An older patient who had knee replacement surgery 2 days ago can ...

[Garrulous]

An older patient who had knee replacement surgery 2 days ago can only tolerate being out of bed with physical therapy twice a day. Which collaborative problem should the nurse identify as a priority for this patient?
 
  a. Potential complication: hypovolemic shock
  b. Potential complication: venous thromboembolism
  c. Potential complication: fluid and electrolyte imbalance
  d. Potential complication: impaired surgical wound healing

Question 2

A patient who has begun to awaken after 30 minutes in the postanesthesia care unit (PACU) is restless and shouting at the nurse. The patient's oxygen saturation is 96, and recent laboratory results are all normal.
 
  Which action by the nurse is most appropriate?
  a. Increase the IV fluid rate.
  b. Assess for bladder distention.
  c. Notify the anesthesia care provider (ACP).
  d. Demonstrate the use of the nurse call bell button.

[stano32]

Answer to Question 1

ANS: B
The patient is older and relatively immobile, which are two risk factors for development of deep vein thrombosis. The other potential complications are possible postoperative problems, but they are not supported by the data about this patient.

Answer to Question 2

ANS: B
Because the patient's assessment indicates physiologic stability, the most likely cause of the patient's agitation is emergence delirium, which will resolve as the patient wakes up more fully. The nurse should look for a cause such as bladder distention. Although hypoxemia is the most common cause, the patient's oxygen saturation is 96. Emergence delirium is common in patients recovering from anesthesia, so there is no need to notify the ACP. Orientation of the patient to bed controls is needed, but is not likely to be effective until the effects of anesthesia have resolved more completely.