ANS SG CH 33

a

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Coronary artery bypass graft after a severe heart attack

e

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Mastectomy (removal of cancerous breast)

c

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Nerve block to relieve pain

c

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Placement of a venous access device for administration of analgesia

a

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Reconstruction of a severed ligament in the knee

b

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Tummy tuck

There is clear evidence that bathing or showering with chlorhexidine before surgery is effective in preventing surgical site infections.

In the study cited in the Evidence-Based Practice feature, what was the recommendation about the use of chlorhexidine or other antibacterial skin washes prior to surgery to prevent surgical site infection?

intubation

Insertion of an endotracheal tube into the patient's trachea to maintain an open airway and administer inhalant anesthesia and oxygen is ________________.

b

Kelly Majetic is going to have a facelift tomorrow. You know that this is what type of surgery? a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative

Serum albumin, hematocrit, prealbumin, transferrin, or hemoglobin

List at least three laboratory tests that provide you with information about a patient's nutritional status.

d

Margaret Gruntmeir has been complaining of abdominal pain for several weeks, and tests have proved inconclusive. The physician has explained to Ms. Gruntmeir that she feels the best course of action is to open the abdomen surgically and see what might be causing the problem. You know that this type of surgical procedure would be considered to be a. Reconstructive. b. Aesthetic. c. Palliative. d. Exploratory. e. Curative.

b

Marla Monett is scheduled to have breast enlargement surgery today at 8:30 a.m. This surgery is classified as what type of surgery? a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative

c,d

Pain control is one of the biggest issues for the patient postoperatively. Which of the following is (are) accurate? (Select all that apply.) a. The patient heals better and faster if there is less use of pain medications. b. It is easy to become addicted to opioid analgesic medications if the patient uses the medication too often. c. It is important to ensure that the patient understands that there are medications that should be taken for pain control. d. It is easier to control pain if the patient asks for medication before the pain gets too severe.

Kidneys and liver

Which two organs are responsible for the metabolism of anesthesia?

c

Who has the responsibility to obtain consent for surgery? a. The nurse b. Office personnel c. The surgeon (physician) d. The unit clerk

c

Who is responsible for ensuring that a postoperative patient's vital signs are stable after the patient has returned to his or her room? a. The certified nursing assistant b. Assistive personnel c. The licensed nurse assigned to the patient d. The surgeon

a,b,c,e

Why is it a good idea to call a time-out prior to initiating surgery? (Select all that apply.) a. Helps to reduce performance of surgery on the wrong side or limb b. Helps to ensure the correct patient c. Ensures that the correct procedure is about to be performed d. Confirms that the physician really needs to perform the surgical procedure e. Ensures that the surgical consent has been signed

a

You are caring for Allen Julius, who has been diagnosed with advanced cancer of the liver. He has been suffering severe discomfort as a result of ascites, the collection of fluid within the peritoneal cavity that puts pressure on all the abdominal organs. The patient and physician have decided that the best course of treatment is palliative: to relieve the discomfort by surgically placing a peritoneal drainage tube to drain the excess fluid. His wife asks you if this surgery will cure him. Your best response would be a. "This procedure is not curative, but it will help to provide him with a higher quality of life by relieving the discomfort of the fluid that has been collecting in the peritoneal cavity." b. "Yes, removing the fluid would cure your husband." c. "No, of course not." d. "You do not really think we can cure your husband at this late stage in the disease process, do you? We have to be realistic."

laparoscopic

____________________ surgery uses a specialized scope and instruments in place of making a large incision.

TED hose (ant embolism hose)

_____________________________ are stockings applied to the legs to assist return of venous blood back to the right side of the heart.

SDCs (sequential compression devices)

____________________________________ are wrapped around the legs to assist the return of venous blood back to the right side of the heart.

e

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Cholecystectomy (removal of the gallbladder)

It is partially dependent on facility policy. However, the minimum should include monitoring vital signs every 15 minutes, if they are stable, for the first hour. Then assessments can be lengthened to every 30 to 60 minutes, according to facility policy. The assessments are performed at progressively lengthening intervals over the first 24 hours.

A patient has just returned to her room from postanesthesia care unit after general anesthesia for gastric bypass. How often should her vital signs be taken over the next 24 hours?

d

A patient must be intubated for which type of anesthesia? a. Local anesthesia b. Regional anesthesia c. Conscious sedation d. General anesthesia

malignant hyperthermia

A rapid and severe rise in body temperature that occurs while under a general anesthesia as a result of an inherited genetic trait is called _______________________.

epidural anesthesia

A small catheter inserted into the epidural space of the spinal column to provide a continual administration of a stronger anesthesia agent

local anesthesia

A very small area of tissue is blocked from sensory perception by injection of a local anesthetic numbing agent, such as lidocaine

It means that her white blood cell count (WBC) is abnormally low, which reduces the ability of her body to fight off infection. Surgery will be postponed until the low WBC has been evaluated.

Andrea Wilson is scheduled for an elective surgery, which is cancelled on review of her preoperative laboratory white blood cell count. It is very low at 1,700/mm3. When she asks what this test result means, how do you explain its significance to her?

PACU (post anesthesia care unit)

Another name for a recovery room is ______________________________________________________.

e

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Colectomy (removal of cancerous portion of the colon)

Pregnancy test or human chorionic gonadotropin test (hCG)

Before an elective surgery is performed on a 24-year-old female patient, which additional laboratory test might be ordered that would not be ordered on a male patient of the same age?

d

Classify the following surgeries for purpose and degree of urgency. a. Reconstructive b. Aesthetic c. Palliative d. Exploratory e. Curative Breast biopsy

approximation

How well the edges of the surgical incision meet and align with one another is called _________________.

extubation

Removal of an endotracheal tube is known as ________________________.

a,b,c,d

Research shows that patients who receive preoperative teaching do better after surgery. Which of the following are benefits of preoperative teaching? (Select all that apply.) a. Reduction in anxiety and fear b. Reduction in complications c. Smoother, shorter recovery d. Better chance of optimal healing

dehiscence

Separation of the wound edges is known as ______________________.

b,c,d

Sequential compression devices and thrombo-embolus deterrent (compression) hose may be used for which of the following reasons? (Select all that apply.) a. To decrease risk for pneumonia b. To decrease risk for deep vein thrombosis c. To prevent pooling of blood in the legs d. To aid in venous blood return e. To reduce the need to ambulate a patient when you are busy

regional anesthesia

Specific nerves and the region innervated by the nerves, such as a finger, or larger areas of the body, such as an arm or lower half of the body, are blocked from sensory perception by injection of a local anesthetic numbing agent, such as lidocaine

exploratory

Surgery done to provide further data and determine a diagnosis for a problem

reconstructive

Surgery done to repair an anatomical or congenital defect

aesthetic

Surgery performed to change or improve one's physical appearance

palliative

Surgery to alleviate symptoms and provide comfort but does not necessarily cure the disease or heal the injury

bier block

Techniques used to isolate the administration of local anesthetic to a specific nerve or region to prevent transmission of sensory information to and from that part of the body; numbness or loss of feeling and loss of ability to voluntarily move the area

a,b,d

The continuous peripheral nerve block (select all that apply) a. Uses an elastomeric reservoir ball to deliver anesthetic medication. b. Is a type of extended anesthesia placed in the operative area. c. Lasts for a maximum of about 36 hours. d. Can be removed by the patient when it is empty.

Practice on paper

The current date is 04/08/28, and it is 10:15 a.m. You have been assigned to Terri Kirby, the preoperative patient in Room 617 who was admitted on 04/07/28. Her ID number is 987123, and her birthdate is 10/01/93. She is scheduled for surgery with a general anesthesia later tomorrow. You have just performed the first portion of your preoperative teaching, which included leg exercises and turning, coughing, and deep-breathing techniques. The patient was able to demonstrate correctly how to perform them. She also acknowledged to you verbally that she understood the importance of performing these tasks after surgery tomorrow. Use the blank nurse's note form (Fig. 33.1) and narrative documentation to chart this teaching session. Use appropriate abbreviations and be succinct. Include both the implementation and evaluation phases of the teaching.

anesthesia

The loss of sensation with or without loss of consciousness accomplished by the administration of inhaled or injected medications

conscious sedation

The patient is asleep but not totally unconscious

general anesthesia

The patient is totally unconscious

c

There are several advantages to having laparoscopic surgery rather than the traditional opening of the operative area with a large incision. Which of the following is not an advantage? a. Reduction in risk for infection b. Less postoperative pain c. Easier-to-perform procedure d. Shorter recovery time

a,b,e,f,g

There are various purposes for which preoperative medications may be given. Which of the following purposes serve as a legitimate reason to administer a preoperative medication? (Select all that apply.) a. Provide relief of apprehension and anxiety b. Provide sedation c. Shorten surgery time d. Reduce risk for pneumonia e. Decrease gastric volume and acidity f. Prevent nausea and vomiting g. Dry secretions and prevent aspiration

Hemorrhage

Tracy Pugh was scheduled last month to have an elective cosmetic surgical procedure done tomorrow. Her preoperative laboratory results have just been posted. Her platelet count, at 75,000/mm3, is too low to proceed with surgery. Her low platelet count puts Tracy at risk for what complication?

The student should list any eight of the following: • Information regarding preoperative preparations, including diagnostic tests, nothing-by-mouth (NPO) status, skin shave or scrub, intestinal preparation, insertion of tubes or IVs, and administration of preoperative medications • What the patient can expect in the operating room (OR), including equipment, bright lights, cold temperatures, and masked staff members wearing caps and gowns that make it difficult to identify each one • Describe general roles of the various OR team members who will be responsible for the patient's care • What the patient will and may experience postoperatively once in the postanesthesia care unit • Actions the patient can take to help prevent complications, decrease discomfort, shorten recovery time, and optimize healing

What types of information should be included in preoperative teaching? List a minimum of eight items.

d

Which member of the surgical team is the primary patient advocate? a. The scrub nurse b. The surgeon c. The anesthesiologist d. The circulating nurse e. The assistant surgeon f. The certified registered nurse anesthetist

The circulating nurse

Which member of the surgical team must be a registered nurse as opposed to being a licensed practical nurse?