Perioperative Quizzes and terminology

If a patient's oxygen saturation is 97%, the heart rate is elevated and the patient is restless the nurse should suspect the patient is in pain T/F

True

Tachycardia is often the earliest sign of malignant hyperthermia. T/F

True

The nurse is preparing an elderly client for a scheduled removal of orthopedic hardware, a procedure to be performed under general anesthetic. The nurse most closely monitor the client for hypothermia. T/F

True

The OR nurse is providing care for a 25-year-old major trauma client who has been involved in a motorcycle accident. What intraoperative change may suggest the presence of anesthesia awareness? Respiratory depression Sudden hypothermia and diaphoresis Vital sign changes and client movement Bleeding that is beyond what is anticipated

Vital signs and client movement

emergency surgery

When immediate surgery is needed to preserve life Limited time for patient to prepare

elective surgery

When surgery is advised but it is not life or death Allows time for patient to prepare

urgent surgery

When surgery is necessary within 24 hours of dx Allows for some time for patient to prepare

surgery To take away/remove tissue

ablative surgery

surgery with Knee, hip, joint replacement (rehabilitative)

ambulatory surgery

The perioperative nurse is providing care for a client who is recovering on the postsurgical unit following a transurethral prostate resection (TUPR). The client is reluctant to ambulate, citing the need to recover in bed. For what complication is the client most at risk? Atelectasis Anemia Dehydration Peripheral edema

atelectasis

Surgery for cosmetic appearance; face life, breast augmentation, burn patients for grafts

cosmetic surgery

The nurse suspects the client is developing postoperative pneumonia. Which clinical manifestation would support the nurse's conclusion? Select all that apply. Wheezes Crackles Rhonchi Afebrile Tachypnea

crackles rhonchi tachypnea

During the first 24 hours after surgery, how often will the nurse evaluate the client's temperature

every 4 hours

Surgery to Relieve pain (cancer patients can have tumor or source removed to help pain or if gallbladder is not functioning and is painful)

palliative surgery

PACU

postanesthesia care unit

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

pressure points should be assessed and well padded

surgery to Improve the functional ability

reconstructive surgery

The nurse is teaching a client about coughing and deep-breathing techniques to prevent postoperative complications. Which statement is most appropriate for the nurse to make to the client at this time as it relates to these techniques? 1. "Use of an incentive spirometer will help prevent pneumonia." 2. "Close monitoring of your oxygen saturation will detect hypoxemia." 3. "Administration of intravenous fluids will prevent or treat fluid imbalance." 4. "Early ambulation and administration of blood thinners will prevent pulmonary embolism."

1

The nurse is preparing a client for surgery scheduled in 2 hours. Which interventions are appropriate in the preoperative period? Select all that apply. 1. Assist the client to void before transfer to the operating room. 2. Check all surgeon's prescriptions to ensure they have been carried out. 3. Teach postoperative breathing exercises before the client is premedicated. 4. Review the client's record for a history and physical report and laboratory reports. 5. Administer all the daily medications 2 hours before the scheduled time of the surgery.

1,2,4

A client who has undergone preadmission testing has had blood drawn for serum laboratory studies, including a complete blood count, coagulation studies, and electrolytes and creatinine levels. Which laboratory result should be reported to the surgeon's office by the nurse, knowing that it could cause surgery to be postponed? 1. Hemoglobin, 8.0 g/dL (80 mmol/L) 2. Sodium, 145 mEq/L (145 mmol/L) 3. Serum creatinine, 0.8 mg/dL (70.6 mcmol/L) 4. Platelets, 210,000 cells/mm3 (210 × 109/L)

1.

An OR nurse is participating in an interdisciplinary audit of infection control practices in the surgical department. The nurse should know that a basic guideline for maintaining surgical asepsis is what? 1. Sterile surfaces or articles may touch other sterile surfaces. 2. Sterile supplies can be used on another client if the packages are intact. 3. The outer lip of a sterile solution is considered sterile. 4. The scrub nurse may pour a sterile solution from a nonsterile bottle.

1. Sterile surfaces or articles may touch other sterile surfaces

The nurse is providing preoperative teaching to a client scheduled for a cholecystectomy. Which intervention would be of highest priority in the preoperative teaching plan? 1. Teaching leg exercises 2. Teaching coughing and deep-breathing exercises 3. Providing instructions regarding fluid restrictions 4. Assessing the client's understanding of the surgical procedure

2.

The nurse has conducted preoperative teaching for a client scheduled for surgery in 1 week. The client has a history of arthritis and has been taking acetylsalicylic acid. The nurse determines that the client needs additional teaching if the client makes which statement? 1."Aspirin can cause bleeding after surgery." 2. "Aspirin can cause my ability to clot blood to be abnormal." 3."I need to continue to take the aspirin until the day of surgery." 4."I need to check with my doctor about the need to stop the aspirin before the scheduled surgery."

3

The nurse is creating a plan of care for a client scheduled for surgery. The nurse should include which activity in the nursing care plan for the client on the day of surgery? 1. Avoid oral hygiene and rinsing with mouthwash. 2. Verify that the client has not eaten for the last 24 hours. 3. Have the client void immediately before going into surgery. 4. Report immediately any slight increase in blood pressure or pulse.

3

Maintaining patient privacy is a primary function of the circulating nurse. Which of the following are also the primary responsibility of the the nurse in this role? Select all that apply Providing emotional support Ensuring sterility Performing the second verification of surgical procedure and site Observing for fire hazards.

ALL Providing emotional support Ensuring sterility Performing the second verification of surgical procedure and site Observing for fire hazards.

The unrestricted zone of the OR only requires the use of scrub clothes and surgical caps. T/F

False

The most common cause of anaphylaxis in the OR is a latex allergy. However, other causes can be medications, fibrin sealants, and plastics. t/f

False (medications most common)

PLASTY

Formation or plastic repair

SCOPY

Looking into

Postoperative phase

Nursing care is administered after patient has surgery From postanesthesia care unit (PACU) to follow-up evaluation in clinical setting or at home

Preoperative phase

Nursing care is administered before patient has surgery

Interoperative phase

Nursing care is administered when patient is in surgery From the time the patient is received in the OR until admission to the PACU

Following admission of the postoperative client to the clinical unit, which of the following assessment data requires the most immediate attention? Blood pressure of 94/62 mm Hg Respiratory rate of 12 breaths per minute Oxygen saturation of 82% Urine output of 60 ml/hr

Oxygen sat of 82%

The OR nurse acts in the circulating role during a client's scheduled cesarean section. For what task is this nurse solely responsible? Performing documentation Estimating the client's blood loss Setting up the sterile tables Keeping track of drains and sponges

Performing documentation

The nurse is reviewing a surgeon's prescription sheet for a preoperative client that states that the client must be nothing by mouth (NPO) after midnight. The nurse should call the surgeon to clarify that which medication should be given to the client and not withheld? Prednisone Ferrous sulfate Cyclobenzaprine Conjugated estrogen

Prednisone

OSTOMY

Providing opening (stoma)

ECTOMY

Removal of organ/gland

RRHAPY

Repair

minimally invasive surgery

Smaller incisions in patient, less disruption in integrity. Ex: Can be laparoscopic or robotic surgery.

The OR nurse is taking the client into the OR when the client informs the operating nurse that his grandmother spiked a very high temperature in the OR and nearly died 15 years ago. What relevance does this information have regarding the client? Answers: The client may be experiencing presurgical anxiety. The client may be at risk for malignant hyperthermia. The grandmother's surgery has minimal relevance to the client's surgery. The client may be at risk for a sudden onset of postsurgical infection and hypothermia.

The client may be at risk for malignant hyperthermia