After a tonsillectomy and adenoidectomy, which finding should alert the nurse to suspect early hemorrhage in a 5-year-old child?

After a tonsillectomy and adenoidectomy, which finding should alert the nurse to suspect early hemorrhage in a 5-year-old child?

• A. Drooling of bright red secretions
• B. Pulse rate of 95 bpm
• C. Vomiting of dark brown emesis
• D. BP of 95/56 mm HG

Answer: (A)

The key idea is recognizing early hemorrhage after a tonsillectomy/adenoidectomy. Fresh, bright red blood in the mouth that is being drooled or spit up indicates ongoing active bleeding from the surgical area. In a 5-year-old, this immediate sign signals hemorrhage sooner than changes in vital signs or the appearance of older blood, because fresh blood reflects a current bleed and requires urgent attention to protect the airway and stop the bleeding. A normal pulse rate at this age, a normal-looking blood pressure, or vomiting dark brown blood are less specific for an acute postoperative bleed. Dark emesis can come from digested or swallowed blood or other sources and isn’t as direct a cue for active bleeding from the tonsil/adenoid sites as bright red secretions drooling, which points to fresh bleeding at the operative site.

The key idea is recognizing early hemorrhage after a tonsillectomy/adenoidectomy. Fresh, bright red blood in the mouth that is being drooled or spit up indicates ongoing active bleeding from the surgical area. In a 5-year-old, this immediate sign signals hemorrhage sooner than changes in vital signs or the appearance of older blood, because fresh blood reflects a current bleed and requires urgent attention to protect the airway and stop the bleeding.

A normal pulse rate at this age, a normal-looking blood pressure, or vomiting dark brown blood are less specific for an acute postoperative bleed. Dark emesis can come from digested or swallowed blood or other sources and isn’t as direct a cue for active bleeding from the tonsil/adenoid sites as bright red secretions drooling, which points to fresh bleeding at the operative site.