74, pulse 104, temperature 100° F, respirations 20
• Alert and oriented to person, place, and time
• Diminished breath sounds and crackles in bilateral lower lobes
• Oxygen saturation 93% on room air
• Skin is warm and dry
• Bowel sounds absent in all four quadrants
• Abdomen tender and slightly distended
• Nasogastric tube to low continuous wall suction draining brownish-green drainage
• Lactated Ringer’s solution infusing at 100 mL/hr
• Abdominal wound is clean and dry, dressing is intact

Diagnostic Studies

• Preoperative chest x-ray was clear, free of any infiltrates or fluid

Discussion Questions

1. What are some possible postoperative complications that C.H. could experience?

2. From the data given, which postoperative complication is C.H. likely experiencing?

3. What assessment data led the nurse to make this decision?

4. What are the priority nursing interventions that the nurse should implement to address this postoperative complication?

5. What diagnostic test might be indicated and why?

6. Identify three outcomes that would indicate that C.H.’s condition is improved as a result of the interventions.