A nurse receiving a post-operative bariatric surgery patient can expect to perform which of the following nursing actions?

Choice A rationale Performing a physical assessment and comparing it to baseline is critical for detecting early signs of complications like anastomotic leaks or pulmonary emboli, which are high risks after bariatric surgery. Vital signs, lung sounds, and bowel sounds must be monitored closely. Baseline comparison allows the nurse to identify subtle changes in hemodynamic status. In the immediate postoperative period, catching a trend of increasing heart rate or decreasing oxygen saturation can be life saving for these high risk patients. Choice B rationale Positioning the patient with the head of the bed at least 45 degrees is essential for maximizing lung expansion. Patients with a higher body mass index (BMI) are at a significantly increased risk for atelectasis and pneumonia after general anesthesia. Elevating the head reduces the pressure of the abdominal contents against the diaphragm, facilitating better gas exchange. This position also helps prevent aspiration and reduces the workload of breathing during the recovery from anesthesia and surgery. Choice C rationale Assessing the abdominal wound for drainage is a standard postoperative requirement to monitor for hemorrhage or infection. In bariatric patients, the large amount of adipose tissue can make wound healing more difficult and increase the risk of seromas or wound dehiscence. The nurse must document the color, amount, and odor of any drainage. Excessive serosanguinous drainage could indicate an impending dehiscence, while purulent drainage suggests a localized infection that needs immediate medical attention to prevent sepsis. Choice D rationale Administering pain medication is a priority to facilitate early ambulation and deep breathing exercises. Effective pain management reduces the sympathetic nervous system response to stress, which can negatively impact healing. When pain is controlled, the patient is more likely to use the incentive spirometer and move in bed, which reduces the risk of deep vein thrombosis. The nurse must balance pain relief with the risk of respiratory depression, especially in patients with obstructive sleep apnea. Choice E rationale Teaching the patient to avoid using a straw is a specific bariatric precaution to prevent the ingestion of excess air, which causes painful gastric distention. The new stomach pouch has a very limited capacity, and swallowed air can cause significant discomfort, bloating, and pressure on the fresh staple lines. Patients must be taught to sip liquids slowly and avoid carbonated beverages or straws to minimize gas. This intervention supports the integrity of the surgical site and increases patient comfort. Choice F rationale Assisting with obtaining initial informed consent is not an appropriate postoperative action because consent must be obtained by the surgeon before the procedure begins. The nurse's role in consent is typically as a witness to the signature and to ensure the patient understands the information provided preoperatively. Doing this postoperatively is legally and ethically invalid. The nurse should instead focus on assessing the patient's understanding of postoperative restrictions and the recovery process during this stage. Choice G rationale Assessing baseline height and weight is a preoperative task used to determine the patient's BMI and calculate anesthetic dosages or nutritional needs. While weight is monitored postoperatively to track progress, the baseline measurement should already be in the record. Performing this immediately after surgery is not a priority compared to airway management and hemodynamic monitoring. The focus during the postoperative phase is on recovery from surgery rather than the initial metrics used for surgical planning.