Scenarios (All Topics)
Postoperative Hemorrhage
Immediate nursing assessment and management for a patient exhibiting signs of active bleeding following surgical intervention.
Assessment Findings
- Tachycardia followed by hypotension
- Decreased urine output (<30 mL/hr)
- Pallor, cool and clammy skin
- Dressing saturation or expanding hematoma
Nursing Interventions
- Apply direct pressure to the bleeding site
- Maintain NPO status and notify the surgeon
- Establish large-bore IV access for fluid resuscitation
- Monitor hemoglobin and hematocrit levels
Emergent Actions
- Lower the head of the bed if not contraindicated
- Administer ordered blood products
- Prepare for potential return to the operating room
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