Peri-Op Questions

During the admission history the client reports to the nurse of taking the usual dose of warfarin (Coumadin) the previous day. The appropriate nursing action is:

Notify the surgeon that the client took warfarin the day before surgery.

A client is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal(subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist's instructions. Why does the client require special positioning for this type of anesthesia?

to prevent cerebrospinal fluid (CSF) leakage

The nurse is admitting a patient who is scheduled for a hysterectomy. Malignant hyperthermia is a potential postoperative complication. In gathering information on the patient's medical history, the nurse should ask?

"Has anyone in your family ever had problems with general anesthesia?"

The client asks the nurse how the spinal anesthesia will be administered. The best response by the nurse is?

"The anesthesiologist will inject the anesthetic into the space around your lower spinal cord."

While receiving report from the operating room, the nurse learns that a client's surgical wound for gallbladder removal is classified as III. What could have caused this wound classification? Select all that apply.

-Gallbladder contents spilled into the surgical site. -A break in sterility occurred during the surgery.

A client is informed that a surgical procedure is to be scheduled in 2 weeks. Which teaching points should the nurse focus to prepare the client for the surgery?

-deep breathing & coughing -caring for the surgical incision -managing constipation -managing pain (Explanation: Maintaining a patent airway is a nursing action that is performed during the post-op phase of surgical care. In the pre-op phase, when the client is alert & oriented, the nurse should focus teaching on deep breathing & coughing exercises, care of the surgical incision, managing constipation, and managing pain)

The nurse is preparing an older adult client for surgery. Which topics should the nurse focus when preparing this client's preoperative teaching?

-level of hearing -teaching on deep breathing & coughing -plans for discharge -actions to prevent pressure ulcers

The postoperative nurse is planning care for a client recovering from major thoracic surgery. Which nursing diagnosis should the nurse select for this client's immediate care needs?

-risk for impaired gas exchange -risk for decreased cardiac output -risk for ineffective airway clearance

A patient will be undergoing a total hip arthroplasty later in the day and it is anticipated that the patient may require blood transfusion during surgery. How can the nurse best ensure the patient's safety if a blood transfusion is required?

Ensure that the patient has had a current cross-match.

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%

A patient underwent an open bowel resection 2 days ago and the nurse's most recent assessment of the patient's abdominal incision reveals that it is dehiscing. What factor should the nurse suspect may have caused the dehiscence?

The patient has vomited three times in the past 12 hours

A patient is scheduled for a surgical procedure. For which surgical procedure should the nurse prepare an informed consent form for the surgeon to sign?

an open reduction of fracture

A client who had abdominal surgery 4 days ago reports that "something gave way" when he sneezed. The nurse observes a wound evisceration. Which nursing action is the first priority?

aplying a sterile, moist dressing

When obtaining the patient's signature on the operative consent form, the patient seems confused about the procedure to be performed. The appropriate response by the nurse is to:

ask the patient what the physician told him & then call the physician if necessary

It is important for the nurse to assist a post surgical client to sit up and turn his or her head to one side when vomiting in order to?

avoid aspiration

The nurse should include the proper use of an incentive spirometer in teaching for a preoperative patient. Postoperative monitoring of this patient would reveal that the incentive spirometry has been effective if the patient has?

clear breath sounds

The nurse is caring for the postoperative patient who has had a spinal anesthesia. The nurse would place highest priority on reporting which assessment?

complaints of a headache

The nurse is preparing a client for emergency surgery to repair liver and colon lacerations caused by a motor vehicle crash. Which information about this type of surgery will the nurse use to guide the client's care?

this is an emergency surgery, the client will be hospitalized longer, the client is at risk for blood loss, the client is at risk for hypothermia

A patient diagnose with colon cancer is being prepared for palliative surgery to correct an intestinal obstruction. The nurse understands that palliative surgery is:

done to relieve symptoms or improve function without correcting the basic problem

The nurse is caring for a postoperative client with a hemovac. The hemovac is expanded and contains approximately 25 cc of serosanguineous drainage. The best nursing action would be to

empty and measure drainage and compress the hemovac

Which of the following should be incorporated into the patient teaching plan to prevent deep vein thrombosis?

encourage the client to move legs frequently and do leg exercises

A nurse assesses a postoperative patient to have the protrusion of abdominal organs through the surgical incision. Which term, documented by the nurse, best describes the assessment findings?

evisceration

A patient asks about the purpose of withholding food and fluid before surgery. Which response by the nurse is appropriate?

it prevents aspiration and respiratory complications

The nurse if doing an assessmnet of a patient who has returned from a cardiac catheterization & had conscious sedation. The nurse should report which of the following findings?

patient is difficult to arouse

One of the major dangers associated with deep venous thrombosis is?

pulmonary embolism

The postoperative care nurse reviews the documentation from the intraoperative phase and determines that several areas are missing. Which areas did the nurse identify as being missing from the intraoperative documentation?

start and stop times of anesthesia, antibiotic infusion times, start and stop times of the procedure

The nurse is discussing the various people whom the client will see when in the operating room suite. Which individuals should the nurse emphasize when discussing this aspect of the surgical process with the client?

surgeon, circulating nurse, anesthesiologist