Fundamentals Question #34

Question

A patient in the postanesthesia care unit after surgery begins to vomit. Which action should the nurse make a priority?

Answers

  1. Place the patient in a side lying position
    • Rationale:
  2. Encourage the patient to take sips of ginger ale
    • Rationale:
  3. Ambulate the patient to the bathroom
    • Rationale:
  4. Provide frequent oral hygiene
    • Rationale:

Overview

Explanation

The correct option is A. Placing the patient in a side lying position while vomiting will decrease the risk of aspiration and would be the priority. At the time of vomiting the patient cannot sip any fluids. Ambulating to the bathroom is contraindicated in the early postoperative period. At the time of vomiting oral hygiene would not be a priority. After the client stops vomiting it can be done to remove residual acid from the vomitus.

Learning Outcomes

Test Taking Tip

Video Rationale