QLexNursing

Encourage sitting up and ambulation

✅ Early ambulation is crucial to prevent postoperative complications such as deep vein thrombosis (DVT) and pulmonary issues (e.g., atelectasis).

✅ It promotes gastrointestinal motility, which is often delayed after anesthesia and abdominal surgery.

✅ Sitting up improves diaphragmatic movement and lung expansion, aiding in ventilation.

✅ Mobility reduces the risk of constipation, which is particularly important given the client’s history of constipation.

✅ The nurse should assist the client gradually and monitor for orthostatic changes or fatigue.

Use incentive spirometer every 1 hour

✅ Incentive spirometry (IS) is a key tool in preventing atelectasis and postoperative pneumonia, especially after abdominal surgery.

✅ Frequent IS use (every hour while awake) helps the client maintain adequate lung expansion and improve oxygenation.

✅ The client had shallow breathing and tachypnea preoperatively, putting her at increased respiratory risk.

✅ Effective IS use also improves cough strength, helping clear secretions that could otherwise cause infection.

✅ Nurses should teach proper technique and document frequency and volume goals.

Promote adequate hydration

✅ Hydration is essential post-surgery to maintain circulatory volume, support healing, and enhance kidney perfusion.

✅ IV fluids such as Lactated Ringer’s were started preoperatively, and oral fluids should be encouraged as tolerated.

✅ Adequate hydration reduces the risk of hypotension, nausea, and urinary retention, all common post-op issues.

✅ It also supports bowel function recovery, which is critical in abdominal procedures.

✅ Monitoring intake and output ensures proper fluid balance and detects early signs of dehydration or fluid overload.

Assess for sedation after pain medications

✅ The client is receiving IV morphine, which can cause respiratory depression, sedation, and altered mental status.

✅ Assessing level of consciousness, respiratory rate, and sedation scale is necessary after each opioid dose.

✅ Early identification of sedation prevents complications such as hypoventilation and aspiration.

✅ Monitoring sedation ensures safe participation in activities like ambulation and incentive spirometry.

✅ It also informs decisions about medication titration or need for naloxone availability.

Administer pain medication after activity

✅ Delaying pain medication until after activity encourages the client to mobilize while pain is manageable but not overly sedated.

✅ This supports engagement in early ambulation, coughing, and IS use without the risk of drowsiness impairing effort.

✅ Post-activity dosing helps relieve soreness from exertion and promotes comfort during recovery.

✅ It also helps the nurse evaluate the true effectiveness of movement interventions before analgesia masks symptoms.

✅ Strategic timing of pain meds enhances both safety and comfort, optimizing postoperative outcomes.