Module 4 - pre-op

The nurse is doing a preoperative patient education with a 61 year old male patient who has a 40/pack year history of cigarette smoking. The patient will undergo an elective bunionectomy at a time that fits work schedule in a few months. What would be the best instruction5 to give to this patient? Aim to quit smoking in the post-operative period to reduce the chance of surgical complications Stop smoking 4 to 8 weeks before the scheduled surgery to enhance pulmonary function and decrease infection Stop smoking at least 6 weeks before the scheduled surgery to enhance pulmonary function and decrease infection. Reduce smoking by at least 50% to prevent the development of pneumonia

Stop smoking 4 to 8 weeks before the scheduled surgery to enhance pulmonary function and decrease infection

The nurse is planning the care of a patient who has type I diabetes and who will be undergoing knee replacement surgery. This patient's care plan should reflect an increased risk of what post-surgical complications? Select all that apply. Hypoglycemia Delirium Acidosis Glucosuria

Acidosis Glucosuria Hypoglycemia

The nurse is preparing a patient for surgery prior to her hysterectomy with out oophorectomy. The nurse is witnessing the patients signature on a consent form. Which comment by the patient would best indicate informed consent? "The physician us going to remove my uterus and told me about the risk bleeding" " I know I'll have pain after surgery but they'll do their best to keep it to a minimum". "Because the physician isn't taking my ovaries, i"ll still be able to have children." " I know I'll be fine because the physician said he has done this procedure a hundred times.

"The physician us going to remove my uterus and told me about the risk bleeding"

The nurse is performing a pre-operative assessment on a patient going to surgery. The patient informs the nurse that he drinks approximately 2 bottles of wine a day and has for the last several years. What postoperative difficulties can the nurse anticipate for this patient? Alcohol withdrawal syndrome 1 week after his last drink Alcohol withdrawal syndrome 2 to 4 days after his last drink Alcohol withdrawal syndrome upon administration of anesthesia Alcohol withdrawal syndrome immediately following surgery

Alcohol withdrawal syndrome 2 to 4 days after his last drink

?Ther OR nurse will be caring for a patient who will receive a strasscral blocs. For what patient would the use of a trans sacral block be appropriate? A 50 year-old woman who will be having a reduction mammoplasty Middle-aged man schedule for a a thoracotomy. An older adult man who will undergo an inguinal hernia repair . A child who requires a cpolsed reduction of a right humerus fracture.

An older adult man who will undergo an inguinal hernia repair .

The patient's surgery is nearly finished and the surgeon has opted to use tissue adhesives to close the surgical would. This requires the nurse to prioritize assessments related to what complication? Hypothermia Malignant hyperthermia Infection Anaphylaxis

Anaphylaxis

Which nursing diagnosis is most appropriate for a client during the pre-operative phase of surgery? Anxiety related to fear of post-operative pain Impaired mobility related to post-operative pain. Knowledge deficit related to pain management Risk for acute pain related to the surgical incision

Anxiety related to fear of post-operative pain

The client is 12 hours post-laminectomy. Which nursing interventions should be implemented ? Administer IV anticoagulants and place on eight (8) L/min. Medicate with IV steroids and keep the be in Trendelenburg position Assess ability to void and log roll the client every 2(two) hours Place stand bags on each side of th head and give cathartic .

Assess ability to void and log roll the client every 2(two) hours

You admit a patient to the PACU who undergone a surgical procedure under general anesthesia. See of general anesthesia puts this patient at risk for: Dehydration Atelectasis Anemia Peripheral edema

Atelectasis

VITAL SIGNS: 0830: pulse 82, respirations 14, blood pressure 92/60, temperature 98.9, pulse ox 96% 1030: pulse 92, respirations 20, blood pressure 110/82, temperature 96.3pulse ox 93% While assessing a client in the Post Anesthesia Care Unit (PACU) the nurse compares the preoperative vital signs at 0830 to the current vital signs at 1030 . Based on this what should the nurse do first? Increase the IV fluid rate Administer oxygenate 4L via nasal canula Call the physician for a pain medication Cover with a warming blanket

Cover with a warming blanket

Your client who has a continuous epidural infusion for post-operative pain control has a loss of sensation at the L4 level. Based on this, which of the following g would you assess? Temperature Bladder scan Bowel sounds lung sounds

Bladder scan

The preoperative nurse has completed the pre-surgical assessment of an 82 year old female patient who is schedule for a left total knee replacement. What planning the patient care, the nurse should address the consequences of the patients aging cardiovascular system. These include as increased risk of which of the following? Hypervolemia Hyponatremia Hyperkalemia Hyperphosphatemia

Hypervolemia

The nurse is preparing an elderly patient for a scheduled removal of orthopedic hardware, a procedure to be performed under general anesthesia . For which adverse effect should the nurse most closely monitor the patient? Hypothermia Arthritis Cerebral ischemia Pulmonary edema

Hypothermia

The nurse is creating a plan of care for a 70 year old obese patient with a history of Type II diabetes. Which of the following post-operative complications does the nurse realize is a higher risk for this client? Pain crisis Bleeding Incontinence Infection

Infection

You are providing preoperative teaching to a client schedule for hip replacement surgery in 1 month. During the preoperative teaching, the patient gives you a list of medications she takes, the dosage and frequency. Which of the following interventions provides the patient with the most accurate information? Instruct the patient to continue any herbal supplements unless otherwise instructed. These will have minimal effect. Instruct the patient to stop taking St. John's Wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents. Instruct the patient to continue taking ephedrine prior to surgery due to its beneficial effect on blood pressure Instruct the patient to discontinue Synthroid due to its effect on blood coagulation and the potential for heart dysrhythmias

Instruct the patient to stop taking St. John's Wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents

An OR nurse os teaching a nursing student about the principles of surgical asepsis as a requirement in the restricted zone of the operating suite. What personnel protective equipment should the nurse war at all times in the restricted zone of the OR? Glovers Mask covering the nose and mouth Goggles Reusable shoe covers

Mask covering the nose and mouth

VITAL SIGNS: 0930: pulse 68, respirations 14, blood pressure 120/79, temperature 97.9, pulse ox 96% 1000: pulse 105, respirations 24, blood pressure 100/50, temperature 98.9pulse ox 92% While assessing a client in the Post Anesthesia Care Unit (PACU) the nurse compares the vital signs at 0930 to the current vital signs at 1000. The nurse further assess the client to find the client's skin is cold and moist, and pale. Based on this what should the nurse suspect? Development of atelectasis Onset of hypovolemic shock Normal response to anesthesia Malignant hypothermia

Onset of hypovolemic shock

The circulating nurse will be participating in a 78 year-old patient's total hip replacement. Which of the following considerations should the nurse prioritize during the preparation of the patient in the OR? The preoperative shave should be done by the4 circulating nurse. Pressure points should be assessed and will padded. The patient should be placed in Trendelenburg position. The patient must be firmly restrained at all times.

Pressure points should be assessed and will padded.

Before preparing a client for surgery, the nurse develops a teaching plan. What is the primary purpose of preoperative teaching? Reduce the risk for postoperative complications Explain the risks associated with surgery Determine client's psychological readiness for surgery Obtain informed consent for surgery

Reduce the risk for postoperative complications

The nurse is performing a preoperative history and physical exam for a client scheduled for an elective lumbar laminectomy in one hour. Which of the following findings would the nurse report to the surgeon as possible cause to postpone surgery? The client is allergic to iodine and penicillin The client is unable to hear without hearing aids The client has an acne outbreak on his lower back The client has a history of sleep apnea

The client has an acne outbreak on his lower back

The nurse is caring for clients on an orthopedic unit. Which client should be assessed first? The client two (2) days post disk fusion who has T100.4, P 96, R24, and B/P 138/78 The client diagnosed with back pain who is complaining of a 4+ on a scale of 1-10 scale. The client who has undergone a myelogram and complains of a headache. The client being diagnosed with back pain who is being discharged and whose ride is here.

The client two (2) days post disk fusion who has T100.4, P 96, R24, and B/P 138/78

In anticipation of a patient's scheduled surgery, the nurse is teaching her to perform deep breathing and coughing to use post operatively. What action should the nurse teach the patient? The patient should take a deep breath in through the mouth and exhale through the mouth, take a short breath, and cough from deep in the lungs. The patient should take three deep breaths and cough hard three times, at least every 15 minutes for the immediately post operative period. The patient should take three deep breaths and exhale forcefully and then take a quick short breath and cough from deep in the lungs The patient should rapidly inhale, hold for 30 seconds or as long as possible and exhale slowly.

The patient should take a deep breath in through the mouth and exhale through the mouth, take a short breath, and cough from deep in the lungs.

The nurse is performing a pre-admission assessment of a patient scheduled for a bilateral mastectomy. Of what purpose of the preadmission assessment should the nurse be aware? Discusses and reviews patient's health insurance coverage Determines the patient's suitability as a surgical candidate Verifies completion of preoperative diagnostic testing Informs the patient of need for postoperative transportation

Verifies completion of preoperative diagnostic testing

What is the most important focus of the circulating nurse when positioning the client on the operating table prior to the actual operation? To provide space at the operating table for the entire surgical team To avoid skin pressure and prevent neuromuscular damage. To minimize the client's risk for anesthesia complications To allow the surgeon maximum visualization of the operative site.

To avoid skin pressure and prevent neuromuscular damage.

The nurse is providing preoperative teaching to a patient scheduled for surgery. The nurse is instructing the patient on the use of deep breathing, coughing, and the use of incentive spirometry when the patient states' i dont know why you're focusing on my breathing. My surgery is on my hip, not my chest." What rationale for these instructions should the n nurse provide. To enhance peripheral circulation To promote optimal lung expansion To prevent pneumothorax To prevent chronic obstructive lung disease (COPD)

To promote optimal lung expansion

The nurse is preparing to send a patient to the OR for a scheduled surgery. What should the nurse ensure is on the chart when it accompanies the patient to surgery? Select all that apply. Social work assessment Verification form Laboratory reports Nurses notes

Verification form Laboratory reports

The nurse is preparing to send a patient to the OR for a scheduled surgery. What should the nurse ensure is on the chart when it accompanies the patient to surgery? Select all that apply. Nurses notes Laboratory reports Social work assessment Verification form

Verification form Laboratory reports

At what time during the procedure does the scrub nurse count sponges and instruments? While setting the sterile field and before closing the incision While handing the surgeon the instruments and sponges During the time out period before surgery and at the end of surgery Prior to the opening and closing of the sterile field

While setting the sterile field and before closing the incision

A patient is admitted to the ED complaining of severe abdominal pain, stating that he has been vomiting "coffee-ground" like emesis. The patient is diagnosed with a perforated gastric ulcer and is informed that he needs surgery. When can the patient most likely anticipate that the surgery will be scheduled? Within 24 hours As soon as the scheduled are done Within the next week Without delay

Without delay

What medication is commonly given in the pre-operative area to alleviate anxiety? metoprolol ( Toprol XL) oxycodone (Lortab) midazolam (Versed) cefazolin ( Ancef)

midazolam (Versed)