A client has returned from an open surgical procedure for a hiatal hernia repair. Which nursing intervention is a priority? A. Providing pain medication as needed B. Assisting with and monitoring incentive spirometry C. Assessing for bladder distention every four hours D. Lowering the head of the bed to prevent hypovolemia

A hiatal hernia repair surgery is a procedure to fix a defect in the diaphragm, allowing the stomach to slide into the chest cavity. This surgery can be done through an open surgical procedure or a laparoscopic approach. After the surgery, some common complications are gastric leakage, infection, and pulmonary complications, so nursing interventions should aim to prevent such complications.

Let's analyze each option provided and determine which one should be prioritized based on the patient's condition and possible complications. A. Providing pain medication as needed - Pain management is an essential part of postoperative care, but it may not be the top priority in this specific case. B. Assisting with and monitoring incentive spirometry - Incentive spirometry is used to prevent pulmonary complications after surgery by encouraging deep breathing and keeping the lungs active. This is crucial for a patient after a hiatal hernia repair surgery, as pulmonary complications are common after this surgery. C. Assessing for bladder distention every four hours - Bladder distention can cause discomfort and complications, but it’s not as likely to happen in patients undergoing hiatal hernia repair surgery, so it is not the top priority in this specific case. D. Lowering the head of the bed to prevent hypovolemia - In this context, lowering the head of the bed probably wouldn't have much effect on preventing hypovolemia, which is a decrease in blood volume. Plus, hypovolemia is not a common complication after a hiatal hernia repair surgery.

Based on the analysis of each option, we can conclude that assisting with and monitoring incentive spirometry (Option B) is the priority nursing intervention for a client who has returned from a hiatal hernia repair surgery. As pulmonary complications are common after this surgery, it is essential to focus on preventing them through encouraging deep breathing and keeping the patient's lungs active using incentive spirometry.