April West, a 44-year-old female client, arrived to the medical-surgical unit from the PACU after
a partial abdominal hysterectomy (ovaries and fallopian tubes remain). The client has an 18-
gauge IV site per right forearm (FA) with D5RL at 125 mL/hr infusing per IV infusion pump.
The lower horizontal abdominal dressing with ABD pad folded in half and covered with a
Tegaderm is dry and intact. The JP drain has 30 mL of sanguineous drainage present. Thigh-high
anti-embolism stockings are intact, and there are orders for pneumatic compression boots to be in place while in bed. A Foley catheter is draining clear amber urine without sediments, and there is
150 mL of urine in the collection bag. The LPN/LVN received a report from the PACU nurse before the client arrived and now needs to perform assessments to prevent postoperative complications.
(Learning Objective 11)
a. What initial assessment should the LPN/LVN perform when the client arrives from
PACU?
b. What additional assessments need to be made in order to prevent postoperative
complications?
Sample Solution
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