Certified Pediatric Nurse (CPN)

What finding would be the most concerning after a child has undergone a tonsillectomy?

1. Fever of 101

2. Increased swallowing

3. Pain score 4/10 on the numeric scale

4. Pain score 7/10 on the numeric scale

The correct answer is: Increased swallowing

Following a tonsillectomy, increased swallowing is particularly concerning because it may indicate that the child is experiencing bleeding from the surgical site. After the procedure, it is normal for some discomfort and pain to occur, which is reflected in varying pain scores. However, the presence of excessive swallowing is often a sign that the child could be trying to clear blood or secretions from the throat, which necessitates immediate medical evaluation. Fever can occur post-surgery, but a mild fever like 101 degrees can be expected as a response to surgery and does not typically signal a serious complication on its own. Pain scores that are moderate (such as 4/10) or even higher (like 7/10) are also common and can be managed with appropriate pain relief methods. Hence, while pain management is important, it is the behavior associated with increased swallowing that raises the most significant alarm for potential postoperative complications.