A patient who is recovering from abdominal surgery has a Penrose ...

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A patient who is recovering from abdominal surgery has a Penrose drain. What should the nurse include in the care of this patient?
 
  1. Make sure there is a safety pin on the end of the drain.
  2. Empty the drain every 30 minutes.
  3. Clean the wound with normal saline every two hours.
  4. Remove the drain four hours postoperatively.

Question 2

An older patient is completing preoperative diagnostic testing. The nurse notes that the patient's carbon dioxide level is elevated. What should the nurse be monitoring for this patient?
 
  1. Respiratory status and arterial blood gases
  2. Serum potassium level
  3. Serum sodium level
  4. Intake and output

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Answer to Question 1

Correct Answer: 1

Penrose drains need a safety pin at the exposed end to prevent the drain from slipping down into the wound. Unless full or assessing for a potential problem, there is no need to empty the drain until the end of the shift. There is no need to clean the wound with saline. Removal of the drain requires a physician's order.

Answer to Question 2

Correct Answer: 1

A patient with an altered carbon dioxide level could have a history of emphysema, chronic bronchitis, asthma, pneumonia, or respiratory acidosis, or it could be caused by vomiting or nasogastric suctioning. The best nursing intervention for this patient would be to monitor the patient's respiratory status and arterial blood gases. A review of the potassium, sodium levels, and intake and output are not the most beneficial to this patient at this time.