Which of the following respiratory complication is most common after surgery?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Explanation

Atelectasis, the collapse of alveoli, is the most frequent respiratory complication after surgery, affecting up to 90% of patients under general anesthesia.
It is primarily caused by inadequate lung expansion resulting from the combined effects of anesthesia, postoperative pain (leading to shallow breathing), and immobility.
This complication typically develops within the first 24-48 hours after surgery and, if left untreated, can progress to pneumonia.

Option A: Pulmonary embolism is a serious but less frequent complication than atelectasis. It involves a blood clot obstructing pulmonary arteries, a different mechanism than alveolar collapse.
Option B: Empyema is a collection of pus in the pleural space. It is an infectious complication, typically secondary to severe pneumonia, lung abscess, or thoracic surgery, not a common outcome of general surgery.
Option D: Pulmonary edema is fluid accumulation in the lung tissue and alveoli. While it can occur postoperatively, it is less common than atelectasis and is usually linked to specific causes like fluid overload or cardiac dysfunction.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Postoperative Respiratory Complications as background academic context rather than a clinical decision trigger.
Nurses are at the forefront of preventing postoperative atelectasis. Proactive implementation of respiratory exercises (incentive spirometry, deep breathing, coughing) and early mobilization are critical nursing responsibilities.
Failure to prevent or treat atelectasis can lead to pneumonia, which increases patient morbidity, length of hospital stay, and healthcare costs.
What if? If the patient has had upper abdominal surgery, the incisional pain will make them very hesitant to cough or breathe deeply. This dramatically increases their risk for atelectasis. Therefore, proactive and effective pain management is a critical prerequisite before encouraging respiratory exercises.

How to Approach the Question

Identify the key terms in the question: 'most common,' 'respiratory complication,' and 'after surgery.'
Consider the universal physiological effects of surgery and general anesthesia. Factors like decreased respiratory drive, pain, and immobility affect nearly every surgical patient.
Evaluate each option based on its frequency. Think about which complication is a direct and almost expected consequence of the postoperative state.
Differentiate between a very common, often mild complication (atelectasis) and less common but potentially more severe complications (pulmonary embolism, empyema, pulmonary edema) to arrive at the correct answer.

Concept Tested & Keywords

Q69gyfG79LusICbGyFlLLS

E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 199-201

E6 Gynecology Williams p. 55-78

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 488-490