Chapter 18 PrepU 310

Which nursing diagnosis should the nurse plan to address first in the client upon arrival in the intraoperative setting?

Anxiety related to ineffective coping with surgical concerns

A 78 year old client is undergoing surgery to repair a right hip fracture. What nursing action is appropriate during the intraoperative phase?

Appropriately position the client using adequate padding and support

The nurse is completing a postoperative assessment for a patient who has received a depolarizing neuromuscular blocking agent. The nursing assessment includes careful monitoring of which body system?

Cardiovascular system

A patient is in the operating room for surgery. Which individual would be responsible for ensuring that procedure and site verification occurs and is documented?

Circulating nurse

The OR personnel responsible for maintaining the safety of the client and the surgical environment is the:

Circulating nurse

What are the circulating nurse's responsibilities, in contrast to the scrub nurse's responsibilities?

Coordinating the surgical team

The anesthesiologist administered a transsacral conduction block. Which documentation by the nurse is consistent with the anesthesia being administered?

Denies sensation to perineum and lower abdomen

A client is having a surgical procedure that requires the client to be in the prone position. What is an expected client outcome?

The client remains free of perioperative positioning injury

A perioperative nurse is conducting an in service education program about maintaining surgical asepsis during the intraoperative period. Which of the following would the nurse emphasize?

The edges of a sterile package, once opened, are considered unsterile

When practicing perioperative care, the nurse monitors clients for what symptoms that are indicative of malignant hyperthermia? Select all that apply.

Cyanosis,Muscle rigidity, Diaphoresis, Irregular heart rate

During the surgical procedure, the client exhibits tachycardia, generalized muscle rigidity, and a temperature of 103°F. The nurse should prepare to administer:

Dantrolene sodium (Dantrium)

A 70 year old patient who is to undergo surgery arrives at the operating room (OR). The nurse, when reviewing the patient's medical record, understands that this patient will require a lower dose of anesthetic agent because of which of the following?

Decreased lean tissue mass

The nurse recognizes that the older adult is at risk for surgical complications due to:

Decreased renal failure

A nurse is administering moderate sedation to a client with chronic obstructive pulmonary disease (COPD). The nurse bases her next action on the principle that

Elevate the head of the bed

Nursing students are reviewing information about agents used for anesthesia. The students demonstrate understanding when they identify which of the following as an inhalation anesthetic?

Halothane

The nurse is teaching the client about usual side effects associated with spinal anesthesia. Which of the following should the nurse include when teaching?

Headache

Which statement by the client indicates further teaching about epidural anesthesia is necessary?

I will become unconscious

A client is receiving general anesthesia. The nurse anesthetist starts to administer the anesthesia. The client begins giggling and kicking her legs. What stage of anesthesia would the nurse document related to the findings?

II

Which stage of surgical anesthesia is also known as excitement?

II

As a circulating nurse, what task are you solely responsible for?

Keeping records

The nurse recognizes the client has reached stage III of general anesthesia when the client:

Lies quietly on the table

The patient is having a repair of a vaginal prolapse. What position does the nurse place the patient in?

Lithotomy position

The nurse understands that the purpose of the "time out" is to:

Maintain the safety of the client

During a procedure, a client's temperature begins to rise rapidly. This is likely the result of which complication?

Malignant hyperthermia

Hypothermia may occur as a result of

Open body wounds

Fentanyl is categorized as which type of intravenous anesthetic agent?

Opioid

A client is to receive general anesthesia with sevoflurane. What does the nurse anticipate would be given with the inhaled anesthesia?

Oxygen

A nurse is monitoring a client recovering from moderate sedation that was administered during a colonoscopy. Which finding requires the nurse's immediate attention?

Oxygen saturation (SaO2) of 85%

Which conduction block anesthetizes the nerves supplying the chest, abdominal wall, and extremities?

Paravertebral anesthesia

The nurse positions the client in the lithotomy position in preparation for

Perineal surgery

The scrub nurse is responsible for:

Preparing the sterile instruments for the surgical procedure

A client receiving moderate sedation for a minor surgical procedure begins to vomit. What should the nurse do first?

Roll the client onto his or her side

A nurse who is part of the surgical team is involved in setting up the sterile tables. The nurse is functioning in which role?

Scrub role

The client vomits during the surgical procedure. The best action by the nurse is:

Suction the client to remove saliva and gastric secretions

Which of the following techniques least exhibits surgical asepsis?

Suctioning the nasopharyngeal cavity of a client

A nurse is working as a registered nurse first assistant as defined by the state's nurse practice act. This nurse practices under the direct supervision of which surgical team member?

Surgeon

Which clinical manifestation is often the earliest sign of malignant hyperthermia?

Tachycardia (heart rate >150 beats per minute)

The nurse is caring for a client during an intra operative procedure. When assessing vital signs, which result indicates a need to alert the anesthesiologist immediately?

Temperature of 102.5F (39C)

The nurse is working in the preoperative area with a client going to surgery for a cholecystectomy. The client has histamine2 receptor antagonists ordered preoperatively. The client asks the nurse why these medications are needed. What would be the nurse's best answer?

These medications decrease gastric acidity and volume

A client is brought to the operating room for an elective surgery. What is the priority action by the circulating nurse?

Verify consent

Which of the following is an inappropriate nursing action by the surgical nurse?

Wearing sterile gloves over artificial nails

Which of the following is the appropriate response to the statement, "I'm so nervous about my surgery"?

You seem nervous about your surgery

A client is undergoing a lumbar puncture. The nurse educates the client about surgical positioning. Which statement by the nurse is appropriate?

You will be lying on your side with your knees to your chest