Certified Pediatric Nurse (CPN)

What would indicate immediate postoperative complications in a child who has had a tonsillectomy?

1. Spitting out brown, coffee-colored secretions

2. Complaining of a sore throat and refusing liquids

3. Vomiting bright red blood

4. Crying

The correct answer is: Vomiting bright red blood

Vomiting bright red blood after a tonsillectomy indicates a serious complication that requires immediate medical attention. Postoperative bleeding is a known risk associated with this procedure, particularly within the first 24 hours after surgery. The presence of bright red blood suggests that it is fresh and indicates ongoing bleeding, which may be a sign of a clot breaking loose or an arterial bleed. This situation can lead to significant health risks, including hypovolemic shock, and necessitates urgent evaluation and intervention. In contrast, spitting out brown, coffee-colored secretions may suggest old blood or dried mucous, which is often less alarming, while a sore throat and refusal of liquids are common after a tonsillectomy due to pain but are not immediately life-threatening. Crying, though distressing, does not usually indicate a serious complication but may reflect discomfort or anxiety following surgery. Thus, among these choices, vomiting bright red blood is the most critical sign of a potential emergency that requires swift action.