The patient is 24-hours-postop from a pelvic reconstruction surgery after fracturing the pelvis in a fall. The patient reports severe abdominal pain and nausea. Upon assessment, the patient’s abdomen is grossly distended and firm. The patient’s skin is diaphoretic and the patient is tachypneic and tachycardic. Pulses and capillary refill time are adequate. During the assessment, the patient vomits a moderate amount of light green liquid. The nurse contacts the provider to report suspicion of which postoperative complication?

Question

The patient is 24-hours-postop from a pelvic reconstruction surgery after fracturing the pelvis in a fall. The patient reports severe abdominal pain and nausea. Upon assessment, the patient&rsquo;s abdomen is grossly distended and firm. The patient&rsquo;s skin is diaphoretic and the patient is tachypneic and tachycardic. Pulses and capillary refill time are adequate. During the assessment, the patient vomits a moderate amount of light green liquid. The nurse contacts the provider to report suspicion of which postoperative complication?

Accepted Answer

Paralytic ileus. During the surgery, the patient&rsquo;s intestines were likely manipulated to keep them out of the way of the procedure. This manipulation, combined with anesthesia, immobility, and pain medication, has likely caused a paralytic ileus. The distended and firm abdomen is caused by the paralytic ileus. The diaphoresis, tachypnea, and tachycardia are likely due to abdominal pain. The patient has been NPO since before surgery, so light green emesis is normal. Septic shock, intestinal perforation, and intra abdominal hemorrhage are all less likely explanations for the patient&rsquo;s tachycardia, tachypnea, and diaphoresis due to the adequacy of pulses and capillary refill time.

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