PRE and POST op evolve

Which statement by the nurse about the effects of ambulation in the postoperative period indicates effective learning?

"Early ambulation helps hasten postoperative recovery."

The nurse is providing educational packets to a patient before gallbladder removal surgery. Which question would the nurse ask to determine whether the patient can read and understand the material presented?

"Can you please tell me, in your own words, what you're reading in this packet?"

The nurse is planning care after a right hip replacement in a patient who smokes cigarettes. Which postoperative instruction would be most important to prevent respiratory complications in a patient who smokes cigarettes?

"Use the incentive spirometer 10 times every hour while awake." Patients who smoke and undergo anesthesia for surgery are at an increased risk for atelectasis and pneumonia. It is important for these patients to diligently perform breathing exercises, such as using the incentive spirometer.

A nurse is assessing a patient who underwent a surgical procedure. The nurse notices a decrease in blood pressure; rapid, thready pulse; cool, clammy, pale skin; tachypnea; and restlessness. Which complication does the nurse suspect?

A drop in blood pressure; rapid, thready pulse; cool, clammy, pale skin; tachypnea; and restlessness are symptoms of hemorrhage. Postoperative hemorrhage may lead to a loss of intravascular volume leading to a drop in blood pressure and a weak, thready pulse. Heart rate and respiratory rate increase to compensate for the low intravascular volume to maintain tissue perfusion.

Which condition in the postoperative patient will indicate that the fluid status is normal?

A urinary output of 30 mL/hr indicates that the patient's fluid balance is normal.

The nurse is caring for a patient who just underwent right hip replacement. The nurse would be most concerned with preventing which postoperative complication?

Although pneumonia, constipation, and muscle atrophy are complications of hip replacement surgery, the most serious and life-threatening complication is an embolus, which could lead to stroke, heart attack, and death.

A patient is scheduled for surgery. The patient has been fasting for the whole night. The surgery was postponed for 3 hours, and the patient feels hungry. Which type of food would be most appropriate to give to the patient?

Clear liquids

Which complications are associated with surgical incisions in a patient?

After a surgery, there is a risk for dehiscence or separation of a surgical incision or rupture of a wound closure within 3 to 14 days. It is associated with postoperative complications, such as distention, vomiting, excessive coughing, dehydration, or infection. Another complication related to surgical wounds is wound evisceration or protrusion of an internal organ through a wound or surgical incision.

The nurse is caring for a patient with cholecystitis who is scheduled for gallbladder removal surgery in 2 hours. Although the patient reports that the patient's pain is well controlled, the patient remains tachycardic, tachypneic, and diaphoretic. When asked what is bothering him, the patient replies, "Nothing. Everything's fine. Will you just leave me alone?" Which response by the nurse is best?

Although the patient states he is fine, his appearance and vital signs suggest otherwise. It is common for patients to be anxious or afraid before surgery. Acknowledging that even though the patient states he is fine, he seems otherwise, prompts the patient, in a nonthreatening manner, to be open about his concerns.

Which action should the nurse perform to help prevent postoperative respiratory complications?

Ambulation within a few hours of surgery helps return cardiovascular and respiratory functions to normal more quickly. The nurse should encourage the patient to use the incentive spirometer device 8 to 10 breaths every hour. The best time to teach the patient about the incentive spirometer is during the preoperative phase.

During the immediate postoperative period, a patient with an external sequential compression device (SCD) wants to ambulate and then sit up for an hour or so without the device. Which statement by the nurse accurately addresses the patient's request?

An SCD device should not be disconnected for more than 30 minutes. The amount of time allowed out of bed when an SCD is being used is not based on whether the patient feels up to it. Patients with an SCD are not confined to bed. Regardless of how well the patient tolerates sitting on the side of the bed, the patient will not be allowed to get out of bed with the device disconnected for an hour.

During the preoperative assessment, the nurse learns the patient has an allergy to bananas. The nurse would be concerned about an allergy to which substance commonly used during surgery?

An allergy to bananas increases the patient's risk for an allergic reaction to latex, which is commonly used in surgery

Which food allergies indicate that a patient is susceptible to latex allergy?

An allergy to kiwi fruit, chestnuts, or avocadoes shows cross-sensitivity to latex. If the patient has an allergy to these foods, then the patient needs to be assessed for latex allergy as well.

Which statement regarding preoperative medication is true?

An introduction to PCA preoperatively is advantageous because the patient is better able to comprehend the concept and operation of the equipment. Surgery cancels all medications prescribed before surgery except for conditions of longstanding duration, such as phenytoin (Dilantin) for seizure control. The surgeon will prescribe medication again, as necessary, after surgery. The nurse institutes safety procedures, such as keeping the bed in low position and the side rails up and monitoring the patient every 15 minutes until the patient leaves for surgery. The patient who has received an opioid analgesic usually requires a smaller amount of anesthetic once in surgery. After receiving preoperative medication, the patient must remain in bed.

The nurse is caring for a patient 6 hours after arrival on the floor after an appendectomy. The nurse notes the patient has not urinated since before the surgery.

Anesthesia can lead to urinary retention, so it is important to monitor the patient's urine output. If the patient has not urinated 8 hours after surgery, the nurse should palpate for urinary retention and alert the health care provider. However, this patient only returned from surgery 6 hours ago, so the appropriate action is to encourage oral fluid intake. It may be necessary to catheterize the patient, but this requires a health care provider prescription and is not appropriate at this time.

The nurse is performing a preoperative assessment on a patient and notes that the patient appears anxious. The nurse understands that preoperative anxiety can have which effect on the patient postoperatively?

Anxiety before surgery can lead to increased length of recovery after surgery, increased pain medication requirements, and increased anesthesia needs. Preoperative anxiety has not been shown to increase risk for hemorrhage.

The nurse is attending to an elderly patient scheduled for a hernia operation. The nurse understands that as a result of aging, the patient may have rigid blood vessel walls and a reduction in sympathetic and parasympathetic innervations to the heart. Which risks increase in this patient following a surgery?

As the body ages, the blood vessel walls become rigid, causing reduction in sympathetic and parasympathetic innervations to the heart. These changes may increase the risk of hemorrhage following a surgery. The patient may also develop an increase in systolic and diastolic pressures. In postoperative patients, lung expansion may be reduced because of decreased strength of the respiratory muscles. After a surgery, the patient may have decreased ability to eliminate drugs because of reduced renal function.

The nurse is providing care for a patient after a right hip replacement. The nurse knows it is vital to turn the patient every 2 hours while the patient is immobile; however, the patient refuses to turn in bed. Which nursing action is best?

Ask the patient why he refuses to turn in bed. The patient may refuse to turn in bed because he feels weak, is in too much pain, or is afraid to reinjure his hip. The nurse can base her interventions around his response. The nurse can ask the charge nurse to help her turn the patient once the patient has agreed and is prepared to turn. It may be necessary to provide more pain medication, but this is presumptive. Although it may be helpful to explain the risks of immobility to the patient, this may not be the best intervention at this time.

The nurse is caring for a patient with an intestinal obstruction. Suddenly, the patient becomes tachycardic, tachypneic, and hypotensive. On assessment, the nurse notes a boardlike abdomen and suspects an intestinal perforation. The nurse knows to prepare the patient for which type of surgery?

Bowel perforation is a medical emergency and must be surgically treated immediately to preserve life. This surgery would not be considered urgent or elective, and transplantation would not occur.

Which factors influence a patient's ability to tolerate a surgery?

Children and elderly patients do not tolerate major surgical procedures well because their rate of metabolism is slower than adults. Therefore, they have a slower response to physiologic changes. Patients who have good overall general health have smoother and faster recovery periods compared with patients with existing health problems. Patients who have a sound nutritional diet recover faster.

Which routine type of sedation might be used for a surgical procedure that does not require complete anesthesia but, rather, a depressed level of consciousness?

Conscious sedation is a routine type of sedation that might be used for a surgical procedure that does not require complete anesthesia but, rather, a depressed level of consciousness. A patient under conscious sedation must independently retain a patent airway and airway reflexes and be able to respond appropriately to physical and verbal stimuli.

The nurse is teaching controlled coughing to a patient after abdominal surgery. Which action is a priority that would be taught in this case?

Deep breathing or coughing places additional stress on the suture line and causes discomfort. Therefore, the nurse splints the incision firmly with hands to reduce incisional pulling. It is not necessary to assess the patient's vital signs because deep breathing does not have any adverse effect on the blood pressure and heart rate. The patient is placed in an upright position to facilitate deep breathing and optimal chest expansion. The patient needs to cough two or three consecutive times without inhaling between coughs to remove mucus more effectively.

Which statement is accurate regarding the older adult facing surgery?

Disorientation or toxic reactions can occur in the older adult after the administration of anesthetics, sedatives, or analgesics. These reactions are often present for days after administration of the medication.

The nurse observes that a postsurgical patient is experiencing symptoms of atelectasis. Which intervention does the nurse implement before reporting to the health care provider?

Dyspnea is a symptom of atelectasis that can be relieved by raising the head of the patient's bed.

In the operating room, a patient tells a circulating nurse that the cataract in the patient's left eye will be removed. If the nurse notes that the consent form indicates that surgery is to be performed on the right eye, which action should the nurse perform first?

Ensuring proper identification of a patient is the responsibility of all members of the surgical team. In a specialty surgical setting, where many patients undergo the same type of surgery each day, such as cataract removal, it is possible that the patient and the record do not match. Nurses should not make assumptions in the care of their patients. The surgical team should perform a timeout where all the team members participate in the identification of the patient. The surgeon and the anesthesiologist are notified once the nurse has confirmed the patient's name and identity. The nurse should not assume that the patient is confused because of old age or premedication. Preoperative medications can be checked after identifying the patient. The patient should first be identified and then further procedures should be carried out.

A patient is scheduled for a coronary artery bypass graft surgery (CABG) under general anesthesia. Which information does the nurse include when explaining general anesthesia to the patient?

General anesthesia involves anesthetizing the entire body. This is the preferred method of anesthesia in major surgeries, such as CABG. The route of administration is IV or inhalation. The amount of drug required is calculated by the anesthetist and depends on the patient's status, weight, duration of surgery, and so on

Which interventions should the nurse implement while encouraging early ambulation in a postoperative patient?

If the patient has a nasogastric tube, it needs to be clamped during ambulation to prevent the stomach contents from draining out. The nurse asks the patient to perform muscle-strengthening exercises, such as bending, lowering, and pressing back knees hard against the bed, to facilitate easy ambulation. The nurse asks the patient to sit on the side of the bed before ambulating for the first time to prevent fluctuation of the vital signs. The nurse encourages the patient to walk farther at each ambulation to improve stamina and functioning. To prevent any accidents, it is necessary to obtain help from another colleague while ambulating an unsteady patient receiving IV fluids.

A postoperative patient is instructed to avoid iced and carbonated beverages in diet to reduce gastrointestinal disturbances. However, the nurse observes that nausea and vomiting persists in the patient. Which order does the nurse expect from the health care provider?

If nausea and vomiting persists even after limiting iced and carbonated beverages in diet, the patient is prescribed antiemetic medications, such as promethazine (Phenergan), benzquinamide (Emete-con), ondansetron (Zofran), or prochlorperazine (Compazine). The patient is encouraged to take six to eight ounces of fluids per hour when oral fluids are introduced after surgery. The patient needs to be on nothing by mouth (NPO) status at midnight before surgery to decrease the risk of intra- and postoperative vomiting and aspiration. Intravenous fluids are administered after the surgery until the patient is able to tolerate oral fluids. Intravenous fluids will not help prevent nausea and vomiting. Instead, antiemetic medications are given intravenously or rectally to stop nausea and vomiting.

The nurse is assessing gastrointestinal function in a postoperative patient. Which assessment finding would indicate that there is normal peristalsis?

If the nurse hears 5 to 30 gurgles in the abdomen per minute, it indicates that the patient has normal peristalsis and the patient can consume foods and fluids. An absence of bowel sounds may indicate a decrease in or absence of intestinal peristalsis, which needs to be reported immediately. Ability to turn every 2 hours will not indicate that the patient has normal gastrointestinal function, but the turning exercise aids gastrointestinal functioning. Experiencing flatus after consuming food indicates the presence of intestinal gas, which is relieved by limiting iced beverages and offering warm liquids.

The nurse is preparing to care for a patient who has just returned from major abdominal surgery. Which intervention by the nurse in the immediate postoperative period will best prevent cardiovascular complications?

In the immediate postoperative period, the nurse should place the SCDs on the patient's legs to promote venous blood return while the patient is immobile. The nurse should facilitate the movement of the patient's arms and legs, not restrict it. Turning, coughing, and deep breathing are important interventions for the respiratory system. Although the patient should ambulate as soon as possible, this is not the best action in the immediate postoperative period.

Which stage of general anesthesia includes the administration of anesthetic agents and endotracheal intubation?

Induction is the stage of general anesthesia that includes the administration of anesthetic agents and endotracheal intubation. Stage IV begins with the cessation of respirations and must be avoided, or it will necessitate the initiation of cardiopulmonary resuscitation and may lead to death. During the emergence phase of anesthesia, anesthetics are decreased, and the patient begins to awaken. Because of the short half-life of currently used anesthetic agents, emergence may occur in the operating room. The maintenance phase of anesthesia includes positioning the patient and preparing the skin for incision, and the surgical procedure itself.

Which different categories of anesthesia are used in surgical procedures?

Local anesthesia involves loss of sensation at the desired site and is commonly used for minor surgical procedures, such as a biopsy of a tumor or removal of a growth. Conscious sedation involves giving drugs that depress the central nervous system or provide analgesia to relieve anxiety or provide amnesia during surgical diagnostic procedures. General anesthesia is used for major surgery requiring extensive tissue manipulation, and it produces amnesia, analgesia, muscle paralysis, and sedation. Regional anesthesia causes loss of sensation in an area of the body and is used for some surgical procedures and pain management. Epidural anesthesia is a type of general anesthesia.

Which statement regarding culture and ethnic considerations is considered to be a true statement?

Native Americans are often stoic when ill. Complaints of pain to the nurse may be in general terms, and undertreatment of pain is common. Verbal consent has more meaning than written consent among Arab Americans because it is based on trust. Chinese Americans may not ask for pain medications after surgery and may require education about pain relief. Direct eye contact may be avoided and considered disrespectful to many Southeast Asians and American Indians.

The nurse observes that a postoperative patient is unable to void after 7 hours. Which intervention does the nurse implement to encourage voiding in the patient?

Noninvasive measures, such as having the patient listen to running water, may facilitate voiding in the patient. Placing the patient's hands in warm water and helping the patient ambulate to the bathroom or bedside commode if the patient is able are other measures to encourage voiding in patients. Increasing the patient's fluid intake will not help the patient to void because anesthesia depresses urinary function. The nurse needs to obtain a prescription for catheterization only after all noninvasive measures for facilitating voiding have failed.

The nurse is performing an initial assessment of a patient who just returned from surgery. The nurse notes bright red on the surgical dressing. Which nursing action is best?

Occasionally, the patient will return from surgery with bloody drainage on the surgical dressing. The nurse should outline the drainage in permanent marker and reassess frequently. If the spot increases, the nurse should contact the health care provider. In general, the first dressing change is performed at a predetermined time by the surgeon; it is inappropriate for the nurse to change the dressing at this time, and it is not necessary to reinforce the dressing as yet. It is not necessary to call the health care provider and prepare the patient to return to surgery at this time.

Which common postoperative complications are likely to be found in patients who are obese?

Patients who are obese are more susceptible to postoperative complications. Embolus forms from venous stasis in the lower extremities. Atelectasis and pneumonia occur because of immobility, reduced ventilatory function, increased secretions, and problems in lung expansion. Hemorrhage can happen in patients with bleeding disorders. A patient who is obese is not at any higher risk of electrolyte imbalances compared with a patient of normal body weight.

Which statement regarding preoperative teaching is true?

Preoperative information helps lessen anxiety, reduce the amount of anesthesia required, decrease postoperative pain, and reduce corticosteroid production.

The nurse is providing preoperative teaching to a patient regarding dietary needs in the postoperative period. Which action is best on the part of the nurse?

The nurse should first determine the patient's current eating habits to help the patient understand how the diet should change in the postoperative period. The nurse can then educate the patient to increase or decrease intake of fats, carbohydrates, and proteins based on the patient's current diet. The patient's understanding of a healthy diet is important but does not apply at this time.

The nurse on a general surgery floor is preparing to care for four postoperative patients. Which patient would the nurse see first?

The nurse should first see the 85-year-old patient who recently underwent a hip replacement. This patient should be seen before the 86-year-old who had an intraarticular injection because it is a more significant surgery and can lead to more significant complications. Younger individuals, such as the 18- and 54-year-old patients, are generally more stable after surgery.

Which statements are true regarding medications and surgery?

Review of the patient's current medication regimen is essential; the use of multiple medications predisposes patients to adverse drug reactions and interactions with other medications. Numerous medications may be given in the perioperative setting. The patient's chart should be "flagged" to alert all health care providers about the patient's allergy status; the patient with a history of allergic responsiveness has a greater potential for demonstrating hypersensitivity reactions to anesthetic agents. Patients should discontinue all anticoagulants before surgery, according to the surgeon's instructions.

Which induction method does the anesthesiologist use while administering regional anesthesia to a patient scheduled for lower abdominal surgery?

Spinal anesthesia is used for lower abdominal surgery because the anesthetic effects extend from the tip of the xiphoid process down to the feet. Nerve block is used for orthopedic surgery involving extremities because the anesthesia needs to block the nerve supply to the operative site. Conscious sedation is another form of anesthesia that is given to relieve anxiety or provide amnesia during surgical diagnostic procedures. Epidural anesthesia blocks sensation in the vaginal and perineal areas and, thus, is often used for obstetric procedures.

The nurse observes that there is swelling at the intravenous (IV) site in a postoperative patient. The nurse also finds that the site is cool to the touch. Which condition does the nurse suspect?

Swelling at the IV site which is also cool to touch indicates that the IV solution has become infiltrated. Infiltration may occur because of movement or inadvertent dislodgment of the needle when the patient ambulates.

The nurse is performing a preoperative assessment on a patient before elective knee replacement surgery. The patient reports an allergy to latex. Which action should the nurse perform first?

The nurse should obtain more information regarding the allergy, including date of onset, details surrounding the event, and the type and extent of the reaction. The nurse should document the finding and contact the surgeon, but the nurse must first seek more information. It is not appropriate to cancel the surgery at this time.

Which interventions should the nurse implement while providing care for a postoperative patient who is unconscious?

The level of consciousness in a postsurgical patient is altered. Therefore, the nurse raises the side rails of the bed to prevent falls. The nurse also keeps a call light within the patient's reach to help the patient inform the nurses about any complications immediately. The nurse raises the bed to a 45-degree angle to reduce the chances of aspirating vomitus. The nurse assesses blood pressure and heart rate frequently as postoperative complications can occur suddenly. The nurse does not place a pillow under the patient's head until the patient has regained complete consciousness because doing so may cause the tongue to obstruct the airway.

Arrange the steps that the nurse teaches the patient to perform turning exercises after a surgery.

The nurse instructs the patient to assume supine position on the right side of the bed so that turning to the left side will not cause the patient to roll toward the bed's edge. The nurse then instructs the patient to place the left hand over the incisional area to splint it. This supports and minimizes pulling on the suture line during turning. The patient is then asked to keep the left leg straight to stabilize the patient's position. The nurse then asks the patient to flex the right knee up and over the left leg to shift weight for easier turning. Finally, the nurse asks the patient to repeat the turning exercise every 2 hours while awake to reduce the risk of vascular and pulmonary complications. p. 1251

A patient experiencing postoperative pain refuses to take analgesics and says that the pain is tolerable. Which instruction does the nurse tell this patient?

The nurse needs to inform the patient that it is inappropriate to delay analgesics until there is severe pain because the medications are more effective when taken at the onset of pain. It is not appropriate to tell the patient to inform the nurse only after the pain is intolerable. The nurse should instead encourage the patient to take medications as directed for effective pain management. Pain medications are administered as prescribed, and the nurse should not delay the dose according to the patient's readiness. The patient may need increased doses of pain medications if there is delay and the pain becomes intolerable later, which may cause side effects. Therefore, it is not appropriate to tell the patient that there will be no adverse effects.

During the preoperative assessment, the nurse learns that the patient takes ginger for intestinal gas. Which preoperative test would the nurse anticipate because of this medication?

The nurse should anticipate that blood clotting studies will be performed because ginger can increase clotting time and increase the risk for bleeding.

The nurse is providing teaching to a patient and his wife regarding postoperative care before a right shoulder replacement. Which comment by the nurse is the best way to facilitate understanding in the patient and his wife?

The nurse should ask open-ended questions to determine the patient and his wife's understanding of the teaching. Asking, "Do you have any questions?" does not facilitate a discussion. Although it is important to determine the patient's concerns, asking if he is concerned about the postoperative concerns requires only a "yes" or "no" answer and does not facilitate discussion. Although a packet may be helpful in facilitating the patient's learning, the nurse should not assume that all questions will be answered by the packet information.

The nurse is caring for a patient 12 hours after abdominal surgery. How can the nurse best facilitate controlled coughing in the postoperative patient?

The nurse should teach the patient to splint the incision to prevent pain and protect the incision while coughing. The patient should not prevent coughs. The nurse should ensure that the patient's pain is well controlled. A patient with uncontrolled pain is less likely to perform the necessary postoperative exercise to prevent complications. The patient should take several deep breaths before coughing.

The nurse is caring for a patient who will have surgery in 3 hours, and the patient's morning medications are due now. Although most medications will be held before surgery because the patient has a prescription for nothing by mouth (NPO), the nurse anticipates administering which medication(s)?

The nurse would plan to administer oral antiseizure and cardiac medications with a small sip of water the morning of the surgery. Intravenous morphine would be given to manage pain because this is not an oral medication. Oral multivitamins would be held before the surgery. Although the enoxaparin (Lovenox) is a subcutaneous medication, it would most likely be held the day of the surgery because of an increased risk of bleeding during the operation.

The nurse in the ambulatory surgery center learns that the patient scheduled for surgery at 11 a.m. drank water at 7 a.m. Which action is best on the part of the nurse?

The patient can have clear liquids until 2 hours before the surgery unless the patient has a condition that causes delayed gastric emptying. Therefore, the appropriate action by the nurse would be to document the finding and continue the assessment. The nurse should report this information as part of the preoperative assessment to the health care provider, but the nurse should finish the assessment first. The surgery does not need to be cancelled at this time. The patient should be educated on the risks of aspiration, but this is not the most correct option.

Which interventions should the nurse implement to prevent thrombus formation in a patient after a knee surgery?

The patient is at risk for thrombosis after a surgery because of inactivity and injury to the blood vessels resulting from anesthesia. The nurse instructs the patient not to cross the legs when in bed because this action impedes blood flow in the legs. The nurse instructs the patient to perform leg exercises every 2 hours and also encourages the patient to get out of bed as often as possible. The nurse avoids using a knee gatch as it hinders venous return in the patient. Reducing fluids and juices in diet is necessary to prevent edema in a patient with deep vein thrombosis.

A patient returns from abdominal surgery at 1300 with a heart rate of 78, respiratory rate of 14, and blood pressure of 128/86. At 1400, the patient complains of light-headedness; the heart rate is 132, respiratory rate is 22, and blood pressure is 84/58. Which action should the nurse perform first?

The patient is demonstrating symptoms of hemorrhage and should be prepared to return to surgery. Although the vital signs should be documented, this is not the nurse's first action. Encouraging deep breathing is not the best action at this time. Naloxone is used to reverse the respiratory depression effects of opioid medications and is not appropriate based on this patient's condition.

The health care provider instructs the nurse to administer preoperative medication before transferring a patient to the surgical suite. Which interventions should the nurse implement after administering the medication?

The patient may experience mild discomfort after receiving the preoperative medication. Therefore, the nurse supports the patient by providing a quiet environment. The patient may experience drowsiness or vertigo, so the nurse places the bed in a low position to prevent falls. The side rails of the bed are also raised to provide safety from falls. The nurse monitors the patient every 15 to 30 minutes to ensure that there are no complications. The nurse encourages the patient to void before administering the medications because the patient needs to be in bed after the medications are given.

The nurse is preparing to care for a patient who has undergone cardiothoracic surgery. During the immediate postoperative period, the nurse would assess which area of the skin for pressure-related breakdown?

The patient undergoing cardiothoracic surgery is on his or her back on a hard surface for an extended period. Therefore, the patient should be assessed for skin breakdown on the occiput, olecranon, calcaneus, sacrum, coccyx, and other dependent areas. This patient would not be at risk for breakdown on the patella, ventral foot, or anterior pelvis.

The nurse is caring for a patient before elective surgery. For which preoperative tasks is the nurse responsible?

The role of the nurse in the preoperative period is to assess the patient's health status, educate the patient about postoperative care needs and expectations, and ensure the consent form has been signed, among other tasks. The nurse will also determine the patient's current level of pain. The operating health care provider should explain the risks and benefits of the surgery and have the patient sign the consent form.

A patient needs surgical removal of an inflamed gallbladder. Which screening tests does the nurse anticipate the surgeon will prescribe?

The screening tests focus on the body systems that are likely to be affected by the surgery. A chest x-ray and ECG help determine the patient's heart and lung function. Blood sugar levels help determine postoperative wound healing and chances of infection. EEG is required for patients suffering from epilepsy and other brain-related disorders. A bone density scan is performed in females after menopause and is not required for this type of procedure.

Which interval is usual at which nursing assessments, including vital signs, are monitored in the postoperative phase?

The usual interval at which nursing assessments, including vital signs, are monitored in the postoperative phase is every 15 minutes times 4

Which statement regarding informed consent is true?

The witness to the signing of a consent form verifies only that this is the person who signed the consent and that it was a voluntary consent.

The nurse is caring for a postoperative patient. Which measures should the nurse take to prevent venous stasis and thrombus formation in the patient?

Venous stasis and thrombus formation are serious circulatory complications after surgery. Measures should be taken to promote a healthy blood supply to the extremities. Early ambulation helps improve venous return and prevents stasis of blood. Graded compression stockings also help prevent stasis. Leg exercises are encouraged to promote normal venous return.

A patient is scheduled for surgery. The patient is being prepared to receive medication. Which actions should the nurse perform before starting the treatment?

Vital signs should be measured to evaluate the patient's stability. All nursing care measures, such as assisting the patient to the bathroom, should be completed before the patient receives any premedication. The patient must sign a consent form before receiving any medications. Surgery cannot be legally or ethically performed until the patient understands the need for a procedure, the steps involved, risks, expected results, and alternative treatments. Coughing exercises should be taught in the preoperative period. It is not an action to be performed before starting premedication. Asking for family history is irrelevant before starting premedication.

Which actions should the nurse take while performing a surgical skin preparation for a patient?

While performing a surgical skin preparation, the nurse assesses the skin for any impairment, such as cuts and nicks, which may lead to the invasion of microorganisms and possible infections. The nurse educates the patient before starting the procedure to relieve the patient's anxiety. Holding the razor at a 30- to 45-degree angle to the skin minimizes the chances of cutting or nicking the skin. The nurse needs to rinse the razor frequently to remove the accumulation of hair from razor and prevent contamination from dirty water. The nurse cleanses the skin with a washcloth and clean, warm water to reduce the number of microorganisms and promote patient comfort.