Ms. Anita asks the nurse when she can start eating after surgery. What is the most appropriate response by th… - GMCH Chandigarh - 2019

GMCH Chandigarh - 2019

Medical & Surgical Nursing

Medium

Appeared in: GMCH Chandigarh - 2019

Explanation

This response correctly links the initiation of oral intake to a key physiological sign: the return of bowel sounds.
It educates the patient on the first step of the post-operative diet progression, which is typically clear fluids.
This answer demonstrates the nurse's role in patient education regarding standard post-operative care protocols.
It addresses the underlying safety principle of ensuring the gastrointestinal tract is functional before introducing food or fluids to prevent complications like nausea, vomiting, and aspiration.

Option A: This is a non-therapeutic communication technique known as 'passing the buck.' It dismisses the patient's concern and avoids the nurse's responsibility to educate the patient on standard care protocols.
Option B: A patient's subjective feeling of hunger (appetite) is not a reliable indicator of gastrointestinal motility. Feeding a patient based on appetite alone without assessing for bowel sounds could lead to complications if a paralytic ileus is present.
Option D: This response is premature. A dietitian is consulted for complex nutritional planning, not for determining the initial timing of post-operative fluids. The immediate decision to start clear liquids is a standard nursing assessment and intervention based on the physician's orders and patient's status.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Post-operative dietary management and nursing communication in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Auscultating for bowel sounds in all four quadrants is a fundamental nursing assessment post-operatively. The absence of bowel sounds after 48-72 hours may indicate a paralytic ileus, which requires medical intervention.
Patient safety is paramount. Early ambulation is a key nursing intervention to help stimulate peristalsis and prevent complications like DVT and post-op ileus.
What if? If a patient has bowel sounds but experiences nausea and vomiting after the first sips of water, the nurse's immediate action should be to make the patient NPO again, document the intolerance, and notify the healthcare provider.

How to Approach the Question

First, identify the core of the question: The patient wants to know when they can eat after surgery. This is a question about standard post-operative care.
Analyze the options from a nursing perspective, considering patient safety, patient education, and therapeutic communication.
Evaluate Option A: 'Ask the doctor' is passing responsibility and not therapeutic. Eliminate it.
Evaluate Option B: 'Appetite' is subjective. Is it the most important clinical sign? No, physiological function (bowel motility) is more critical. Eliminate it.
Evaluate Option D: 'Dietitian' is for specialized, long-term planning, not the immediate first step. Eliminate it.
Evaluate Option C: This option links a clinical assessment (bowel sounds) to a specific action (starting clear fluids). This reflects standard, safe nursing practice and provides direct, educational information to the patient. This is the strongest option.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 203-205

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 123-125