Certified Neuroscience Registered Nurse (CNRN) Practice Exam

Which of the following behaviors by nursing staff could contribute to the development of postoperative ileus?

1. Encouraging early mobilization

2. Administering opioids without monitoring

3. Providing patient education after surgery

4. Instructing on cough and deep breathing exercises

The correct answer is: Administering opioids without monitoring

The administration of opioids without monitoring is a key factor that can contribute to the development of postoperative ileus. Opioids are known to have gastrointestinal side effects, including decreased gastrointestinal motility and constipation. When nursing staff provide opioids without appropriate monitoring, they may not be able to assess the patient's response to the medication, including any signs of diminished bowel activity or increased abdominal discomfort. This lack of oversight can lead to an inadequate response to the potential complications caused by opioids, ultimately increasing the risk of postoperative ileus, a condition where the bowel becomes inactive and fails to pass gas or stool. Early mobilization and patient education after surgery, while important in promoting recovery, actually serve to enhance bowel function and reduce the risk of ileus. Additionally, instructing patients on cough and deep breathing exercises can help in preventing pulmonary complications, and when combined with other measures, can facilitate a quicker return to normal bowel activity. Thus, these actions promote a healthier postoperative recovery rather than contribute to bowel complications.