A male client who had abdominal surgery 5 days ago, and hospitalized because of a surgical wound infection, tells the nurse that he feels like his insides just spilled out when he coughed. Which action should the nurse take first?

A. Obtain sterile towels soaked in saline: Sterile saline-soaked dressings are used if wound evisceration has occurred to protect exposed organs and prevent tissue desiccation. However, this intervention should only occur after confirming that evisceration is present. Implementing treatment before assessment may delay identification of the exact complication. B. Assure the client that such feelings occur with wound infections: A sensation that “insides spilled out” after coughing strongly suggests wound dehiscence or evisceration, which is a surgical emergency rather than a typical symptom of wound infection. Providing reassurance without assessment could delay urgent treatment and place the client at risk for complications. C. Notify the healthcare provider (HCP): Notification of the healthcare provider is appropriate if dehiscence or evisceration is confirmed because surgical repair may be required. However, the nurse must first assess the wound to determine the client’s condition. Immediate reporting without assessment would provide incomplete information and delay appropriate interventions. D. Visualize the abdominal incision: The priority action is immediate assessment of the surgical wound. A client reporting a sensation that the abdomen has “opened” after coughing raises concern for wound dehiscence or evisceration, a postoperative complication most common around 5–7 days after abdominal surgery. Direct visualization allows the nurse to determine if the wound has separated or if organs are protruding and then initiate emergency measures.