8-18. OTHER POSTOPERATIVE COMPLICATIONS
a. Atelectasis is the incomplete expansion or collapse of alveoli with retained
mucus, involving a portion of the lung and resulting in poor gas exchange. Signs and
symptoms of atelectasis include dyspnea, cyanosis, restlessness, apprehension, crackles,
and decreased lung sounds over affected areas. The primary purposes of care for the
patient with atelectasis are to ensure oxygenation of tissue, prevent further atelectasis,
and expand the involved lung tissue.
b. Hypovolemic shock is the type most commonly seen in the postoperative
patient. Hypovolemic shock occurs when there is a decrease in blood volume. Signs and
symptoms are hypotension; cold, clammy skin; a weak, thready and rapid pulse; deep,
rapid respirations; decreased urine output; thirst; restlessness; and apprehension.
c. Hemorrhage is excessive blood loss, either internally or externally.
Hemorrhage may lead to hypovolemic shock.
d. Thrombophlebitis is inflammation of a vein associated with thrombus (blood
clot) formation. Thrombophlebitis is more commonly seen in the legs of a postoperative
patient. Signs and symptoms are elevated temperature, pain and cramping in the calf or
thigh of the involved extremity, redness and swelling in the affected area, and pain with
dorsiflexion of the foot (figure 8-5). Care for the patient with thrombophlebitis includes
preventing a clot from breaking loose and becoming an embolus that travels to the lungs,
heart, or brain and preventing other clot formation.
Figure 8-5. Dorsiflection of the foot.
8-19. WOUND COMPLICATIONS
a. Nursing implications in relation to prevention and early detection of wound
complications include assessing vital signs, especially monitoring an elevated
temperature; assisting the patient to maintain nutritional status, and use of medical
asepsis. The integumentary system is the body's natural barrier against invasion of
infectious microorganisms. Possible negative effects of surgery on the integumentary
system include wound infection, dehiscence, and evisceration.