In the PACU after mastectomy, which action is best performed by an RN rather than an LPN or UAP?

• A. Administer analgesics on command
• B. Monitor the dressing for signs of bleeding
• C. Document the dressing status in the chart
• D. Assist patient to ambulate

Answer: (B)

Postoperative wound assessment and early identification of bleeding risk is a priority in the PACU. The RN must perform a careful evaluation of the dressing, looking for signs that bleeding is occurring or that a hematoma is forming. This isn’t just checking the dressing once; it involves integrating the amount and character of drainage, changes in the dressing over time, and the patient’s vital signs and symptoms. If new bleeding is suspected or if the patient’s hemodynamic status changes, the RN must escalate promptly and coordinate with the surgical team. While LPNs and UAPs can assist with other tasks—such as helping the patient to ambulate or documenting information—the initial dressing assessment that could indicate a complication requires the clinical judgment and decision-making typical of an RN. Therefore, monitoring the dressing for signs of bleeding is the action that best fits RN responsibilities in this scenario.