2025-09-26·8 min read·Clinical Nursing
Post-Operative Complications: NCLEX Nursing Review
Early and late post-operative complications including hemorrhage, DVT, ileus, and wound dehiscence.
Early Complications (0-24 hours)
- Hemorrhage: Tachycardia, hypotension, restlessness, increased drainage. Apply pressure, notify surgeon
- Respiratory depression: From anesthesia/opioids. Monitor RR, SpO2, have naloxone available
- Aspiration: NPO until gag reflex returns, HOB elevated
- Malignant hyperthermia: Rare reaction to anesthesia - rapidly rising temperature, muscle rigidity. Treatment: dantrolene
Intermediate Complications (1-3 days)
- Atelectasis: Most common cause of post-op fever in first 48 hours. Incentive spirometry every 1-2 hours
- Urinary retention: Common after anesthesia. Assess for distended bladder
- Paralytic ileus: Absent bowel sounds, distension, no flatus. NPO, NG tube, ambulation
Late Complications (>3 days)
- Wound infection: Fever, redness, warmth, purulent drainage (3-5 days post-op)
- DVT/PE: Calf pain, swelling. Prevention: SCDs, early ambulation, anticoagulants
- Wound dehiscence/evisceration: Cover with moist sterile saline dressing, notify surgeon immediately, do NOT push organs back in
Study more at Perioperative Nursing deep dive and Physiological study guide.