One hour after arriving on the postoperative unit, a woman who received spinal anesthesia 5 hours ago is complaining of severe abdominal incisional pain. Her vital signs include oral temperature 99° F (37.2° C, heart rate 110 beats/minute, respiratory rate 30 breaths/minute, and blood pressure 160/90 mm Hg. The client's skin is pale, and the surgical dressing is dry and intact. Which intervention is most important for the nurse to implement?
Explanation & Rationale
A. Administering an IV analgesic is the most important intervention for managing the client's severe abdominal incisional pain. Prompt pain management is essential for the client's comfort and well-being, and severe pain can lead to increased physiological stress responses, such as tachycardia and hypertension. B. Providing a pillow for splinting may help alleviate pain to some extent, but it does not address the underlying cause of the severe abdominal incisional pain. Pain management with analgesics is the priority. C. Assessing the IV site for patency is important for ensuring the delivery of medications, but it is not the most urgent intervention in this situation where the client is experiencing severe pain. D. Placing the client in a high-Fowler's position may help alleviate some discomfort, but it is not the most important intervention for managing the client's severe abdominal incisional pain. Administering analgesics should be prioritized.