A 7-year-old child is scheduled for a tonsillectomy and adenoidectomy tomorrow morning. Which safety measure i…

Question

A 7-year-old child is scheduled for a tonsillectomy and adenoidectomy tomorrow morning. Which safety measure is the MOST critical for the nurse to implement in the immediate postoperative period?

Accepted Answer

보기 4: Observe for frequent swallowing and bleeding from the surgical site

Observing for frequent swallowing and bleeding is the most critical safety measure as hemorrhage is a life-threatening complication post-tonsillectomy. Other interventions like pain assessment and positioning are important but secondary to bleeding monitoring.

Answer

보기 1: Monitor for signs of dehydration and encourage fluid intake

Answer

보기 2: Assess pain level using age-appropriate pain scales every 2 hours

Answer

보기 3: Position the child prone or on the side to facilitate drainage and prevent aspiration

Concept	Key Points
Priority Complication	Hemorrhage - Life-threatening; monitor for frequent swallowing, restlessness, pallor, tachycardia, vomiting bright red blood.
Key Assessment	Frequent swallowing (cardinal sign), checking throat with flashlight, vital sign changes (tachycardia, hypotension).
Positioning	Prone or side-lying to promote drainage and prevent aspiration until fully alert.
Diet/Fluids	Cool, clear liquids initially; advance to soft, bland foods. Avoid red/purple liquids, citrus, hot, spicy, or rough foods.
Pain Management	Use acetaminophen or opioids as ordered. Avoid aspirin, ibuprofen, naproxen (increase bleeding risk).

Post-Op Priority: T&A vs. Other Pediatric Surgeries	Tonsillectomy & Adenoidectomy	Appendectomy	Fracture Cast Application
Primary Safety Concern	Airway & Hemorrhage (occult bleeding, aspiration)	Infection & Peritonitis (fever, abdominal pain, distension)	Neurovascular Compromise (5 Ps: Pain, Pallor, Pulselessness, Paresthesia, Paralysis)
Key Assessment	Frequent swallowing, throat inspection	Abdominal assessment, wound check, bowel sounds	Circulation, sensation, movement distal to cast
Critical Teaching	Report bleeding, avoid certain foods/meds	Report fever, increased pain, nausea	Report cast tightness, numbness, severe pain

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A 7-year-old child is scheduled for a tonsillectomy and adenoidectomy tomorrow morning. Which safety measure is the MOST critical for the nurse to implement in the immediate postoperative period?

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