n1220 wk 3 preoperative and postoperative care (with practice eaq questions)

Which question would the nurse ask the patient when completing the preoperative assessment? 1 "What is your weight?" 2 "What is your occupation?" 3 "What type of insurance do you have?" 4 "What medications are you currently taking?"

4

Which surgical procedure is categorized under curative surgery? 1 Ileostomy creation 2 Rhinoplasty 3 Joint arthroscopy 4 Appendectomy

4

Which descriptor of urination is associated with the term oliguria? 1 Scanty 2 Painful 3 Bloody 4 Frequent

1

Which type of drain is useful for a patient with a cholecystectomy? 1 T-tube 2 Penrose 3 Hemovac 4 Jackson-Pratt

1

Which factor increases a patient's risk for delayed wound healing? Select all that apply. One, some, or all responses may be correct. 1 Older age 2 Obesity 3 Compromised immune system 4 Diabetes 5 Smoking

1, 2, 3, 4, 5

Which condition can contribute to impaired wound healing after surgery? Select all that apply. One, some, or all responses may be correct. 1 Obesity 2 Diabetes 3 Dysrhythmias 4 Weak immune system 5 Electrolyte imbalances

1, 2, 4

Which factor may increase the risk for surgical or postoperative complications? Select all that apply. One, some, or all responses may be correct. 1 Diabetes 2 Cardiac disease 3 Marital status 4 Antihypertensive drugs 5 Age older than 65 years

1, 2, 4, 5

Which information must be provided to the patient when obtaining informed consent for surgery? Select all that apply. One, some, or all responses may be correct. 1 The reason for and nature of the surgery 2 The identities of nursing staff that may assist in surgery 3 The risks associated with the use of anesthesia 4 The available options and their possible risks 5 The risks associated with the surgical procedure and its potential outcomes

1, 3, 4 ,5

Which topic is included in preoperative patient teaching? Select all that apply. One, some, or all responses may be correct. 1 Splinting 2 Incisional care 3 Pain management 4 Incentive spirometry 5 Lower extremity exercises

1, 3, 4, 5

Normal nasogastric (NG) tube drainage should have which color or characteristic? 1 Pink 2 Green 3 Brown 4 Coffee-ground

2

Which condition is indicated by the presence of a pulse deficit when assessing the vital signs of a postoperative patient? 1 Dyspnea 2 Dysrhythmia 3 Hypothermia 4 Deep vein thrombosis

2

Which purpose of having a patient sign an informed consent form before surgery is accurate? 1 It contains information about the surgeon. 2 It protects the patient from unwanted procedures. 3 It informs the patient of side effects of preoperative medications. 4 It provides detail about the anesthetic to be administered.

2

Which drug is used to reduce prolonged GI symptoms in postoperative patients? 1 Morphine 2 Ketorolac 3 Ondansetron 4 Hydromorphone

3

Which explanation supports the use of electric clippers and depilatories to remove hair at the surgical site? 1 It is the easiest method. 2 It helps with wound healing. 3 It reduces the potential for infection. 4 It is a less time-consuming method.

3

Which explanation would the nurse review with the patient before an operation as the primary need for vascular access? 1 To hydrate the patient 2 To reduce the chance of infection 3 To deliver a general anesthetic 4 To warm the patient

3

Which postoperative condition is considered to be a neuromuscular complication of surgery? 1 Sepsis 2 Atelectasis 3 Hypothermia 4 Pressure ulcers

3

Which procedure is an example of a minimally invasive surgery (MIS)? 1 Partial mastectomy 2 Radical prostatectomy 3 Arthroscopy 4 Mitral valve replacement

3

Which term describes a splitting open of a wound for a postoperative patient? 1 Drainage 2 Intubation 3 Dehiscence 4 Evisceration

3

At what time interval is lung function assessed in a postoperative patient during the first 24 hours after surgery? Record your answer as a whole number. Every ___ hours.

4

The need for antibiotics for infection prevention is re-evaluated at which time after surgery? 1 2 hours 2 6 hours 3 12 hours 4 24 hours

4

Which condition may arise because of nasogastric tube drainage? 1 Pneumonia 2 Constipation 3 Urinary retention 4 Metabolic alkalosis

4

Which is an example of an elective surgery? 1 Appendectomy 2 Acute cholecystitis 3 Intestinal obstruction 4 Total knee replacement

4

Which other substance may a patient be allergic to in conjunction with a shellfish allergy? 1 Latex 2 Morphine 3 Folic acid 4 Povidone-iodine

4

How often would the nurse assess wound healing in a postoperative patient after the health care provider removes the initial dressing? Record your answer using a whole number. Every ___ hours

8

Postoperative Patient Education (cardiovascular)

• Anti-embolism stockings • Pneumatic compression devices • Leg exercises • Mobility

preoperative meds

• Anticholinergics (Atropine, Glycopyrolate (Robinul), Scopolamine) -Blocks acetylcholine receptors - Control pre-op secretions - Dry mouth, throat, nasal, constipation, IOP, urinary retention, dry skin • Antiemetic/ H2 Receptors (Ondansetron (Zofran), Metoclopramide (Reglan), Droperidol (Inaspine) - Prevents N/V - Decreases gastric secretions • Anxiolytic (Benzodiazepines, Diazepam, Lorazepam, Alprazolam) - Controls anxiety and provides pre-op sedation, induces amnesia • Sedatives (Barbituates, Phenobarbital, Xanax, Restoril, Ambien, Sodium Pentothal) - Depressed CNS function - Very high doses have sedative and hypnotic effects for anesthesia

Postoperative Patient Education (respiratory)

• Deep breathing • Incentive spirometry • Coughing & splinting

Postoperative Patient Education (GI: constipation, paralytic ileus)

• Early Ambulation • Increase fiber intake • Hydration • Laxatives, enemas

Postoperative Complications

• Hematological - hemorrhage • Respiratory - atelectasis, pneumonia, PE • Cardiovascular - hypotension, cardiac dysrhythmias, VTE • Urinary - urinary retention, low urine output • Gastrointestinal - paralytic ileus, constipation • Neurological - CVA / stroke • Immunological - infection • Wound Healing - dehiscence, eviscerations, infection • Psychological - body image problems

Postoperative Patient Education (wound healing)

• Predisposing Factors - Diabetes - Uremia - Obesity - Malnutrition - Steroids • Signs & Symptoms - Fever - Foul smelling or green drainage from wound - Edema - Redness

Postoperative Patient Education (GU: urinary retention)

• Run water • Sit upright • Hydration • Early ambulation • Catheterization