Chapter 15 Perioperative Care

The preoperative nurse is admitting a client for same-day surgery. What is the nurse's priority action? Teach the client how to use an incentive spirometer Assess the client's vital signs Complete the preoperative checklist Start a large bore intravenous line

Complete the preoperative checklist

What is the nurse's highest priority of care during the preoperative phase of care? Teaching to prevent complications Ensuring the client's physiological safety Explaining the 0-10 pain assessment scale Asking the client about support system

Ensuring the client's physiological safety

Prior to surgery, the nurse is reviewing the client's readiness for surgery. Which observation can be a "show stopper" and requires the surgeon be notified? Select all that apply. Hypertension Use of aspirin Nausea Elevated white blood cells A new cough

Hypertension Use of aspirin Elevated white blood cells A new cough

During the preoperative period, the nurse would notify the healthcare provider of which of the following assessment findings? Select all that apply. Increased blood pressure Normal sinus rhythm on ECG tracing Elevated white blood cell count Client taking aspirin daily for pain Fever

Increased blood pressure Elevated white blood cell count Client taking aspirin daily for pain Fever

Jason is being prepared for knee surgery. The nurse completes the preoperative checklist, health history, and admitting assessment. A latex allergy is noted.

allergy band CORRECT. The client requires proper identification of allergies so that an error does not take place during medication administration.

The nurse conducts client education based on the information collected during the client history and physical assessment process. The nurse suggests DVT prophylaxis.

heparin CORRECT. A surgical client is at risk for the development of deep vein thrombosis (DVT) during the postoperative period. The nurse should include information about preventing DVT during preoperative education, including post-operative prophylaxis.

Julie is admitted to a surgical clinic in preparation for breast reduction surgery. During the initial assessment, she informs the nurse of her allergy to penicillin and notes that she smokes 10 cigarettes each day. Her vital signs are obtained.

preoperative checklist CORRECT. The nurse's priority activity is to initiate the preoperative checklist. Each facility's unique checklist will ensure that necessary documentation, admission assessment, physical preparation, and client education have been completed before the client enters the surgical suite.

The nurse is completing the preoperative checklist for a client scheduled to undergo knee replacement surgery. Which actions must the nurse take? Select all that apply. Obtain a full medical history Assess client's current health status Give client a copy of current lab work Hang prescribed intravenous antibiotic Perform a "time-out" at the bedside

Obtain a full medical history Assess client's current health status Hang prescribed intravenous antibiotic Perform a "time-out" at the bedside

The preoperative nurse needs further instruction from the nurse manager when which action is observed? The nurse places compression stockings on the client's legs before the procedure. The nurse asks the client's spouse to witness the surgical consent. The nurse prints current lab results and places a copy on the chart. The nurse tells the client that early ambulation after surgery is best.

The nurse asks the client's spouse to witness the surgical consent.

The nurse reviews the blood work to confirm that all preventive measures are in place before Joe's scheduled orthopedic surgery. It is possible that he will require blood products during surgery.

blood consent CORRECT. A signed blood consent is required before surgery. The client should also undergo a type and screen to determine blood type and the presence of antibodies will be used to cross match blood in case the client needs blood during the surgical procedure.

The nurse is reviewing Juan's allergies and documents that he is allergic to penicillin. The nurse then reviews the preoperative medication list to ensure that Juan has not been prescribed a penicillin product.

cefazolin sodium CORRECT. Cefazolin sodium, a cephalosporin antibiotic, should be questioned by the nurse. A client with a penicillin allergy is also likely to exhibit an allergic reaction to this drug classification.

The nurse is admitting Alvin for sinus surgery. Alvin tells the nurse "I've been hospitalized 25 times in my 72 years of life."

client history CORRECT. A detailed medical history and assessment is required to ensure a safe and successful surgery. The preoperative nurse is responsible for obtaining and documenting this history on admission.

Melva is scheduled for a heart surgery. The surgeon comes to the preoperative area to review the surgical procedure with her. Alternatives are discussed, along with the benefits and risks associated with the surgery. Melva says she understands everything.

informed consent CORRECT. Informed consent is when a client autonomously grants permission to a provider to perform a surgical procedure, after understanding and considering all its alternatives, benefits, and risks. Although obtaining consent is the role of the provider, it is the nurse's responsibility to ensure that the client has all information needed to make an informed decision about the procedure. In addition to reviewing the consent form with the client and validating his or her understanding, nurses often serve as the witness to the consent. However, you are witnessing the physical signature, not the information provided. You should never sign as a witness if the client has not signed the consent form in your presence. As part of preoperative procedures, the nurse is also responsible for documenting that a signed consent has been placed in the client's chart.

The nurse notes that Marlene smokes and documents this for the surgical team to review. The surgeon plans to provide pain medication post-operatively.

opioid narcotics CORRECT. Marlene is at an increased risk for experiencing respiratory depression with narcotics as a result of her smoking history. It is important for the nurse to relay this information to the surgical team.

The nurse obtains the wristband and allergy band for a preoperative client, Samuel. He confirms that this information on the bands is correct. The nurse reviews the information on the wristband with the client and asks him to name the procedure and surgical site.

time-out CORRECT. A time-out, or "pause for cause," starts when the client enters the surgical facility. On admission, he or she receives a wristband printed with identifying information. After reviewing the wristband, the client confirms all information is correct. The nurse then has the client name the procedure and surgical site. This process is the first time-out before the client enters the surgical suite.