Adult Health Ch. 17

What action by the nurse best encompasses the preoperative phase?

Educating clients on signs and symptoms of infection

An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?

Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients.

When is the ideal time to discuss preoperative teaching

Preadmission visit

Once the operating team has assembled in the room, the circulating nurse calls for a "time out." What action should the nurse take during the time out?

Review the scheduled procedure, site, and client.

Nursing assessment findings reveal that the client is afraid of dying during the surgical procedure. Which surgical team member would be most helpful in addressing the client's concern?

Surgeon

A nurse is teaching a client about diaphragmatic breathing. What client action indicates that further teaching is needed?

The client exhales forcefully with a short expiration.

Sudden withdrawal of which of the following may result in seizures?

Tranquilizers

A nurse evaluates the potential effects of a client's medication therapies before surgery. Which drug classification may cause respiratory depression from an associated electrolyte imbalance during anesthesia?

diuretics

You are the nurse working in an ambulatory surgery center. A teenage son of your clients ask you why so many people have surgery. What would be your best reply?

"Many people have diagnostic or short therapeutic surgical procedures."

The nurse recognizes that which of the following clients is at the lowest risk for perioperative complications?

A client who has a history of arthritis

The nurse expects informed consent to be obtained for insertion of:

A gastrostomy tube

A client is scheduled for a surgical procedure. When planning the client's care, the nurse should consider that which of the following conditions will increase the client's risk of complications after surgery?

A history of diabetes

In preparing the client for transfer to the operating room, which of the following actions by the nurse is inappropriate?

Allow the client to wear dentures.

The nurse recognizes that the client most at risk for mortality associated with surgery is the:

Client with chronic alcoholism

At which time does the nurse realize that it is best to begin teaching about care needed during the postoperative period?

During the preoperative period

A fractured skull would be classified under which category of surgery based on urgency?

Emergent

The nurse is caring for a client needing emergency surgery. Which preoperative teaching is least important to prepare the client for surgery?

Post-discharge diet

A client is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications?

Splint the incision site using a pillow during deep breathing and coughing exercises.

Following diagnostic testing, a patient requires a cholecystectomy. This surgical procedure would be categorized as which of the following?

Urgent

The perioperative nurse has a number of major responsibilities when a patient is admitted to a surgical unit or center. Which of the following is the most important function?

Verifies that operative consent is signed

Which nutrient plays an important role in normal blood clotting?

Vitamin K

At what point does the preoperative period end?

When the client is transferred onto the operating table

A physically fit older adult is scheduled for right knee replacement. What factor for the client would create an increased risk for postoperative complications?

current smoking history

A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which post-surgical risk factor would decrease if the surgical client maintained strict blood glycemic control?

wound healing

For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery?

7

A gunshot wound would be classified under which category of surgery based on urgency?

Emergent

The nurse assesses a client to determine if there is increased risk for complications intraoperatively or postoperatively. Which are general risk factors? Select all that apply.

health status age nutritional status physical condition

The nurse recognizes that written informed consent is required for insertion of a(n):

Peripherally-inserted central catheter.

Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery?

Physician

The nurse in the preoperative area has just medicated her client according to the anesthesiologist's orders. What is the nurse's priority action at this time?

Place the side rails in the up position and make sure the call button is in reach.

Which nursing statement would best decrease a client's anxiety before an emergency operative procedure?

"Let me explain to you what will happen next."

The nurse has provided preoperative instructions to a client scheduled for surgery at an ambulatory care center. Which statement, made by the client, would indicate that further instruction is needed?

"The nurse will explain the details of the surgery before I sign a consent."

The physician schedules an elective surgical procedure for a patient who smokes cigarettes. When should the nurse recommend that the patient cease smoking before the surgical procedure to minimize risks associate with cigarette smoking?

1 to 2 months

A client having a surgical procedure takes aspirin 325 mg daily for prevention of platelet aggregation. When should the client stop taking the aspirin before the surgery?

7 to 10 days

What is the blood glucose level goal for a diabetic client who will be having a surgical procedure?

80 to 110 mg/dL

A client is undergoing a surgical procedure to repair an ulcerated colon. Which client education topics will be discussed preoperatively? Select all that apply.

postoperative pain control intravenous fluids and other lines and tubes cough and deep-breathing exercises

Clients who have received corticosteroids preoperatively are at risk for which type of insufficiency?

Adrenal

A client refuses to remove her wedding band when preparing for surgery. What is the best action for the nurse to take?

Allow the client to wear the ring and cover it with tape.

You are caring for a client preoperatively who is very anxious and fearful about their surgery. You know that this client's anxiety can cause problems with the surgical experience. What type of problems can this client have because of their anxiety and fear?

Anxious clients have a poor response to surgery and are prone to complications.

The nurse is assigned a client scheduled for an outpatient colonoscopy in an ambulatory care setting. During which phase of perioperative care would the nurse document the admission vital signs in the recovery room?

During the postoperative phase

Informed consent from the surgical client is essential in all of the following categories of surgery except:

Emergent surgery

Which of the following nursing activities would not be part of the preoperative phase of care? Select all that apply.

Ensuring that the sponge, needle, and instrument counts are correct Administering medications, fluid, and blood component therapy, if prescribed

The nurse is conducting a preoperative assessment on a client scheduled for gallbladder surgery. The client reports a frequent cough producing green sputum for 3 days and denies fever. Upon auscultation, the nurse notes rhonchi throughout the right lung, with an occasional expiratory wheeze. Respiratory rate is 20, temperature is 99.8 (taken orally), heart rate is 87, and blood pressure is 124/70. What is the best action by the nurse?

Notify the surgeon to possibly delay the surgery.

A client is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications?

Osteoporosis

Regarding the surgical client, which phase refers to the period of time that spans the entire surgical experience?

Perioperative

You are physically preparing a client for surgery and instruct the person to remove any jewelry. The client refuses to remove a wedding band. What should you do in this situation with approval from your facility?

Place gauze under and over the ring and apply adhesive tape over it.

A client is preparing to undergo a curative surgical procedure. Which of the following is the type of surgery the client could be having? Select all that apply.

Removal of a tumor Removal of a diseased appendix

Which nursing assessment finding indicates the preoperative client has not met expected outcomes?

Sobs uncontrollably about pending amputation of foot.

A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?

Use diaphragmatic breathing.

The nurse is caring for a patient with liver disease who had a surgical procedure. When should the nurse alert the physician?

When the patient's blood ammonia concentration reaches 180 mg/dL

A client is preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What is most important for the nurse to monitor during the operative experience with the client?

adrenal insufficiency

A 17-year-old client is having same-day surgery. Solely during the intraoperative phase of perioperative care, the nurse:

continuously monitors the sedated client.

When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as

emergency