While caring for a patient with abdominal surgery on the first postoperative day, the nurse notices new bright-red drainage about 6 cm in diameter on the dressing. In response, the nurse should first:

• A. Reinforce the dressing.
• B. Take the patient's vital signs.
• C. Recheck the dressing in 1 hour for increased drainage.
• D. Notify the patient's surgeon.

Answer: (B)

The key idea here is prioritizing the patient’s stability when there’s potential postoperative bleeding. Bright-red drainage on the dressing shortly after surgery can indicate active hemorrhage, so the first step is to quickly assess the patient’s circulatory status by taking vital signs. Heart rate, blood pressure, respiratory rate, and mental status help reveal whether the patient is compensating or already in decompensation from blood loss. If vitals show instability (for example, tachycardia with hypotension or declining mental status), you need to escalate care and notify the surgeon promptly. Reinforcing the dressing or rechecking the dressing later won’t address a possible drop in circulating volume, and delaying assessment could miss ongoing hemorrhage. If vitals are stable, continue close monitoring and consider reinforcing the dressing while continuing to observe for changes, but the immediate action is to obtain and interpret the patient’s vital signs to guide next steps.