NCLEX-RNReduction of Risk PotentialMedium
On postoperative day 1 following abdominal surgery, a client has a temperature of 100.8°F (38.2°C), bibasilar crackles, shallow respirations, and is splinting the incision due to pain. Which nursing intervention is the priority?
- AAdminister an empiric antibiotic immediately
- BEncourage coughing, deep breathing, incentive spirometry, and provide adequate analgesia
- CApply supplemental oxygen only and reassess in 4 hours
- DRestrict oral fluids to reduce respiratory secretions
Show answer & explanationAnswer & explanation
Correct answer: B. Encourage coughing, deep breathing, incentive spirometry, and provide adequate analgesia
Low-grade fever with bibasilar crackles and shallow breathing on postoperative day 1 is characteristic of atelectasis, often worsened by pain-related splinting. Effective pain control combined with pulmonary hygiene measures (coughing, deep breathing, incentive spirometry) helps reinflate alveoli and prevent progression to pneumonia.
Why the other options are wrong
- A. Antibiotics are not indicated for atelectasis, which is not an infectious process.
- C. Oxygen alone does not address the underlying atelectasis or encourage lung expansion.
- D. Fluid restriction does not improve lung expansion and may thicken secretions.
Postoperative Atelectasis
Collapse of alveoli commonly occurring 24–48 hours after abdominal or thoracic surgery due to shallow breathing from pain, presenting with low-grade fever and crackles.
- Common cause of early postoperative fever
- Prevented and treated with incentive spirometry, coughing/deep breathing, and ambulation
- Adequate analgesia improves the client's ability to breathe deeply
Memory trick: Cough, breathe, walk—don't let lungs balk