Sherpath Module 6: Perioperative Care

Which statement by the nurse demonstrates an understanding of preoperative care?

"Please sign both consent forms for anesthesia and blood products."

For the patient who is scheduled to undergo a total hip replacement, which complaint requires further evaluation by the nurse?

"I have dull, achy pain in my right calf."

Which statement made by the nurse during the preoperative period best teaches the patient regarding the primary purpose of the device shown in the image?

"This device will help to keep your lungs expanded after surgery."

The nurse is providing patient education regarding external pneumatic compression devices. Which statement by the patient demonstrates effective teaching?

"You will apply these before my surgery."

Which is the most appropriate time to give the preoperative prophylactic antibiotic to a patient who is scheduled to have surgery at 9:30 a.m.?

0915

Which action will the nurse encourage a postoperative patient to take as soon as possible to promote peristalsis?

Ambulation

Which action will the nurse perform when the nurse finds an open surgical wound with protrusions of internal organs upon assessment of the patient in the postanesthesia care unit?

Apply a sterile dressing moistened with warm saline and notify the surgeon

Which preoperative medication may lead to urinary retention in a patient after surgery?

Atropine

For which surgical procedure would the nurse most likely expect to administer an IV potassium replacement?

Bowel resection

Which assessment finding in the pre-operative phase leads the nurse to suspect that a patient has a chronic lack of oxygen?

Clubbing of the fingers

While preparing a patient for an ambulatory care surgical procedure, how would the nurse address an older-adult patient's concern about inadequate support systems after surgery?

Coordinate with the case manager for post-discharge care

Match the appropriate reason for surgery to the appropriate term.

Curative: performed to resolve a health problem by removing or repairing the cause Diagnostic: performed to determine the cause and origin of a disorder by sampling tissue Reconstructive: performed on abnormal or damaged body structures to improve functional ability

Malignant hyperthermia is an inherited muscle disorder that is a life-threatening complication of surgery. (blank) is the only medication approved for treatment of this condition.

Dantrolene sodium

Which factor may increase the risk for surgical or postoperative complications? Select all that apply. One, some, or all responses may be correct.

Diabetes Antihypertensive drugs Cardiac disease Over 65 years old

A patient with diabetes who is scheduled for vascular surgery is admitted on the day of surgery with several orders. Which order would the nurse accomplish first?

Draw blood for glucose, electrolyte, and CBC values

Which intervention by the nurse involves promoting surgical care improvement project (SCIP) core measures?

Ensuring the correct hair removal processes

In which order would the nurse complete the following actions of a preoperative checklist?

First: Inform patient to wash with a special soap before arrival to the facility Second: confirm the patient's identity upon arrival to the facility Third: confirm that the informed consent has been signed Fourth: administer the preoperative sedatives and opioid analgesics

Arrange the steps for practicing the proper technique for deep breathing in their correct sequence.

First: Sit upright on the edge of the bed with feet placed firmly on the floor Second: take a gentle breath in and release breath completely Third: take a deep breath, and hold for 5 seconds Fourth: exhale through the nose and mouth

In which order does a patient regain sensory and motor function after local or regional anesthesia?

First: sense of touch Second: sense of pain Third: sense of temperature Fourth: ability to move

A patient who was involved in a motor vehicle accident arrives at the emergency department and requires immediate surgery to stop massive internal hemorrhaging. The patient is unconscious, and no family or spouse is present. Which action would the nurse anticipate?

Getting written consultation from 2 other health care providers before surgery

The nurse is collecting history on a 67-year-old woman who is scheduled to undergo laparoscopic cholecystectomy. Which finding would the nurse need to communicate to the surgical team before the patient could proceed with the surgery? Select all that apply. One, some, or all responses may be correct.

Hemoglobin of 10.2 g/dL The patient is a full code The patient's mother spiked a fever right after her hip replacement. The patient states, "My tongue get really swollen after eating shrimp."

Which result would the nurse report to the surgeon when reviewing a patient's preoperative laboratory report? Select all that apply. One, some, or all responses may be correct.

Hemoglobin=8.5 g/dL Serum potassium=5.5 mEq/L Serum creatinine=2.5 mg/dL

Which order would the nurse question when preparing a patient for surgery? Select all that apply. One, some, or all responses may be correct.

Hold morning dose of daily seizure medication Administer warfarin 5 mg daily

Which surgery is an example of a surgical procedure performed to relieve the symptoms of a disease?

Ileostomy creation

Which point would be included in a teaching plan when explaining to a preoperative patient the reasons to perform coughing and splinting? Select all that apply. One, some, or all responses may be correct.

It expels secretions It keeps the lungs clear It prevents atelectasis It prevents pneumonia

Which condition may arise because of nasogastric tube drainage?

Metabolic alkalosis

A patient who has received a sedative preoperatively is ready for surgery when the nurse realizes that the informed consent form has not been signed. The surgeon explained the procedure earlier, and the patient reported no further questions. There is no family or next of kin present. Which action would the nurse take?

Notify the surgeon and anticipate surgery cancellation

Which respiratory condition is a potential complication associated with surgery? Select all that apply. One, some, or all responses may be correct.

Pneumonia Laryngeal edema Atelectasis

Which surgical wound assessment finding would indicate a wound infection?

Purulent and odorous drainage

Which assessment finding requires immediate intervention in a postoperative patient after general anesthesia?

Respiratory rate of 6 breaths/min

Which responsibility is associated with the nurse in the informed consent process? Select all that apply. One, some, or all responses may be correct.

Serve as a witness to the signature Verify that the consent form is signed Clarify facts and dispel myths that the patient may have about the procedure

Which topic is included in preoperative patient teaching? Select all that apply. One, some, or all responses may be correct.

Splinting Incentive spirometry Lower extremity exercises Pain management

Which information must be provided to the patient when obtaining informed consent for surgery? Select all that apply. One, some, or all responses may be correct.

The available options and their possible risks The risks associated with the use of anesthesia The risks associated with the surgical procedure and its potential outcomes The reason for and nature of the surgery

For which reason would a nasogastric tube (NG) be inserted during abdominal surgery?

To promote GI rest

For which reason would a transparent plastic surgical dressing be placed over the incision for a patient with a joint replacement? Select all that apply. One, some, or all responses may be correct.

To reduce the frequency of the dressing changes To directly observe the wound To prevent contamination

Which component is part of an effective postoperative hand-off report? Select all that apply. One, some, or all responses may be correct.

Type and extent of surgery Status of current VS When the next dose of antibiotics, cardiac drugs, and other medications are due Pre-operative and intra-operative respiratory function and dysfunction Any health problems or pathophysiologic conditions

A patient with which condition requires immediate attention in the post-anesthesia care unit?

Urine output is <20 ml/hr

Which food is contraindicated in patients with povidone-iodine allergy?

shellfish