Med Surg Chapter 17 Unit 2
A patient having a surgical procedure takes aspirin 325 mg daily for prevention of platelet aggregation. When should the patient stop taking the aspirin before the surgery?
7 to 10 days Explanation: Aspirin, a common OTC medication that inhibits platelet aggregation, should be prudently discontinued 7 to 10 days before surgery; otherwise, the patient may be at increased risk for bleeding (Rothrock, 2010)
A patient undergoes induction for general anesthesia at 8:30 a.m. and is being assessed continuously for the development of malignant hyperthermia. At which time would the patient be most likely to exhibit manifestations of this condition?
8:40 to 8:50 a.m. Explanation: Malignant hyperthermia usually manifests about 10 to 20 minutes after the induction of anesthesia, which in this case would 8:40 to 8:50 a.m.
The nurse is triaging the surgical patients. Which patient would the nurse document as urgent for surgical care?
A patient with an acute gallbladder infection Explanation: An acute gallbladder infection is considered an urgent surgical procedure. Cosmetic surgery and cataract surgery are not considered urgent surgical procedures. Severe bleeding could be considered an emergent surgical procedure
Required surgery
A required surgery means that the patient needs to have surgery.
Elective surgery
An elective surgery is classified as a surgery that the patient should have.
Urgent surgery
An urgent surgery is one which the patient required prompt attention.
When should the nurse encourage the postoperative patient to get out of bed?
As soon as it is indicated Explanation: Postoperative activity orders are checked before the patient is assisted to get out of bed, in many instances, on the evening following surgery. Sitting up at the edge of the bed for a few minutes may be all that the patient who has undergone a major surgical procedure can tolerate at first.
The OR personnel responsible for maintaining the safety of the client and the surgical environment is the:
Circulating nurse Explanation: The circulating nurse is responsible for maintaining the safety of the client and the surgical environment.
The nurse recognizes that the client most at risk for mortality associated with surgery is the:
Client with chronic alcoholism Correct Explanation: The client with chronic alcoholism who experiences alcohol withdrawal symptoms is at significant risk for mortality, which can be attributed to cardiac dysrthymias, cardiomyopathy, and bleeding tendencies.
What medication should the nurse prepare to administer in the event the patient has malignant hyperthermia?
Dantrolene sodium (Dantrium) Correct Explanation: Anesthesia and surgery should be postponed. However, if end-tidal carbon dioxide (CO2) monitoring and dantrolene sodium (Dantrium) are available and the anesthesiologist is experienced in managing malignant hyperthermia, the surgery may continue using a different anesthetic agent (Barash et al., 2009).
The nurse is physically preparing a client for surgery. What area does the nurse know needs to be addressed before the client is taken to the operating room?
Elimination Correct Explanation: When physically preparing a client for surgery these areas need to be addressed: skin preparation; elimination; attire/grooming; prosthesis; foods and fluids; and care of valuables. The physical preparation of a client for surgery does not include the areas of medication, activity, or the client's support system.
Emergent surgery
Emergent surgery occurs when the patient requires immediate attention.
A nurse asks a client who had abdominal surgery 3 days ago if he has moved his bowels since surgery. The client states, "I haven't moved my bowels, but I am passing gas." How should the nurse intervene?
Encourage the client to ambulate at least three times per day. Explanation: The nurse should encourage the client to ambulate at least three times per day. Ambulating stimulates peristalsis, which helps the bowels to move. It isn't appropriate to apply heat to a surgical wound. Moreover, heat application can't be initiated without a physician order. A tap water enema is typically administered as a last resort after other methods fail. A physician's order is needed with a tap water enema as well. Notifying the physician isn't necessary at this point because the client is exhibiting bowel function by passing flatus.
When integrating the principles for maintaining surgical asepsis during surgery, which of the following would be most appropriate?
Ensuring gown sleeves remain sterile 2 inches above the elbow to cuff Explanation: In the operating room, the sleeves of a gown are considered sterile from 2 inches above the elbow to the stockinette cuff. In addition, the gown is considered sterile in front from the chest to the level of the sterile field. When draping a table or patient, the sterile drape is held well above the surface to be covered and positioned from front to back. Circulating nurses and unsterile items contact only unsterile areas
First intention
First-intention healing is characterized by a closed incision with little tissue reaction and the absence of signs and symptoms of infection.
A patient has been administered ketamine (Ketalar) for moderate sedation. What is the priority nursing intervention?
Frequent monitoring of vital signs Explanation: Vital signs must be monitored frequently to assess for respiratory depression and intervene quickly. Oxygen may need to be administered if respiratory depression occurs; therefore, monitoring vital signs is a higher priority nursing intervention. Providing a dark quiet room is appropriate after the procedure is completed and the patient is recovering. Hallucinations may be experienced as a side effect of the medication
Which stage of anesthesia is termed surgical anesthesia?
III Correct Explanation: Stage III may be maintained for hours with proper administration of the anesthetic. Stage I is beginning anesthesia, where the patient breathes in the anesthetic mixture and experiences warmth, dizziness, and a feeling of detachment. Stage II is the excitement stage, which may be characterized by struggling, singing, laughing, or crying. Stage IV is a stage of medullary depression and is reached when too much anesthesia has been administered
During a procedure, a client's temperature begins to rise rapidly. This is likely the result of which of the following complications?
Malignant hyperthermia Explanation: This inherited disorder occurs when body temperature, muscle metabolism, and heat production increase rapidly, progressively, and uncontrollably in response to stress and some anesthetic agents. If the client's temperature begins to rise rapidly, anesthesia is discontinued, and the OR team implements measures to correct physiologic problems, such as fever or dysrhythmias. Hypothermia is a lower than expected body temperature. Signs of infection would not present during the procedure. Increased body temperature would not indicate fluid volume excess
After teaching a class about agents commonly associated with the development of malignant hyperthermia, the instructor determines that additional teaching is needed when the students identify which drug as a possible cause?
Morphine Explanation: Morphine is not associated with malignant hyperthermia. Agents such as halothan, succinylcholine, and epinephrine can induce malignant hyperthermia.
What is the priority action by the scrub nurse when the surgeon is starting to close the surgical wound?
Obtain a sponge count. Explanation: Standards call for the scrub nurse and the circulating nurse to obtain a sponge count at the beginning of the surgery when the surgical wound is being sutured and when the skin is being sutured. Tissue specimens should be labeled when obtained. The sutures should be ready prior to the surgeon needing them. While the scrub nurse hands equipment to the surgeon, the sponge count is a higher priority action.
A postoperative patient, with an open abdominal wound is currently taking corticosteroids. The physician orders a wound culture of the abdominal wound even though there are no signs and symptoms of infection. What action by the nurse is appropriate?
Obtain the wound culture specimen. Explanation: Corticosteroids may mask the presence of infection by impairing the normal inflammatory response. The culture should be obtained even though the patient is not demonstrating traditional signs and symptoms of infection. The order should not be discontinued or held until purulent drainage is noted because the infection could worsen and the patient will possibly develop sepsis. An antibiotic cleaning agent should not be used before obtaining the specimen because it will alter the growth of the organisms
Trendelenburg position
On his back, with his head lowered, so that the plane of his body meets the horizontal on an angle. The Trendelenburg position usually is used for surgery on the lower abdomen and pelvis to obtain good exposure by displacing the intestines into the upper abdomen
A patient is scheduled for a reduction mammoplasty. What classification of surgery does the nurse understand that this is?
Optional Explanation: Cosmetic surgery, including reduction mammoplasties, is optional, as the decision to have the surgery rests with the patient.
An intravenous anesthetic that, in large doses, has a powerful respiratory depressant effect sufficient to cause apnea and cardiovascular depression is:
Pentothal Correct Explanation: Thiopental sodium (Pentothal) is commonly used for induction anesthesia. It may cause laryngospasm. Large doses can cause apnea and cardiovascular depression.
The nurse recognizes that written informed consent is required for insertion of a(n):
Peripherally-inserted central catheter. Correct Explanation: Nonsurgical invasive procedures, such as insertion of a peripherally-inserted central catheter, that carry more than a slight risk to the client require written informed consent.
A postoperative client is experiencing a flash pulmonary edema. What finding in the client's sputum is consistent with this problem?
Pink color Explanation: Flash pulmonary edema that occurs when protein and fluid accumulate in the alveoli unrelated to elevated pulmonary artery occlusive pressure. Signs and symptoms include agitation, tachypnea, tachycardia, decreased pulse oximetry readings, frothy, pink sputum, and crackles on auscultation.
An obese patient is scheduled for open abdominal surgery. What priority education should the nurse provide this patient?
Prevention of respiratory complications All answers are correct but the obese patient has an increased susceptibility to respiratory complications, and maintaining a patent airway would be the priority.
The anesthesiologist will use moderate (conscious) sedation during the client's surgical procedure. The circulating nurse will expect the client to:
Respond verbally during the procedure Explanation: Clients can respond to verbal and physical stimuli and maintain an oral airway and protective reflexes during moderate sedation.
(see full question) Which method of wound healing is one in which wound edges are not surgically approximated and integumentary continuity is restored by granulation?
Second-intention healing Explanation: When wounds dehisce, they will be allowed to heal by secondary intention. Primary or first-intention healing is the method of healing in which wound edges are surgically approximated and integumentary continuity is restored without granulating. Third-intention healing is a method of healing in which surgical approximation of wound edges is delayed and integumentary continuity is restored by bringing apposing granulations together.
There are four stages of general anesthesia. Select the stage during which the OR nurse knows not to touch the patient (except for safety reasons) because of possible uncontrolled movements.
Stage II: excitement Correct Explanation: The excitement stage, characterized variously by struggling, shouting, talking, singing, laughing, or crying, is often avoided if the anesthetic is administered smoothly and quickly. Because of the possibility of uncontrolled movements, the patient should not be touched except for purposes of restraint
Stage IV
Stage IV: medullary depression is characterized by shallow respirations, a weak, thready pulse, dilated pupils that do not react to light, and cyanosis.
The nurse is aware that the amino acid, arginine,
Stimulates T-cell response Correct Explanation: Arginine is necessary for collagen synthesis and deposition, increases wound strength, and stimulates T-cell response.
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 Correct Explanation: The registered nurse first assistant practices under the direct supervision of the surgeon. The circulating nurse works in collaboration with other members of the health care team to plan the best course of action for each patient. The scrub nurse assists the surgeon during the procedure as well as setting up sterile tables and preparing equipment. The anesthetist administers the anesthetic medications
The nurse is caring for a patient who is at risk for malignant hyperthermia subsequent to general anesthesia. What is the most common early sign that the nurse should assess for?
Tachycardia Explanation: The initial symptoms of malignant hyperthermia are related to cardiovascular and musculoskeletal activity. Tachycardia (an abnormally high heart rate) is often the earliest sign. Sympathetic nervous stimulation also leads to ventricular dysrhythmia, hypotension, decreased cardiac output, oliguria, and, later, cardiac arrest. With the abnormal transport of calcium, rigidity or tetanuslike movements occur, often in the jaw. Generalized muscle rigidity is one of the earliest signs.
Which of the following clinical manifestations is often the earliest sign of malignant hyperthermia?
Tachycardia (heart rate above 150 beats per minute) Explanation: Tachycardia is often the earliest sign of malignant hyperthermia. Hypotension is a later sign of malignant hyperthermia. The rise in temperature is actually a late sign that develops rapidly. Scant urinary output is a later sign of malignant hyperthermia.
The nurse should determine that a client is coughing effectively after surgery if the nurse observes which of the following activities?
The client takes a deep abdominal breath and then "huff" or "hack" coughs three or four times. Explanation: Taking a deep abdominal breath and then "huff" coughing is the most effective manner of coughing. This technique helps facilitate removal of secretions and conserves energy for the client. The client should breathe slowly but not hold her breath. Short, panting breaths and then coughing from the throat do not promote expectoration of sputum from the lungs. Coughing forcefully can cause alveoli to collapse; "huff" coughing prevents this.
When is the ideal time to discuss preoperative teaching
The ideal timing for preoperative teaching is not on the day of surgery but during the preadmission visit, when diagnostic tests are performed. Teaching should be done long before the patient enters the preop area. Preoperative teaching should not be done when the patient is sedated.
What action during a surgical procedure requires immediate intervention by the circulating nurse?
The scrub nurse calling the blood bank to obtain blood products Explanation: The scrub nurse is "scrubbed" in and should only come in contact with sterile equipment. Using the phone to call the blood bank is the responsibility of the circulating nurse and it would break the sterility of the scrub nurse. The surgeon has "scrubbed" and should only touch within sterile fields. The anesthesiologist should monitor blood gas levels as needed, and it is appropriate for the registered nurse first assistant to suture the surgical wound
Sudden withdrawal of which of the following may result in seizures?
Tranquilizers Correct Explanation: Abrupt withdrawal of tranquilizers may result in anxiety, tension, and even seizures if withdrawn suddenly. Abrupt withdrawal of steroids may precipitate cardiovascular collapse. Monoamine oxidase inhibitors increase the hypotensive effects of anesthetics. Thiazide diuretics may cause excessive respiratory depression during anesthesia due to an associated electrolyte imbalance
A patient begins to vomit during surgery. Place the actions below in the order in which they would be performed.
Turn the patient to the side. Lower the head of the surgical table. Provide a basin for collection. Suction to remove saliva. Explanation: If a patient gags or begins to vomit, the patient is turned to the side, the head of the table is lowered, and a basin is provided to collect the vomitus. Suction is used to remove saliva and vomited gastric contents.
A perioperative nurse is assigned to complete a preoperative assessment on a patient who is scheduled for surgery for kidney stones. The nurse knows that the surgery is scheduled the following day and would therefore be classified as:
Urgent Explanation: Surgery for kidney or urethral stones requires prompt attention and is considered urgent.
A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?
Use diaphragmatic breathing. Explanation: In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing helps to strengthen the diaphragm and maximizes ventilation. Exhalation should be longer than inhalation to prevent collapse of the bronchioles. The client with chronic bronchitis should exhale through pursed lips to prolong exhalation, keep the bronchioles from collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing — increases lung expansion.
Which of the following sets of clinical data would allow the nurse to conclude that the nursing actions taken to prevent postoperative pneumonia have been effective?
Vital signs within normal limits; absence of chills and cough Explanation: Pneumonia is characterized by chills, fever, tachypnea, tachycardia, and sometimes cough.
Select the nutrient that is important for postoperative wound healing because it helps form collagen.
Vitamin C Explanation: Vitamin C is important for capillary formation, tissue synthesis, and wound healing through collagen formation. Vitamin A decreases the inflammatory response in wounds. Magnesium is essential for wound repair, and protein allows collagen deposition.
Lithotomy Explanation: The lithotomy position is used for nearly all perineal, rectal, and vaginal surgeries.
Which position is used for perineal surgical procedures?
The potential effects of prior medication therapy must be evaluated before surgery. Which of the following drug classifications may cause respiratory depression from an associated electrolyte imbalance during anesthesia?
You selected: Corticosteroids Incorrect Correct response: Diuretics - Diuretics because they decrease blood pressure.
The nurse recognizes that a traumatic wound with fecal contamination would be classified as
dirty. Explanation: An example of a dirty wound includes a traumatic wound with delayed repair, devitalized tissue, foreign bodies, or fecal contamination. A clean wound is at a nontraumatic site or at an uninfected site. Examples of clean-contaminated wounds include appendectomy or a minor break in aseptic technique. An example of a contaminated wound is gross spillage from the GI tract.
The nurse is preparing a client for surgery. The nurse would notify the surgeon if the client made which of the following statements?
• "I took my Coumadin as usual last evening." • "I took two aspirins for joint pain this morning." The nurse needs to alert the surgeon to any medications the client has taken that increase the client's risk for bleeding. Aspirin inhibits platelet aggregation and should be stopped at least 7 to 10 days prior to surgery. Coumadin (warfarin) interferes with the synthesis of vitamin K-dependent clotting factors. The type of surgical procedure and the medical condition of the client determine when the Coumadin should be stopped prior to surgery
The nurse is reviewing a preoperative informed consent when preparing the client for surgery. Which contents of the informed consent are required? Select all that apply.
• Explanation of procedure • Potential risks • Benefits of surgery • Description of alternatives Explanation: Informed consents should be in writing and contain an explanation of procedure and risks, description of benefits and alternative, an offer to answer questions about procedure, ability to withdraw consent, and statement informing the client if the protocol differs from customary procedure. An estimated time of procedure and personnel present are not required in the informed consent.
You are providing preoperative care to a 51-year-old male client who is anxious about his total hip replacement surgery. "What if I can never walk again? I don't want to end up like my father!" What are some ways you might help alleviate his anxiety? Select all that apply.
• Make sure the client understands what will happen during surgery. • Listen empathetically to the client's concerns about the procedure. • Review the client's postoperative goals following the procedure. • Ask the client if he would like to speak with a clergyperson. Preparing the client emotionally and spiritually is as important as doing so physically. Anxiety and fear, if extreme, can affect a client's condition during and after surgery. Careful preoperative teaching and listening by the nurse about what will happen and what to expect can help allay some of these fears and anxieties.
A 76-year-old patient had surgery for an abdominal hernia. The PACU nurse assesses that the patient is confused and is trying to climb out of the bed and pull at the cardiac monitor lines. At this time, what interventions by the nurse are appropriate? Select all that apply.
• Reorient the patient. • Assess for hypoxia. • Assess for urine output. Explanation: The nurse should provide reassurance and reorient the patient as needed. Hypoxia and urinary retention may cause acute confusion in the older adult postoperative patient, so it would be appropriate for the nurse to assess for hypoxia and urine output. Opioid pain medications may cause further confusion; consultation with the physician about the type and dosage of the pain medication should occur. Ambulating the patient may be a safety issue, especially if the patient is bleeding or hypoxic. Applying wrist restraints should only be used as a last resort
A physician's admitting note lists a wound as healing by second intention. What does the nurse expect to find?
A wound in which the edges were not approximated Explanation: Second-intention healing (granulation) occurs in infected wounds (abscess) or in wounds in which the edges have not been approximated.
Patients who have received corticosteroids preoperatively are at risk for which type of insufficiency?
Adrenal Correct Explanation: Patients who have received corticosteroids are at risk of adrenal insufficiency. Insufficiency related to corticosteroids does not occur to the pituitary, thyroid, or parathyroid glands
During the preoperative assessment, the nurse learns that the client has been taking prednisone. The nurse realizes that the client is at risk for:
Cardiovascular collapse. Correct Explanation: Prednisone, a corticosteroid, can result in cardiovascular collapse if suddenly discontinued. A bolus of corticosteroid may be given intravenously immediately before and after surgery. Hydrochlorothiazide and anesthetics may interact, resulting in respiratory depression. Phenothiazines may potentiate the hypotensive action of anesthetics. Anticoagulants can increase the risk of bleeding.
(see full question) A PACU nurse receives a postoperative patient who received general anesthesia with a hard plastic oral airway in place. The patient has clear lung sounds, even and unlabored respirations of 16, and an oxygen saturation of 98%. The patient is minimally responsive to painful stimuli. What action by the nurse is most appropriate?
Continue with frequent patient assessments. Explanation: An immediate postoperative patient may be transferred to the PACU with a hard plastic oral airway. The airway should not be removed until the patient is showing signs of gagging or choking. The neurological status is appropriate for a patient that received general anesthesia. There is no information provided that requires the patient to have vitals taken more frequently than the standard 15 minutes. The nurse should continue with frequent patient assessments.
A nurse is caring for a client with a postoperative wound evisceration. Which action should the nurse perform first?
Cover the protruding internal organs with sterile gauze moistened with sterile saline solution. Correct Explanation: Immediately covering the wound with moistened gauze prevents the organs from drying. The gauze and the saline solution must be sterile to reduce the risk of infection. Although providing support to reduce the client's anxiety is important, it isn't the priority nursing action. The organs shouldn't be pushed back into the abdomen; doing so may tear or damage them. Evisceration requires emergency surgery; therefore, the nurse should put the client on nothing-by-mouth status immediately.
Nursing assessment findings reveal urinary output < 30 ml/hr, tachycardia, tachypnea, decreased hemoglobin, and acute confusion. The findings are indicative of which nursing diagnosis?
Decreased cardiac output Explanation: Clinical manifestations of decreased cardiac output include tachycardia, tachypnea, urinary output < 30 ml/hr, decreased hemoglobin and hematocrit, and acute confusion.
A medical student, scheduled to observe surgery, enters the unrestricted surgical zone wearing jeans, a t-shirt, and tennis shoes. What is the best action by the nurse?
Educate the medical student on required attire for each surgical zone. Explanation: It would be best to educate the medical student on the required attire for each surgical zone. Since the student will be observing a surgery, the student will need to dress appropriately in each zone to decrease the risk of introducing pathogens. The unrestricted zone allows for street clothes; therefore, the student does not need to be removed. If no action is taken by the nurse, the student could enter the semirestricted or restricted zone without appropriate attire. Providing a cap and mask does not address the need to change out of the street clothes to observe the surgery
Nursing assessment findings reveal a temperature of 96.2°F, pulse oximetry 90%, shivering, and client complains of chilling. The findings are indicative of which nursing diagnosis?
Ineffective thermoregulation Explanation: Clinical manifestations of hypothermia include a low body temperature, shivering, chilling, and hypoxia.
You are physically preparing a client for surgery and instruct the person to remove any jewelry. The client refuses to remove a wedding band. What should you do in this situation with approval from your facility?
Place gauze under and over the ring and apply adhesive tape over it. Explanation: If the client is reluctant to remove a wedding band, the nurse may slip gauze under the ring, then loop the gauze around the finger and wrist or apply adhesive tape over a plain wedding band. You would not tell the client that he or she cannot go to the operating room wearing the ring. You would never medicate the client and then remove the ring against his or her will. It is not necessary to tell the physician and the anesthesiologist that the client does not want to remove the wedding band.
When caring for a postsurgical patient, the nurse observes that the client has hemorrhaged and is in hypovolemic shock. Which nursing intervention will manage and minimize hemorrhage and shock?
Reinforcing dressing or applying pressure if bleeding is frank Explanation: The nurse should reinforce the dressing or apply pressure if bleeding is frank. The nurse should keep the head of the bed flat unless it is contraindicated. Encouraging the patient to breathe deeply will not help manage and minimize hemorrhage and shock. Monitoring the vital signs every 15 minutes is an appropriate nursing intervention but will not minimize hemorrhage and shock; it will just help to determine the extent and progression of the problem.
A postoperative client is being evaluated for discharge and currently has an Aldrete score of 8. Which of the following is the most likely outcome for this client? You selected: The client can be discharged from the PACU.
The Aldrete score is usually 8 to 10 before discharge from the PACU. Clients with a score of less than 7 must remain in the PACU until their condition improves or they are transferred to an intensive care area, depending on their preoperative baseline score
A client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse's first response is to:
place saline-soaked sterile dressings on the wound. Explanation: The nurse should first place saline-soaked sterile dressings on the open wound to prevent tissue drying and possible infection. Then the nurse should call the physician and take the client's vital signs. The dehiscence needs to be surgically closed, so the nurse should never try to close it.
Which of the following factors may contribute to rapid and shallow respirations in a postoperative client? Select all that apply.
• Pain • Constricting dressings • Abdominal distention • Obesity Explanation: Often, because of the effects of analgesic and anesthetic medications, respirations are slow. Shallow and rapid respirations may be caused by pain, constricting dressings, gastric dilation, abdominal distention, or obesity.
A postanesthesia care unit (PACU) nurse is caring for a patient with the following assessment data: pale, cool, moist skin; thready pulse of 122; blood pressure 78/60; urine output of 25 mL/h; temperature 99.2°F. What interventions by the nurse are appropriate? Select all that apply.
Correct response: • Maintain a patent airway. • Frequently monitor neurological status. • Administer blood products per orders. • Apply oxygen per orders. Explanation: The patient is demonstrating signs and symptoms of shock. The patient in shock may lose the ability to protect his or her airway. Frequently neurological assessment can provide information related to decrease oxygen to the brain. Administering the blood products may reverse the signs and symptoms of shock. There is an increased need for oxygen when in shock, so it is appropriate to apply oxygen. The head of the bed should not be elevated. The patient should be lying flat or in the Trendelenburg position. Applying a warming blanket when the patient is not hypothermic may cause vasodilation, which could further decrease blood pressure and perfusion to vital organs
An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?
Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients. Explanation: The underlying principle that guides preoperative assessment, surgical care, and postoperative care is that elderly clients have less physiologic reserve (the ability of an organ to return to normal after a disturbance in its equilibrium) than younger clients. The hazards of surgery for the elderly are proportional to the number and severity of coexisting health problems and the nature and duration of the operative procedure. Respiratory and cardiac complications are the leading causes of postoperative morbidity and mortality in older adults
A 17-year-old male client is having same-day surgery to remove a neuroma from his foot. Which of the following nursing interventions would occur during the intra operative phase of peri operative care?
The nurse continuously monitors the sedated client. Explanation: Intraoperative care includes the entire surgical procedure. During sedation, the nurse continuously evaluates the client. Monitoring during all phases includes assessment of heart rate, respiratory rate, BP, oxygen saturation, and level of consciousness. This would occur during the preoperative phase of perioperative care. During the postoperative phase of perioperative care, an important assessment is determining how the client is recovering from anesthesia.
