Certified Neuroscience Registered Nurse (CNRN) Practice Exam

Which respiratory intervention should be avoided to decrease the risk of anastomotic leak with gastric sleeve surgery?

1. Incentive spirometry

2. Oxygen therapy

3. Continuous positive airway pressure (CPAP)

4. Postural drainage

The correct answer is: Continuous positive airway pressure (CPAP)

In the context of gastric sleeve surgery, avoiding continuous positive airway pressure (CPAP) is important due to the potential for increased pressure within the thoracic cavity and the abdominal space. CPAP works by delivering a steady stream of pressurized air to keep the airways open, which can inadvertently increase intragastric pressure. This added pressure may exacerbate the risk of complications, such as an anastomotic leak at the surgical site where the stomach has been resected. On the other hand, other interventions like incentive spirometry, oxygen therapy, and postural drainage are beneficial in the postoperative phase. Incentive spirometry helps prevent atelectasis and promotes lung expansion, which is crucial after abdominal surgery. Oxygen therapy ensures adequate oxygenation, particularly if the patient is in a respiratory distress state. Postural drainage can aid in clearing secretions and improving respiratory function. Therefore, these methods are generally considered safe and helpful in the recovery process, while CPAP should be approached with caution due to its potential risks related to increased pressure.