Postoperative patient with fever and wound drainage; what actions are appropriate?

• A. Assess wound, monitor vitals.
• B. Notify the surgeon immediately without assessing.
• C. Assess wound, monitor vitals, collect cultures if ordered, maintain wound care, and notify the surgeon.
• D. Discontinue wound care and discharge.

Answer: (C)

When a postoperative patient develops fever and wound drainage, approach it as a potential wound infection and perform a thorough, coordinated assessment. Begin with the wound itself: check the dressing, inspect the wound edges, note the amount, color, and odor of drainage, and look for signs of dehiscence or surrounding skin irritation. Then monitor vital signs tracking temperature trends and indicators of systemic involvement such as heart rate, blood pressure, respiratory rate, and oxygen saturation. If there is an order for cultures, obtain wound cultures and any indicated blood or other cultures promptly to identify the organism and guide treatment; follow protocol and provider orders for specimen collection. Continue wound care with proper aseptic technique and dressing changes to protect the site and manage drainage, while ensuring the wound is kept clean and well cared for. Communicate your findings and trends to the surgeon, including vitals, wound appearance, and culture status, so a timely decision can be made about antibiotics, further diagnostic testing, or potential interventions. Discontinuing wound care or discharging the patient would raise the infection risk and is inappropriate, and escalating care without assessment can miss critical details. This combined approach supports early detection, appropriate treatment, and patient safety.