Preoperative Care

Trauma to the body requires ______________________________ during the healing process.

high metabolic activity

elevation of body temperature above normal

hyperthermia

below normal body temperature

hypothermia

When transporting a patient on a stretcher or in a bed, the side rails should be

in the up and locked position

Several methods are available for transferring an unconscious patient from the stretcher to the operating bed. _______________ is the best option to use during the transfer.

the transfer board

Hypocalcemia is caused from a deficiency of what electrolyte?

Calcium

Electrolytes include all of the following except:

Carbonic acid

Differences between systolic and diastolic

Pulse Pressure

The process of breathing; the inspiration and expiration of air involving the muscles of the chest and abdomen

Respiration

Hyponatremia is caused from the deficiency of what electrolyte?

Sodium

Sixty percent of our surgical patients are affected by

Hypothermia

NANDA

North American Nursing Diagnosis Association

The basic metabolic panel includes all of the following except:

Oxygen

Gary Roberts is on anticoagulant drugs. Which of the following tests may be done to check the clotting time of his blood?

PT/PTT

Needs that require the Surgical Technologist to monitor amounts of irrigation fluids used during the case are:

Physiological Domain: Nutrition

Which group of patients should be scheduled early in the day for a surgical procedure?

diabetic patients

pressure at its lowest when the heart is relaxed

diastolic

Care that is usually "hands on" and can be therapeutic or diagnostic is referred to as ________________.

direct care

The placing of information into the patient's chart is known as:

documentation

record of electrical activity of the heart

electrocardiogram

Joan Morris is a 67-year-old woman admitted to a teaching hospital for cerebral angiography. The patient, a native English speaker and high school graduate whose daughter is a physician, had been well until several months earlier, when she fell and struck her head. Magnetic resonance imaging showed two large cerebral aneurysms. The interventional radiology service admitted her for cerebral angiography. The day after admission, cerebral angiography was performed, and one of the aneurysms was successfully embolized. The second aneurysm was deemed more amenable to surgical therapy, for which a subsequent admission was planned. After angiography, the patient was transferred to the oncology floor rather than returning to her original bed on the telemetry unit. Discharge was planned for the following day. The next morning, however, the patient was taken for an invasive cardiac electrophysiology study. Approximately 1 hour into the procedure, it became apparent that Ms. Morris was the wrong patient. The study was aborted and she was returned to her room in stable condition In your opinion, what errors occurred with Ms. Morris' case? (5 points)

Better communication between the staff should have been implemented. Ms. Morris was taken to the wrong floor after her surgery which aided in the overall mistake as she was not where she was supposed to be for later discharge. There should have been a name alert attached to her chart to warn the healthcare staff that there was another patient with a similar name. When the healthcare worker went to get Ms. Morris they should have made sure to ask her her name, date of birth, and what procedure they were going to be doing on her. A timeout in the OR should have been done (if it wasn't).

Identify the true statements about blood pressure measurement. (4 pts) (There is more than one.)

-Can be obtained by direct or indirect methods, -Pressure is higher during systole and lower in diastole, -Readings can be intermittent or continuous

A preoperative checklist is completed to ensure the patient is properly prepared for the surgical procedure. List three items to be included on the checklist.

-History & Physical -Surgical Consent Form -Patient Identification

An EKG

-may be routine for patients over 40 -is required if a patient has a suspected/known cardiac disease

Patients should be transported slowly and

-with side rails in the upright and locked position -feet first

The Nursing Process consists of six steps. Name them in order

1. Assessment 2. Nursing Diagnosis 3. Outcome Identification 4. Planning 5. Implementation 6. Evaluation

Describe four methods of obtaining a patient's temperature during the preop assessment.

-Axillary -Oral -Rectal -Tympanic

List 8 components of a Standard Transport Bed or "stretcher".

1. IV(Standard) Pole 2. Restraining (safety) straps 3. Side rails 4. Mattress 5. Shelf 6. Wheel 7. Frame 8. Wheel locks

Normal Hemoglobin numbers for a female are:

12.4-14.9 g/dl

Which of the following ages defines a preschooler?

4 to 6 years

Normal Hematocrit numbers for a male are:

42-52%

The normal pulse rate for an adult is _________________________.

60-100bpm

The normal axillary temperature is

97.6 F or 36.5 C

Chandra is a 13-year-old who was involved in an automobile accident. She has a severe facial laceration but was not rendered unconscious and has no negative neurological signs. She is coming to the OR where a plastic surgeon will repair her facial laceration. What are the psychological concerns that Chandra may have? Which concerns may take priority? (4 points)

Chandra may have concerns of facial scarring, safety during the procedure, death, and social acceptance from peers. Her concerns of safety and death take priority as they are the first needs that need to be met on Maslow's Pyramid.

Feverish; pertaining to a fever

Febrile

Why is the order "NPO after midnight" important with a preoperative patient?

The patient's stomach should be empty prior to surgery to prevent emesis which could lead to aspiration and aspiration pneumonia.

How can the surgical team help ease Chandra's experience? (3 points)

They can use simple factual language to explain the procedure and a kind and compassionate voice with friendly body language can help calm her. Since she is worried about the acceptance from her peers,the healthcare worker can also explain that with the advances in surgery there will be minimal scaring.

The ability to communicate and interact with people of different cultures and beliefs is __________________________________________.

cultural competence

Your operating team is dealing with an elderly patient who does not speak English. Although an interpreter was brought in to explain the surgery and associated risks, you still feel the patient has unmet psychosocial needs. What can you do?

Use a friendly voice, open body language, and a calming smile to help ease the patient. Pictures can also be used to help the patient understand better so her fears about the procedure can lighten.

A heart rate of less than 60 beats per minute may indicate not pathology but

a fit athlete

Identify the false statement about pulse oximetry.

a reading of 90% or less is normal

An electrocardiogram is

an electrical recording of heart activity

heart rate counted at the apex of the heart using a stethoscope

apical pulse

A unit of blood drawn from a patient and kept for their own use during a surgical procedure is known as a/an ________________________unit.

autologous

Once placed on the operating room bed, the patient may never

be left alone

Sequential compression devices (SCDs) are used on patients having surgery to prevent

blood pooling

abnormally slow heart rate

bradycardia

Pediatric patient groups are defined according to approximate ______________ age groups.

chronological

When surgical technologists apply knowledge and experience gained in the past to solve a current problem, they are using a process known as _________________________

critical thinking

If a transfusion is anticipated, the patient's blood is typed and ___________.

crossmatched

A heart rate of 110-130 beats per minute is normal for what age group?

infants

Axillary temperature readings are _______________ oral measurements.

lower than

When transferring a patient from the operating room bed to his/her transport bed, always

make sure the wheels are locked

Hematocrit

measures the percentage of RBCs to total volume

Supplying fluid, electrolytes and organic substances to cells in order to maintain electrical activity and transport of materials in and out of the cells is a physiological response of _______________.

nutrition

Beat of the heart as felt through the walls of the arteries

pulse

As an age group, _____________________ welcome explanations and descriptions of how things work and how devices and equipment in the environment relate to their own bodies.

school-age children

Hemoglobin

serves as a transport mechanism for CO2 and O2

pressure at its peak during contraction on the heart

systolic

The first complaint many patients verbalize about the operating room is that

the temperature is too low

Which of the following types of thermometers provides an accurate measurement of core temperature because it shares a blood supply with the hypothalamus?

tympanic probe

Which of the following is the most basic form of assessment

vital signs