Chp 17, PreOp

The patient scheduled for a colectomy asks the nurse why cefazolin has been prescribed by the health care provider. What is the most appropriate response by the nurse? "Cefazolin is being given for two days to prevent postoperative infection." "Cefazolin is an antiinflammatory drug that will help the surgical site to heal effectively." "Cefazolin will prevent you from getting a stomach ulcer until you are eating a full diet again." "Cefazolin is an analgesic that will make it easier to tolerate the continuous passive-motion machine after surgery on the knee."

"Cefazolin is being given for two days to prevent postoperative infection."

During preoperative nursing assessment of a patient, what questions should the nurse ask to determine if the patient has a latex allergy? Select all that apply. "Do you take any herbal supplements?" "Have you ever had hay fever or asthma?" "Do you have a history of allergy to any specific drug?" "Do you work or have you worked in the rubber industry?" "Are you allergic to food items like eggs and chestnuts?"

"Have you ever had hay fever or asthma?" "Do you work or have you worked in the rubber industry?" "Are you allergic to food items like eggs and chestnuts?"

A patient with diabetes is waiting in the preoperative holding area for a hernia operation. The patient asks the nurse if the daily insulin dose should be taken. Which response is the most appropriate? "Replace the insulin with an oral drug." "I will check with the surgeon and let you know." "Take half of the dose of insulin because you are fasting." "Avoid taking insulin because it may cause hypoglycemia."

"I will check with the surgeon and let you know."

The nurse is preparing to administer a preoperative dose of cefazolin prior to an open cholecystectomy. What is the best explanation to the patient about why they are receiving this medication? "It will prevent postoperative pneumonia." "It will treat your urinary tract infection (UTI)." "It will prevent postoperative surgical-site infection." "It will remove harmful bacteria from your intestines before surgery."

"It will prevent postoperative surgical-site infection."

The nurse is performing a preoperative assessment for a patient scheduled for surgery. What does the nurse explain to the patient is the reason for obtaining accurate documentation of the current medications being taken? "Some medications may alter the patient's perceptions about surgery." "Some anesthetics alter renal and hepatic function, causing toxicity of other drugs." "Some medications may interact with anesthetics, altering the potency and effect of the drugs." "Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after surgery."

"Some medications may interact with anesthetics, altering the potency and effect of the drugs."

A preoperative patient with suspected bowel obstruction asks why his or her dose of warfarin is being withheld. Which response by the nurse is most accurate? "This medication is contraindicated with the type of anesthesia you are receiving." "This medication could cause excessive bleeding during surgery if it is not stopped beforehand." "All unnecessary medications are stopped before surgery to prevent you from vomiting under anesthesia." "This medication may increase respiratory depression associated with anesthetic agents and must be avoided."

"This medication could cause excessive bleeding during surgery if it is not stopped beforehand."

The nurse is preparing to give a dose of cefazolin 1.5 g intravenous piggyback (IVPB) to a patient before surgery. The vials available on the unit contain 500 mg in powder form. The instructions state to "dilute each 500 mg with 5 mL of sterile water." After reconstituting the medication, the nurse should draw up how many total milliliters of solution for dosage preparation? Record your answer using a whole number.

15 ml

A nurse is preparing a patient for cataract surgery. The nurse needs to instill different eye drops into the patient's eyes. How many minutes should the nurse wait between each set of eye drops? 5 minutes 10 minutes 30 minutes There is no wait time between instillations.

5 minutes

A patient with an abdominal mass is scheduled for surgery today. Before the patient is admitted to the operating room, which preoperative documentation must be attached to the chart? An electrocardiogram A complete physical examination Laboratory-test findings, including kidney- and liver-function parameters All nursing subjective objective assessment plan (SOAP) notes for this admission

A complete physical examination

An alert patient needs a tracheostomy after being intubated for seven days with an endotracheal tube and cannot be weaned from the ventilator. The patient does not want the tracheostomy, but their family insists that the surgery be performed. What is the best action for the nurse to take? Advocate for the patient's rights. Try to change the patient's mind. Tell the family they cannot interfere. Call surgery to cancel the procedure.

Advocate for the patient's rights.

Five minutes after receiving a preoperative sedative medication by intravenous (IV) injection, a patient asks to get up to go to the bathroom to urinate. What is the most appropriate action for the nurse to take? Allow the patient to use the urinal/bedpan after explaining the need to maintain safety. Assist the patient to the bathroom and stay next to the door to assist patient back to bed when done. Allow the patient to go to the bathroom because the onset of the medication will be more than five minutes. Ask the patient to hold the urine for a short period because a urinary catheter will be placed in the operating room.

Allow the patient to use the urinal/bedpan after explaining the need to maintain safety.

The patient tells the nurse in the preoperative setting that they have noticed diffuse skin rashes when hospitalized in the past and have food allergies to bananas and avocados. What is the priority action by the nurse? Notify the anesthetist to evaluate the patient. Ask additional questions to assess for a possible latex allergy. No intervention is needed because the patient needs to have this surgery. Notify the operating room (OR) staff immediately so that latex-free supplies can be used.

Ask additional questions to assess for a possible latex allergy.

A patient with Alzheimer's disease arrives via ambulance from a long-term care center to the preoperative area for placement of a feeding tube. The ambulance service hands the nurse a chart and states the nursing home did not obtain consent for the procedure. The patient is confused. What is the nurse's best course of action? Help the patient sign an "X" on the consent form representing his or her legal signature. Send the patient back to the nursing home and reschedule the procedure for a future date. Contact the family member identified as the patient's power of attorney on the patient's medical record to obtain consent. Notify the nursing supervisor of the lack of consent and request special permission for emergent status so the surgical procedure can be completed.

Contact the family member identified as the patient's power of attorney on the patient's medical record to obtain consent.

An older adult patient is undergoing preoperative assessment and teaching. What nursing interventions are appropriate during the education process? Select all that apply. Administer a sedative to relieve fear and anxiety. Help the patient walk safely to the operating room. Coordinate assessment with the team of health care providers. Speak slowly when giving preoperative instructions to the patient. Understand that the patient may have sensory and cognitive deficits.

Coordinate assessment with the team of health care providers. Speak slowly when giving preoperative instructions to the patient. Understand that the patient may have sensory and cognitive deficits.

As the nurse is preparing a patient for outpatient surgery, the patient wants to give the patient's hearing aid to the spouse so it will not be lost during surgery. Which action by the nurse should be taken in this situation? Encourage the patient to wear it for the surgery. Tape the hearing aid to the patient's ear to prevent loss. Give the hearing aid to the spouse as the patient wishes. Tell the surgery nurse that the patient has the hearing aid out.

Encourage the patient to wear it for the surgery.

A patient with obesity (BMI 26.1 kg/m 2) is scheduled for a laparoscopic hernia repair at an outpatient surgery setting. What should the nurse be prepared for prior to the surgery? Explain to the patient that surgery will use minimally invasive techniques. Explain to the patient that this setting is not appropriate for this procedure. Explain to the patient that surgery will involve removing a portion of the colon. Explain to the surgical services team that the patient will need special preparation.

Explain to the patient that surgery will use minimally invasive techniques.

An older adult patient is being prepared for a cholecystectomy. What assessment data need to be included for this patient? Select all that apply. Fluid balance history Foods the patient dislikes Current mobility problems Current cognitive function

Fluid balance history Current mobility problems Current cognitive function

The nurse is administering a preoperative medication orally. What nursing action is appropriate when performing this intervention? Give the medicine with a glass of milk. Give the medicine with a small sip of water. Give the medicine the night before surgery. Give the medicine 5 minutes before going to the operating room.

Give the medicine with a small sip of water.

During the preoperative assessment of a patient, the nurse finds that the patient is taking diuretics. What is the most important nursing intervention before surgery? Administer antibiotic prophylaxis. Have a serum potassium level drawn. Apply a compression device to the legs. Administer vasoactive drugs as advised.

Have a serum potassium level drawn.

The nurse is preparing a patient for surgery when they state, "I am terrified to be put to sleep. What if I don't wake up?" What is the priority action by the nurse? Administer an antianxiety medication to the patient. Teach the patient to use guided imagery to help manage fear. Describe the type of anesthesia expected with the patient's particular surgery. Inform the anesthesia care provider (ACP) so that he or she can talk further to the patient.

Inform the anesthesia care provider (ACP) so that he or she can talk further to the patient.

The nurse is admitting a patient to the same-day surgery unit and informs the nurse that they took kava last night to help them sleep. Which nursing action would be most appropriate? Tell the patient that using kava to help sleep often is helpful. Inform the anesthesiologist of the patient's recent use of kava. Tell the patient that the kava should continue to help with relaxation before surgery. Inform the patient about the dangers of taking herbal medicines without consulting a health care provider.

Inform the anesthesiologist of the patient's recent use of kava.

A patient is scheduled for a prostatectomy in one week. During the preoperative meeting he reports that he takes a fish oil capsule daily. Which of the following is the priority intervention? Tell the patient to stop taking the dietary supplement on the day before surgery. Notify the anesthesia care provider because this product interferes with anesthetics. Ask the patient if he has noticed any side effects from taking this dietary supplement. Inform the health care provider because the procedure may need to be rescheduled.

Inform the health care provider because the procedure may need to be rescheduled.

When completing a preoperative assessment before surgery, the nurse finds that the patient is taking the herb ginkgo. What is the most appropriate nursing action? Tell the patient that consuming herbs is an unhealthy practice. Inform the patient to discontinue the herb and return the next day. Inform the surgeon because the surgery would need to be rescheduled. Tell the patient that the herb is safe and continue with surgery preparation.

Inform the surgeon because the surgery would need to be rescheduled.

A woman is admitted to the hospital for an elective surgery. Her laboratory reports reveal that she is pregnant. An ultrasound of the abdomen shows that the fetus is 4 weeks old. What action should the nurse take immediately? Inform the surgeon. Inform the anesthetist. Inform the patient's husband. Continue preparation for surgery.

Inform the surgeon.

An older adult patient has been admitted before having surgery for a bilateral mastectomy and breast reconstruction. What should the nurse include in the patient's preoperative teaching? Select all that apply. Information about various options for reconstructive surgery Information about the risks and benefits of her particular surgery Information about risk factors for breast cancer and the role of screening Information about where in the hospital she will be taken postoperatively Information about performing postoperative deep breathing and coughing exercises

Information about where in the hospital she will be taken postoperatively Information about performing postoperative deep breathing and coughing exercises

A patient is scheduled for gastrointestinal surgery. Upon checking the patient's history, it is found that the patient is on long-term anticoagulation therapy. What action should the nurse take? Provide herbal therapy to minimize the risk of postoperative bleeding. Instruct the patient to discontinue the anticoagulation therapy 1 week before the surgery. Provide the patient with information to resume anticoagulation therapy 1 month after surgery. Instruct the patient to discontinue the anticoagulation therapy and expect to administer IV heparin during the perioperative period.

Instruct the patient to discontinue the anticoagulation therapy and expect to administer IV heparin during the perioperative period.

A patient reports a history of drinking whiskey in large quantities for 10 years during a preoperative assessment. Which nursing intervention would help prevent postoperative complications related to the patient's alcohol history? Instruct the patient to replace whiskey with a less potent beverage. Permit the patient to consume alcohol until the day before surgery. Recommend to the patient reducing the frequency of alcohol intake. Instruct the patient to stop consuming alcohol under medical supervision.

Instruct the patient to stop consuming alcohol under medical supervision.

A diabetic patient taking insulin is scheduled for a thyroidectomy. What should the nurse tell the patient about insulin injections around the time of the surgery? Insulin should be given only after the surgery. Insulin should be stopped one day before surgery. Insulin should be stopped at least one week before surgery. Insulin will be given after arrival in the preoperative holding area.

Insulin will be given after arrival in the preoperative holding area.

A patient due for surgery expresses concern about choosing between ambulatory surgery and inpatient regular surgery. Which information should the nurse include when comparing ambulatory to inpatient surgery for the patient? Select all that apply. It involves minimal laboratory tests. It requires fewer preoperative medications. It reduces the risk of hospital-acquired infections. It helps patients recover comfortably in the hospital. It is more expensive for both patients and insurers.

It involves minimal laboratory tests. It requires fewer preoperative medications. It reduces the risk of hospital-acquired infections.

A patient is admitted to the hospital for elective surgery. The patient is taking nonsteroidal antiinflammatory drugs (NSAIDs) for knee pain. The nurse recognizes that NSAID use will have what effect on a postoperative patient? It may increase the risk of infections. It may cause atelectasis postoperatively. It may increase risk of postoperative bleeding. It may cause clotting of blood in the deep veins of legs.

It may increase risk of postoperative bleeding.

A patient is scheduled for surgery to repair a deviated nasal septum and is to have nothing by mouth (NPO) orders since midnight and now surgery is delayed for several hours. The patient tells the nurse, "I am very hungry and thirsty, and I have a headache because I missed my morning coffee." Which nursing actions are appropriate in this case? Select all that apply. Give heavy food to the patient. Give black coffee to the patient. Give clear liquids to the patient. Keep the patient apprised of the situation. Tell the anesthesia care provider about the situation.

Keep the patient apprised of the situation. Tell the anesthesia care provider about the situation.

A public health nurse is advising a group of patients to regularly exercise and take multivitamin tablets. What should the nurse tell them about multivitamin use if they need a surgical intervention? Multivitamin tablets can be taken until the day of surgery. Multivitamin tablets can be taken until 1 week before surgery. Multivitamin tablets can be taken until the day before surgery. Multivitamin tablets should be avoided for several days after surgery.

Multivitamin tablets can be taken until the day before surgery.

The nurse asks the patient scheduled for a total hip replacement to sign the operative permit as directed in the health care provider's preoperative prescriptions. The patient states that the health care provider has not really explained what is involved in the surgical procedure. What is the most appropriate action by the nurse? Ask family members to clarify the information for the patient. Have the patient sign the form and explain the procedure to the patient. Notify the health care provider about the conversation with the patient and delay the signature. Have the patient sign the consent form and ask the health care provider to discuss again before surgery.

Notify the health care provider about the conversation with the patient and delay the signature.

When reviewing the preoperative forms, the nurse notices that the informed consent form is not signed. What is the best action for the nurse to take? Have the patient sign a consent form. Have the family sign the form for the patient. Notify the health care provider to obtain consent for surgery. Teach the patient about the surgery and get verbal permission.

Notify the health care provider to obtain consent for surgery.

A nurse discusses pain medications when providing preoperative teaching to a patient. The patient asks the nurse about the effects of opioid medications. What should the nurse include in the explanation? Select all that apply. Opioids cause amnesia. Opioids decrease intraoperative pain. Opioids decrease the risk of infections. Opioids relieve pain during preoperative procedures. Opioids decrease intraoperative anesthetic requirements.

Opioids decrease intraoperative pain. Opioids relieve pain during preoperative procedures. Opioids decrease intraoperative anesthetic requirements.

The nurse is caring for a patient with renal dysfunction who is scheduled for surgery. What are the priority nursing interventions in this situation? Select all that apply. Order renal function test preoperatively. Order coagulation studies preoperatively. Check for the serum potassium levels preoperatively. Report to perioperative team if the patient has a problem voiding. Ready the sequential compression device in the preoperative holding area.

Order renal function test preoperatively. Report to perioperative team if the patient has a problem voiding.

A patient taking warfarin and digoxin for treatment of atrial fibrillation is instructed to discontinue the use prior to surgery. What should the nurse closely monitor this patient for? Pulmonary embolism Increased blood pressure Excessive bleeding from incision sites Increased peripheral vascular resistance

P.E.

The nurse is to administer preoperative antibiotics to a group of patients. What patients are determined to require this medication? Select all that apply. Patients undergoing cataract surgery Patients with known coronary artery disease Patients undergoing gastrointestinal surgery Patients undergoing joint replacement surgery Patients with a history of valvular heart diseases

Patients undergoing gastrointestinal surgery Patients undergoing joint replacement surgery Patients with a history of valvular heart diseases

An older adult female patient has come to the ambulatory surgery center for surgery. Based on the assessment record below, what test should the nurse obtain for the health care provider before this patient's surgery? Blood glucose Pregnancy Potassium Albumin

Potassium

An unconscious patient needs to undergo emergency surgery. There are no family members or friends available. What action should the nurse take regarding obtaining consent for the surgery? Call the local magistrate to get consent for the surgery. Obtain consent from a legally appointed representative. Avoid giving any treatment because it is illegal to treat without consent. Proceed with plans for surgery; consent is not required for a true medical emergency.

Proceed with plans for surgery; consent is not required for a true medical emergency.

The patient who is a devout Catholic is having surgery the following day for a heart valve replacement. The patient voices general concern about the surgery. Which is the best method for the nurse to use to help decrease the patient's anxiety? Share the surgical story of a neighbor who is also a devout Catholic. Assure the patient that it is normal to have fears of dying during surgery. Provide web-based and audiovisual teaching materials about the surgery. Reassure the patient that this surgery doesn't usually result in a large blood loss.

Provide web-based and audiovisual teaching materials about the surgery.

The nurse is preparing a patient for surgery. What nursing actions are important to carry out prior to surgery? Select all that apply. Remove cosmetics, nail polish, and artificial nails. Remove hearing aids to prevent damage or loss of the devices. Remove jewelry in piercings if electrocautery devices will be used. Remove all prosthetics, including dentures, contact lenses, and glasses. Ascertain that the patient has an empty bladder before going to operating room.

Remove cosmetics, nail polish, and artificial nails. Remove jewelry in piercings if electrocautery devices will be used. Remove all prosthetics, including dentures, contact lenses, and glasses. Ascertain that the patient has an empty bladder before going to operating room.

A patient is scheduled for knee replacement surgery. The patient states that 5 years ago their father died due to sudden cardiac arrest. What is the most appropriate action by the nurse? Check the platelet count of the patient. Check the hematocrit level of the patient. Review the electrocardiogram of the patient. Determine that the patient will be unaffected.

Review the electrocardiogram of the patient.

The nurse is transporting a patient to the operating room. What concern should be the first priority for the nurse? Premedication Laboratory tests Safety of the patient Preoperative assessments

Safety of the patient

The nurse is to administer preoperative medications for a patient who is scheduled for surgery at 7:30: cefazolin intravenously (IV) to be infused 30 minutes before surgery, midazolam IV before surgery, and a scopolamine patch behind the ear. Which medication should the nurse administer first? Cefazolin Fentanyl Midazolam Scopolamine

Scopolamine

The nurse is taking a detailed history preoperatively about a patient's medications. What is the highest priority regarding the patient's medication history? All medications are held on the day of surgery. Some medications are contraindicated for use with anesthetics. Medications may cause the patient to be unable to make informed decisions. The patient's healing may be delayed if medications are taken before surgery.

Some medications are contraindicated for use with anesthetics.

A patient is refusing to remove their wedding ring on the morning of surgery. What action is most appropriate by the nurse? Ask the patient's husband to convince her to remove the ring. Tape the ring securely to the finger and document the encounter. Have the patient's mental status assessed in preparation for surgery. Note the presence of the ring in the nurses' notes section of the chart.

Tape the ring securely to the finger and document the encounter.

While performing preoperative teaching, the patient asks when to stop drinking water before the surgery. Based on the most recent practice guidelines established by the American Society of Anesthesiologists, what is the best response by the nurse? The patient needs to be NPO after midnight. The patient must be nothing by mouth (NPO) after breakfast. The patient can drink clear liquids up to 2 hours before surgery. The patient can drink clear liquids up until the patient is moved to the operating room.

The patient can drink clear liquids up to 2 hours before surgery.

The nurse is assessing a patient who is scheduled for an appendectomy and orders a serum potassium analysis. What is the reason for the nurse's action? The patient is a chronic smoker. The patient is on diuretic therapy. The patient has a prosthetic heart valve. The patient is on antihypertensive medication.

The patient is on diuretic therapy.

The nurse is preparing a patient who is scheduled to undergo surgery in the morning. The patient states they will eat a garlic-saturated dinner since they won't be able to eat this favourite food for a while. What should the nurse inform the patient they may be at risk for? The patient may experience excessive sedation. The patient may experience excessive nausea after the surgery. The patient may experience excessive bleeding during the surgery. The patient may experience an increase in blood pressure during the surgery.

The patient may experience excessive bleeding during the surgery.

A patient is a chronic smoker and is scheduled to have a benign tumor on the neck removed. To prevent perioperative complications, the nurse should instruct the patient to refrain from smoking for how many weeks before surgery? The patient may smoke up until the day of surgery. The patient should stop smoking 1 week before surgery. The patient should stop smoking at least 6 weeks before surgery. The patient should stop smoking at least 6 months before surgery.

The patient should stop smoking at least 6 weeks before surgery.

A patient with a body mass index (BMI) of 45 is admitted for abdominal surgery. The nurse explains to the patient the potential complications of abdominal surgery caused by obesity. Which statements should the nurse include in the explanation? Select all that apply. Access to the surgical site is easy. Recovery from anesthesia is faster. The risk of wound infection is higher. Anesthesia administration is more difficult. The risk of a postoperative incisional hernia may be higher.

The risk of wound infection is higher. Anesthesia administration is more difficult. The risk of a postoperative incisional hernia may be higher.

An older adult patient is admitted to the surgical unit for a right hemicolectomy. The nurse is concerned regarding the hydration status of this patient. What reason does the nurse have for this concern? It is difficult to find intravenous access in older patients. Skin turgor assessment is not a reliable measure for dehydration in this patient. There is an increased loss of water and electrolytes through sweating in old people. There is a narrow margin of safety between overhydration and underhydration in elderly patients.

There is a narrow margin of safety between overhydration and underhydration in elderly patients.

A patient has provided an informed consent for an elective tubal ligation under general anesthesia. The nurse recalls that the patient can revoke the consent for the surgery at what stage? Select all that apply. After the surgery has started When the patient is partially informed Just before the scheduled surgery time After the patient has signed the consent form When the patient is in the preoperative holding area

When the patient is partially informed Just before the scheduled surgery time After the patient has signed the consent form When the patient is in the preoperative holding area

A 17-year-old patient that is an emancipated minor with an arm fracture is scheduled for surgery and shows the nurse a statement from the court for verification. Which intervention by the nurse is most appropriate? Notify the health care provider that the patient is below 18 years old. Witness the operative permit after the health care provider obtains consent. Call a parent or legal guardian to sign the permit because the patient is under 18. Investigate the state's nurse practice act related to emancipated minors and informed consent.

Witness the operative permit after the health care provider obtains consent.