Final answer:
The nurse should notify the surgeon immediately when clear fluid is identified on the surgical dressing of a client following lumbar spinal surgery. Clear fluid may indicate a cerebrospinal fluid (CSF) leak, which requires prompt intervention to prevent complications.
Step-by-step explanation:
The nurse should implement the action of notifying the surgeon immediately when clear fluid is identified on the surgical dressing of a client who just returned to the unit following lumbar spinal surgery. The presence of clear fluid may indicate a cerebrospinal fluid (CSF) leak, which is a potential complication of the surgery. This leakage can lead to serious complications, such as infection, and requires prompt intervention.
CSF should be clear, as in a normal sample. However, an abnormally cloudy appearance may indicate an infection, which must be further tested to confirm the presence of microorganisms. Therefore, the nurse should not ignore the presence of clear fluid and should take action to notify the surgeon for timely evaluation and management.