After adrenalectomy with high-dose corticosteroids, which assessment cue would be considered a potential complication rather than an expected finding?

After adrenalectomy with high-dose corticosteroids, which assessment cue would be considered a potential complication rather than an expected finding?

• A. Pain rating 3/10
• B. Surgical dressing drainage
• C. Blood pressure 90/60
• D. Abdominal examination bowel sounds present

Answer: (C)

The situation tests how you recognize signs of instability after major surgery with steroid replacement. After an adrenalectomy, patients receive exogenous corticosteroids to prevent adrenal crisis, so the expected postoperative findings include mild to moderate pain, some wound drainage, and return of bowel sounds as the GI tract awakens. A blood pressure of 90/60, however, signals potential-compromised perfusion rather than an expected finding. Low blood pressure can indicate hemorrhage with hypovolemia, which requires immediate assessment and action (checking dressings, estimating blood loss, fluids or blood products as needed, and evaluating steroid dosing and adrenal function). While other choices—such as manageable pain, typical wound drainage, and present bowel sounds—fit the normal postoperative course, hypotension points to a possible complication that needs prompt attention.

The situation tests how you recognize signs of instability after major surgery with steroid replacement. After an adrenalectomy, patients receive exogenous corticosteroids to prevent adrenal crisis, so the expected postoperative findings include mild to moderate pain, some wound drainage, and return of bowel sounds as the GI tract awakens. A blood pressure of 90/60, however, signals potential-compromised perfusion rather than an expected finding. Low blood pressure can indicate hemorrhage with hypovolemia, which requires immediate assessment and action (checking dressings, estimating blood loss, fluids or blood products as needed, and evaluating steroid dosing and adrenal function). While other choices—such as manageable pain, typical wound drainage, and present bowel sounds—fit the normal postoperative course, hypotension points to a possible complication that needs prompt attention.