Post op complication question

[nursesky]

So let's say the vital signs for an abdominal surgery post op patient are a high pulse rate, low blood pressure, increasing respiratory rate over 20, increasing temperature of 37.9, and O2 sat of 80% on 3L of oxygen. The patient also has a NG tube for decompression and hemovac. What is this a sign of?

[RescueNinjaKy]

All those vitals point towards shock/sepsis. At my hospital we have a sepsis bpa that fires off with those kind of vitals. Go look up the pathophysiology of sepsis and shock. What are the treatments for it?

[Lev, MSN, RN, NP]

Sounds like sepsis.

[LobotRN, BSN, RN]

Expected vitals post OP abdominal surgery. Nurse should provide discharge instructions and plan for d/c in AM. Also remove the 3L of oxygen. It is unnecessary in this circumstance.

(FUNNY!)

But on a more serious note, How long post op? Immediately after I vote hemorrhagic complication. A day or two later, I vote sepsis. What is the WBC? Lactate? This can really be a chicken-n-egg situation...either way its shocking!

[Rose_Queen, BSN, MSN, RN]

Expected vitals post OP abdominal surgery. Nurse should provide discharge instructions and plan for d/c in AM. Also remove the 3L of oxygen. It is unnecessary in this circumstance.

I like your style.

OP, there is a lot of missing information here. How long post-op? What's in the hemovac? What's coming out of the NGT?

[Lev, MSN, RN, NP]

So let's say the vital signs for an abdominal surgery post op patient are a high pulse rate, low blood pressure, increasing respiratory rate over 20, increasing temperature of 37.9, and O2 sat of 80% on 3L of oxygen. The patient also has a NG tube for decompression and hemovac. What is this a sign of?

I'm going to analyze the signs and symptoms that you mentioned.

High pulse rate. Pain, fever, hypovolemia, infection, compensation for low BP, anemia, pulmonary embolus, trauma (surgery)

Low blood pressure. Anesthesia, pain medication, hypovolemia (blood or fluid loss), infection (fluid shifts).

Increasing RR >20. Pain, infection, atelectasis, pulmonary embolus

Increasing temp. Normal post op, infection, atelectasis, pulmonary embolus

O2 sat of 80% on 3L of oxygen. Probe is not working, decompensated COPD, severe fluid overload, pulmonary embolism, (respiratory or systemic) infection, severe respiratory depression from anesthesia or narcotics, sleep apnea not on CPAP.

The common thread is some sort of infection, probably respiratory in nature which is leading to sepsis.