On the second postoperative day after abdominal surgery, the patient has an oral temperature of 100.8 F. Which action should the nurse take first?

• A. Have the patient use the incentive spirometer.
• B. Assess the surgical incision for redness and swelling.
• C. Administer the ordered PRN acetaminophen (Tylenol).
• D. Notify the patient's health care provider about the fever.

Answer: (A)

A mild fever on the second postoperative day after abdominal surgery is most often due to shallow breathing and atelectasis from anesthesia and pain. Encouraging lung expansion with an incentive spirometer is the best first action because it directly targets the most likely cause by promoting deep breathing, improving ventilation, and helping mobilize secretions. This intervention helps reopen collapsed alveoli, reduces the risk of pneumonia, and can help tempers the fever that arises from atelectasis.

While inspecting the incision for infection and giving an antipyretic can be appropriate, they don’t address the common early postop trigger as effectively as improving lung expansion does. If fever persists beyond 48–72 hours, or if there are new or worsening signs such as chest pain, tachypnea, hypoxia, or crackles on exam, then reassessment and communication with the provider are warranted.