Question

a nurse is caring for a client who is 4 hr postoperative following a laparoscopic cholecystectomy. which of the following findings should the nurse expect?
right shoulder pain
urine output 20 ml/hr
temperature 38.4° c (101.1° f)
oxygen saturation 92%

Explanation:

• Right shoulder pain: During laparoscopic cholecystectomy, carbon dioxide gas is used to inflate the abdomen. This gas can irritate the diaphragm, and the phrenic nerve (which innervates the diaphragm) also has branches that can refer pain to the right shoulder. This is a common, expected finding in the early postoperative period after this procedure.
• Urine output 20 mL/hr: A urine output of less than 30 mL/hr (in an adult) is considered oliguria and is not an expected finding post - operatively; it may indicate dehydration, renal issues, or hypovolemia.
• Temperature 38.4°C (101.1°F): A temperature this high 4 hours post - laparoscopic cholecystectomy is more likely to be a sign of infection or a complication rather than an expected finding. Mild postoperative temperature elevation (low - grade, e.g., up to 37.8°C or 100°F) can be due to the surgical stress response, but 38.4°C is above that and is concerning for infection.
• Oxygen saturation 92%: A normal oxygen saturation is typically 95 - 100% (for a healthy individual). An oxygen saturation of 92% is lower than normal and would not be an expected finding post - laparoscopic cholecystectomy without other complications (like respiratory depression from anesthesia, which is not typical 4 hours post - op in an uncomplicated case).

Answer:

Right shoulder pain