Which of these parameters indicates infection in a postoperative patient?

Daman & Diu Staff Nurse - 2018

Medical & Surgical Nursing

Medium

Appeared in: Daman & Diu Staff Nurse - 2018

Explanation

A red, warm, and tender incision site represents the classic localized signs of inflammation and infection.
These signs are known as rubor (redness), calor (warmth), and dolor (pain/tenderness), which are key indicators of a Surgical Site Infection (SSI).
Unlike systemic signs like fever or an abnormal white blood cell count, which can be non-specific, these local signs point directly to the source of the infection at the surgical wound.

Option A: A White Blood Cell (WBC) count of 6,000 cells/cu.mm is within the normal physiological range for an adult (typically 4,500-11,000 cells/cu.mm) and does not indicate an active infection.
Option B: The presence of an indwelling urinary catheter is a significant risk factor for developing a urinary tract infection (UTI), but it is not a clinical sign or symptom of an infection itself.
Option C: A rectal temperature of 37.8°C (100.0°F) is a low-grade fever. In the immediate postoperative period (first 24-48 hours), this is very common and is more often attributed to the systemic inflammatory response to surgical trauma or atelectasis (the 'Wind' of the 5 W's) rather than infection.

Clinical Relevance

Nursing practice connection: Use the key finding related to Identification of signs of postoperative surgical site infection to guide bedside assessment, documentation, and the next nursing action.
Early and accurate assessment of surgical wounds is a critical nursing responsibility to prevent complications such as wound dehiscence, evisceration, and sepsis.
Nurses must differentiate between normal postoperative inflammation and the signs of a developing infection to ensure timely reporting and intervention.
What if? If the patient's WBC count was 15,000 cells/cu.mm and temperature was 39.0°C along with the red, warm, tender incision, the concern would escalate from a localized SSI to a systemic infection, requiring immediate physician notification, probable blood cultures, and initiation of broad-spectrum antibiotics.

How to Approach the Question

First, identify the key concept in the question: finding a direct indicator of a postoperative infection.
Evaluate each option to determine if it is a sign of infection, a risk factor for infection, or a normal/expected finding.
Analyze Option A: Recall the normal range for a white blood cell count (approx. 4,500-11,000 cells/cu.mm). A count of 6,000 is normal, so this is incorrect.
Analyze Option B: Recognize that an indwelling catheter is a device that increases risk, not a sign of infection itself.
Analyze Option C: Consider the context of a postoperative patient. A low-grade fever is a common, non-specific inflammatory response soon after surgery.
Analyze Option D: Identify redness, warmth, and tenderness as the classic, localized signs of infection at a specific site.

Concept Tested & Keywords

Concept Tested: Identification of signs of postoperative surgical site infection.
Stem keywords: postoperative patient, infection, parameter
Lead-in keywords: Which
Negative lead-in flag: false

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