Blood loss and urinary retention are major concerns in patients who have undergone stomach surgery. A nasogastric tube will be placed and should be closely monitored. Small volumes of bright, bloody drainage from the nasogastric tube can be expected for the first 2 to 3 hours because it is not uncommon to have bleeding at the anastomotic site in these procedures. However, bright bleeding that does not decrease after this period or bleeding that becomes excessive (more than 75 ml/hr) should be reported immediately to the surgeon. Observe the nasogastric tube and its drainage closely because blood easily clots and clogs the tube; notify the surgeon immediately if the tube stops draining or appears obstructed with blood. Because blood loss may be highly significant in this patient, cardiovascular status must receive careful scrutiny. Vital signs are checked frequently, and a certain amount of hypotension and tachycardia is to be expected. If hypotension and tachycardia persist or maintain a downward trend, the surgeon should be notified. Blood replacement may have to be instituted. Hemoglobin and hematocrit levels should be reassessed at regular intervals (e.g., every 4 to 6 hours postoperatively) and the surgeon notified of specific decreases. Little or no drainage should be expected from the incision unless drains are in place. If drainage appears, the dressing should be reinforced, and the surgeon notified. The first and initial dressing is considered a surgical dressing and is therefore replaced only by the surgeon. Surgical dressings that are saturated are reinforced by the PACU RN with documentation of the number and type of sterile dressings applied to reinforce the area. The patient may need an evaluation of the surgical dressing in combination with other clinical parameters and potential complications. Drains with copious output may need a drainage device applied over them to protect the patient’s skin and allow for accurate measurement of drainage (Schick & Windle, 2016).