Chapter 17 PrepU: Preoperative Nursing Management

Which nursing statement would best decrease a client's anxiety before an emergency operative procedure?

"Let me explain to you what will happen next."

The nurse has provided preoperative instructions to a client scheduled for surgery at an ambulatory care center. Which statement, made by the client, would indicate that further instruction is needed?

"The nurse will explain the details of the surgery before I sign a consent."

normal serum creatinine

0.6-1.5 mg/dL

The physician schedules an elective surgical procedure for a patient who smokes cigarettes. When should the nurse recommend that the patient cease smoking before the surgical procedure to minimize risks associate with cigarette smoking?

1 to 2 months

A client having a surgical procedure takes aspirin 325 mg daily for prevention of platelet aggregation. When should the client stop taking the aspirin before the surgery?

7 to 10 days

normal calcium levels

8.5-10.5 mg/dL

A client is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications?

80 to 110 mg/dL

A patient with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to laboratory results?

A blood urea nitrogen level of 42 mg/dL

Clients who have received corticosteroids preoperatively are at risk for which type of insufficiency?

Adrenal

Which of the following activities are nursing activities in the preoperative phase of care? Select all that apply.

Discussing and reviewing the advanced directive document Establishing an intravenous line Beginning discharge planning

urine creatine levels

Elevations in urine creatine may indicate a decrease in GFR and kidney failure Creatine clearance is the gold standard for measuring GFR

A patient with uncontrolled diabetes is scheduled for a surgical procedure. What chief life-threatening hazard should the nurse monitor for?

Hypoglycemia

The nurse is providing preoperative care to a client who is anxious about 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 the nurse might help alleviate the client's 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.

A nurse is witnessing a client sign the consent form for surgery. After signing the consent form, the client starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate?

Request that the surgeon come and answer the questions.

Once the operating team has assembled in the room, the circulating nurse calls for a "time out." What action should the nurse take during the time out?

Review the scheduled procedure, site, and client.

A client is preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What is most important for the nurse to monitor during the operative experience with the client?

adrenal insufficiency

A nurse evaluates the potential effects of a client's medication therapies before surgery. Which drug classification may cause respiratory depression from an associated electrolyte imbalance during anesthesia?

diuretics

The nurse assesses a client to determine if there is increased risk for complications intraoperatively or postoperatively. Which are general risk factors? Select all that apply.

nutritional status age physical condition health status

The nurse is reviewing the pre-admission laboratory findings of the client scheduled for surgery. Which laboratory value would be of greatest concern to the nurse?

potassium 6.2 mEq/L

Normal magnesium levels

1.5-2.5 mEq/L

normal bUN levels

10-20 mg/dL

Normal sodium levels

135-145 mEq/L

normal potassium levels

3.5-5.0 mEq/L

normal creatine kinase

36-160 Units/L (F) 50-204 units/L (M)

For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery?

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