At 0700, the nurse reviews Mr. B's postoperative-day-5 handoff. The record shows blood pressure 124/76 mm Hg and lactate 1.4 mmol/L, but overnight he developed temperature 38.6 C with heart rate 102/min. Yesterday the incision was intact and dry during the afternoon assessment, whereas it now has purulent yellow drainage saturating the current dressing. The abdomen remains soft without rigidity or crepitus, while the incision has erythema extending 5 cm with increasing incisional tenderness. Mr. B remains alert, tolerates a diet, and ambulates with assistance, but his WBC increased from 9.2 to 16.8 x 10^9/L with neutrophilia. The nurse confirms that postoperative prophylactic antibiotics stopped after incision closure and notes two loose staples at the newly draining lateral area. Mr. B has diabetes and obesity, and discharge had been planned for tomorrow.
At 0700, the nurse reviews Mr. B's postoperative-day-5 handoff. The record shows blood pressure 124/76 mm Hg and lactate 1.4 mmol/L, but overnight he developed temperature 38.6 C with heart rate 102/min. Yesterday the incision was intact and dry during the afternoon assessment, whereas it now has purulent yellow drainage saturating the current dressing. The abdomen remains soft without rigidity or crepitus, while the incision has erythema extending 5 cm with increasing incisional tenderness. Mr. B remains alert, tolerates a diet, and ambulates with assistance, but his WBC increased from 9.2 to 16.8 x 10^9/L with neutrophilia. The nurse confirms that postoperative prophylactic antibiotics stopped after incision closure and notes two loose staples at the newly draining lateral area. Mr. B has diabetes and obesity, and discharge had been planned for tomorrow.