A nurse is changing the dressing of a client who is 1 week postoperative following abdominal surgery and notes the presence of serosanguineous drainage. The nurse should recognize that this is an indication of which of the following circumstances?
Explanation & Rationale
Choice A reason: Serosanguineous drainage, a mix of serous fluid and blood, is expected 1 week post-abdominal surgery during the inflammatory and proliferative healing phases. It indicates normal wound healing, making this the correct interpretation. Choice B reason: Infection typically causes purulent drainage (thick, yellow-green) with odor or fever, not serosanguineous drainage. The described drainage aligns with normal healing, making infection an incorrect assumption at this stage. Choice C reason: Hemorrhage involves sanguineous drainage (bright red, heavy blood), not serosanguineous, which is lighter and mixed. The drainage described does not suggest active bleeding, making hemorrhage an incorrect interpretation. Choice D reason: Serosanguineous drainage is normal and does not warrant immediate surgical intervention unless accompanied by signs like excessive bleeding or dehiscence. This drainage is expected, making surgical intervention unnecessary and incorrect.