The client is scheduled for a transphenoidal hypophysectomy. During the immediate post-operative period, which nursing task should receive priority? A. Checking the gag reflex B. Assessing the urinary output C. Checking nasal discharge for glucose D. Checking for Homan's sign

Transphenoidal hypophysectomy is a surgical procedure to remove a pituitary tumor through the nose and sinuses without opening the skull. Given the location of the surgery, potential post-operative complications may include cerebrospinal fluid leaks, altered gag reflex, infections, and changes in hormonal balance. Understanding these factors will help prioritize post-operative care.

To determine which nursing task should receive priority, let's analyze each of the given options: A. Checking the gag reflex - An alteration in the gag reflex may indicate complications from the surgery that can lead to aspiration and other respiratory issues. B. Assessing the urinary output - This is important in most post-surgical patients. In the case of transphenoidal hypophysectomy, it is necessary to monitor potential urine output changes due to hormonal imbalances (e.g., diabetes insipidus). C. Checking nasal discharge for glucose - This task is crucial to detect a cerebrospinal fluid (CSF) leak, which can occur due to the surgical approach and the proximity of the tumor to the dura mater. A CSF leak can lead to meningitis. D. Checking for Homan's sign - Homan's sign (pain in the calf on dorsiflexion of the ankle) is an indication for deep vein thrombosis (DVT). Although DVT is a known postoperative complication, it is not specific to the transphenoidal hypophysectomy.

Prioritizing the nursing tasks should be based on the risk of complications, and the considerations are specific to the procedure. A - Checking the gag reflex is important, but it's not as urgent as identifying CSF leaks which have higher risks of severe complications. B - Although assessing urinary output is necessary, it is not the most immediate post-operative priority. C - Checking nasal discharge for glucose is vital, as early detection of CSF leaks can help prevent severe complications like meningitis. D - Checking for Homan's sign is relevant but not specific to this type of surgery. Therefore, the nursing task that should receive priority during the immediate post-operative period after a transphenoidal hypophysectomy is: C. Checking nasal discharge for glucose