FA Davis: Med-Surg 1: Preoperative Nursing: Ch 15, 16, 17

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Question 5 of 5 Prior to surgery, the nurse is teaching the patient about interventions used to prevent postoperative complications. Which patient teaching topics may the nurse want to discuss with the patient? Select all that apply. Early ambulation Compression devices Incentive spirometer use Upper extremity range of motion Blood clot prevention

? Blood clot prevention

Question 4 of 5 Which findings would a nurse most likely observe during phase II of the postoperative period? Select all that apply. Patient responds to painful stimuli Normal oxygen saturation rate Blood pressure stabilization Patient verbalizes pain 9/10 on 0-10 scale Patient denies nausea and has no vomiting

Blood pressure stabilization Patient verbalizes pain 9/10 on 0-10 scale Patient denies nausea and has no vomiting

Question 3 of 5 The nurse is caring for a patient with superficial burns on greater than 20 percent total body surface area. What body systems would the nurse monitor? Select all that apply. Cardiovascular Gastrointestinal Nervous Renal Immunologic

Cardiovascular Gastrointestinal Renal Immunologic

Question 8 of 8 You begin to conduct patient education based on the information you have collected during the patient history and physical assessment process. Drag and drop the priority teaching based on Julie's history of smoking. cefazolin sodium culture and sensitivity DVT prophylaxis informed consent patient history preoperative checklist preoperative teaching respiratory depression time-out type and screen vancomycin HCL

DVT prophylaxis CORRECT. Smoking increases Julie's risk of respiratory depression during the surgical procedure and for deep vein thrombosis (DVT) during the postoperative period. The nurse should include information about preventing DVT during preoperative education.

Question 2 of 5 Can you identify appropriate nursing actions when providing care to a postoperative client? For each client scenario, drag and drop the correct nursing interventions to the box. Handoff communication between OR and PACU staff: Occurs with two members of the OR team Includes a detailed health history assessment by system Details the procedure performed Includes medications received during surgery, including pain medications Includes all laboratory results since admission

Details the procedure performed Includes medications received during surgery, including pain medications CORRECT. The handoff communication that occurs between OR and PACU staff will include details of the procedure performed and medications received during surgery, including pain medications. The handoff communication should occur with three members of the OR team and should also include a summary of pertinent health history information and pertinent laboratory results only.

Question 4 of 5 The nurse is explaining to the nursing student that a patient can have burns from other than thermal injuries. What are types of burns that the nurse would include in the discussion with the student? Select all that apply. Electrical Chemical Radiation Biological Agricultural

Electrical Chemical Radiation

Question 2 of 5 What is the priority role of the operating room nurse during any surgical procedure? Ensuring patient safety and preventing injury Assuming team leader duties Verifying accuracy of patient's medical history Documenting the details of the procedure

Ensuring patient safety and preventing injury

Question 3 of 6 Joseph has a burn that affects the epidermis, dermis, and portions of the subcutaneous tissue; this is classified as a ________ burn. His burn does not affect the dermis through to the bottom layer of the dermis, which would be classified as _______ burn. Superficial; superficial partial thickness Deep partial thickness; full thickness Full thickness; superficial partial thickness Full thickness; deep partial thickness

Full thickness; superficial partial thickness CORRECT. A full thickness burn will involve damage to the epidermis, dermis, and portions of the subcutaneous tissues. A superficial partial thickness only involves damage from the epidermis through the bottom layer of the dermis.

Question 2 of 5 Immediately after surgery, the post-anesthesia care unit nurse receives a report from a member of the anesthesia care team. What information should this report contain? Select all that apply. General patient report Pharmacological report Procedural report from circulating nurse Anesthetic report Discharge instructions

General patient report Pharmacological report Procedural report from circulating nurse Anesthetic report

Question 4 of 5 A patient with a major burn injury is at great risk of burn shock. What factor causes this type of shock? Infection Massive fluid shift Loss of blood Organ dysfunction

Massive fluid shift

Question 6 of 6 You are caring for Will, who has a deep partial thickness burn to the left lower extremity. What would be the priority nursing action related to the location of the burn? Monitor pedal pulses for the first 48 hours Monitor urine output every 2 hours Assess pain every 4 hours and as needed (PRN) Assess ability to ambulate and implement appropriate safety protocol

Monitor pedal pulses for the first 48 hours CORRECT. You would closely monitor pedal pulses for the first 48 hours to assess for the potential development of compartment syndrome, a painful and serious condition in which pressure within the muscle builds to dangerous levels. The other nursing actions could be appropriate, but are not related specifically to the location of the burn.

Question 1 of 5 Can you identify appropriate nursing actions when providing care to a postoperative client? For each client scenario, drag and drop the correct nursing interventions to the box. PACU vital signs that must be checked include: Monitoring for a patent airway Assessing pulse oximetry Monitoring blood pressure Assessing surgical site Palpating a brachial pulse

Monitoring for a patent airway Assessing pulse oximetry Monitoring blood pressure CORRECT. Nursing actions that are accurate when monitoring vital signs in the PACU include monitoring for a patent airway, assessing pulse oximetry, and monitoring blood pressure. Apical and peripheral pulses are palpated; however, the brachial pulse is not a noted peripheral pulse to assess when monitoring vital signs in this setting. While it is important to assess the surgical site, this action is not appropriate when monitoring PACU vital signs.

Post-Assessment Questions Post-Assessment for Intraoperative Care Question 1 of 5 The operating room nurse needs further teaching when which finding is observed? Two people are assisting the patient to the operating room table Irrigation fluid is being warmed before administration Operating room doors are left open during surgical procedure Mask, head cover, gown, and shoe covers worn in sterile area

Operating room doors are left open during surgical procedure

Question 3 of 5 A new staff nurse in the operating room requires further education when stating that which team member may be nonsterile? Operating room nurse Anesthesia provider Circulating registered nurse Operating room director

Operating room nurse

Question 4 of 6 You are working in the ED and see Vivian, a patient in triage who was involved in a fire. Vivian has no burns to the skin, but is speaking hoarsely and has singed eyebrows. What is your priority action? Start an IV with 0.9% normal saline at 125 mL/hr per order Assess the patient's pain level Perform immediate respiratory assessment Assist with intubation as necessary

Perform immediate respiratory assessment CORRECT. You would perform an immediate assessment of the patient to evaluate respiratory rate, effort, breath sounds, presence of carbon (soot) in the sputum, oxygen saturation, confusion, and agitation. While assessing the pain level is part of the physical assessment, this should occur after the respiratory assessment. IV and intubation assistance may also be required, but not before the respiratory assessment.

Question 5 of 5 The nurse caring for a burn patient is monitoring the lab values of what two electrolytes most closely during the burn shock phase? Potassium and sodium Chloride and magnesium Calcium and potassium Sodium and chloride

Potassium and sodium

Post-Assessment for Postoperative Care Question 1 of 5 During phase I of the postoperative period, the nurse notices that the patient's surgical dressing contains an area of bright, red bleeding. Which action should the nurse take? Assess the patient's temperature. Notify the anesthesiologist. Reinforce the surgical dressing. Measure urinary output for past hour.

Reinforce the surgical dressing.

Question 3 of 5 The post-anesthesia care unit nurse should administer pain medications based on which assessment findings in a patient who remains very drowsy? Select all that apply. Restlessness Relaxed jaw Pupil dilation Heart rate of 118 beats/minute Respiratory rate of 10 breaths /minute

Restlessness Pupil dilation Heart rate of 118 beats/minute

Question 1 of 6 Jane has a burn that is affecting the epidermal layer of the skin. She does not require medical intervention. How should this burn be classified? Superficial Superficial partial thickness Deep partial thickness Full thickness

Superficial CORRECT. A superficial burn only affects the epidermal (top) layer of skin and does not typically require medical intervention to heal.

Question 5 of 6 Susan has a burn affecting the epidermis to the superficial layers of the dermis. It is expected to hear in one to two weeks with minimal scarring. How should this burn be classified? Superficial Superficial partial thickness Deep partial thickness Full thickness

Superficial partial thickness Superficial partial thickness burns affect the epidermis through to the superficial layers of the dermis. These burns usually heal in one to two weeks with minimal or no scarring.

Question 2 of 5 The nurse is aware the burn patient has a deep partial thickness burn when making which assessment observation? The burn affects only the epidermal layer of the skin. The burn affects the epidermis through to the superficial layers of the dermis. The burn affects the epidermis through to the lower layers of the dermis. The burn affects the epidermis, dermis, and portions of the subcutaneous tissue.

The burn affects the epidermis through to the lower layers of the dermis.

Pre-Assessment Questions Question 1 of 5 The nurse is caring for a patient who has a large full-thickness burn and is going to the operating room to have a burn excision. The nurse notes on the surgical consent that an allograft is planned. The tissue for an allograft is from which source? The patient's own skin The skin from a pig The skin from a cadaver The skin grown in the lab from a biopsy of the patient's own skin

The skin from a cadaver

Question 4 of 5 The operating room director must intervene when which action has been reported by the operating room nurse? "Time-out" procedures are performed before every surgical procedure. The surgical assistant reaches his hands below the waist to pick up an item. The patient's body has been padded while on the operating room table. Two or more people move patients from the stretcher to the operating room table.

The surgical assistant reaches his hands below the waist to pick up an item.

Question 5 of 5 Which actions should the operating room team perform according to The Joint Commission's universal protocol? Select all that apply. Verify the correct procedure. Verify the correct patient. Verify the correct date. Verify the correct site. Verify the correct hospital.

Verify the correct procedure. Verify the correct patient. Verify the correct site.

Question 5 of 5 During Phase I of the postoperative period, the nurse will perform which of the following priority assessments? Select all that apply. Capillary refill Auscultation of bowel sounds Vital signs Level of consciousness Airway patency

Vital signs Level of consciousness Airway patency

Question 4 of 5 A patient has undergone general anesthesia during hip replacement surgery. The nurse should perform which priority assessment when the patient first arrives to the post-anesthesia care unit? Ability to ambulate safely Understanding of post-operative care Vital signs evaluation Check surgical wound

Vital signs evaluation

Question 6 of 10 Bill is placed in a lateral position during a surgical procedure. The nurse places a padded roll under the lower axilla. Drag and drop the risk the nurse is attempting to avoid with this intervention. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

brachial plexus injury CORRECT. A patient who is placed in the lateral position for a surgical procedure is at an increased risk for a brachial plexus injury. The padded roll under the lower axilla decreases the patient's risk for developing this injury.

Question 5 of 5 The nurse is explaining the difference between an escharotomy and a fasciotomy to the patient's family. What information should the nurse share with the family? "A fasciotomy is a procedure performed to relieve pressure and only extends through the eschar and into the immediate subcutaneous fat. An escharotomy is an incision that extends through the subcutaneous fat and muscle fascia, allowing for expansion of the muscle compartment." "A fasciotomy is an incision that extends through the subcutaneous fat and muscle fascia, allowing for expansion of the muscle compartment. An escharotomy is a procedure performed to relieve pressure and only extends through the eschar and into the immediate subcutaneous fat." "A fasciotomy is the surgical removal of eschar tissue to promote healing and remove infection. An escharotomy is a procedure performed to relieve pressure and only extends through the eschar and into the immediate subcutaneous fat." "The terms fasciotomy and escharotomy are used interchangeably for a procedure that is used to remove eschar to promote healing and remove infection."

"A fasciotomy is an incision that extends through the subcutaneous fat and muscle fascia, allowing for expansion of the muscle compartment. An escharotomy is a procedure performed to relieve pressure and only extends through the eschar and into the immediate subcutaneous fat."

Question 3 of 5 Which assessment findings should the preoperative nurse report to the surgeon? Select all that apply. -Blood pressure 179/93 mm Hg -Daily baby aspirin use -Sinus rhythm on electrocardiogram -White blood cell count 8,000 per mcL -Oral temperature 100.6 degrees Fahrenheit

-Blood pressure 179/93 mm Hg -Daily baby aspirin use -Oral temperature 100.6 degrees Fahrenheit

Question 4 of 5 The preoperative nurse is admitting a patient for same-day surgery. What is the nurse's priority action? -Teach the patient how to use an incentive spirometer -Assess the patient's vital signs -Complete the preoperative checklist -Start a large bore intravenous line

-Complete the preoperative checklist

Question 2 of 5 What role does the preoperative nurse have in obtaining consent for anesthesia? Select all that apply. -Inform patient about type of anesthesia and medications to be used -Ensure patient understands information being presented -Inform patient about the risks associated with type of anesthesia planned -Inform patient about how the anesthesia is administered -Request a time-out prior to obtaining consent

-Ensure patient understands information being presented

Pre-Assessment Question 1 of 5 The nurse in the preoperative area knows that a complete informed consent includes which of the following components? Select all that apply. -Name of the surgeon performing surgery -Consent to administer blood products -Consent for anesthesia -Exact length of time surgery is to take -Description of how the surgery will benefit the patient

-Name of the surgeon performing surgery -Consent to administer blood products -Consent for anesthesia -Description of how the surgery will benefit the patient

Question 5 of 5 A patient scheduled for abdominal surgery states he is concerned about post-operative pain. Which patient teaching topics best address the patient's concern? Select all that apply. -Splinting of the wound -Need for early ambulation -Patient-controlled analgesia use -Use of compression stockings -Use incentive spirometry every hour

-Splinting of the wound -Patient-controlled analgesia use

Question 4 of 5 Which actions should the operating room nurse perform to ensure the safety of the patient? Select all that apply. Apply safety strap across patient's ankles once patient is on the OR table. Frequently monitor patient's respiratory rate. Ensure the side rails are in the up position. Carefully position patient's arms on the instrument table. Cross the patient's legs over the calf area instead of the ankles.

? Frequently monitor patient's respiratory rate. Ensure the side rails are in the up position.

Pre-Assessment for Intraoperative Care Question 1 of 5 To identify whether a client is developing malignant hyperthermia, which assessment finding should the nurse identify first? Severe muscle rigidity Elevated heart rate Elevated end tidal carbon dioxide Brown urine output

? Elevated heart rate The initial symptoms of malignant hyperthermia are related to cardiovascular and musculoskeletal activity. Tachycardia (heart rate >150 bpm) is often the first sign. In addition to tachycardia, sympathetic nervous system stimulation leads to ventricular arrhythmia, hypotension, decreased cardiac output, oliguria, and later, cardiac arrest.

Question 2 of 5 During the preoperative period, the nurse would notify the healthcare provider of which of the following assessment findings? Select all that apply. Increased blood pressure Normal sinus rhythm on ECG tracing Elevated white blood cell count Patient taking aspirin daily for pain Fever

? Increased blood pressure Elevated white blood cell count Patient taking aspirin daily for pain Fever

Question 1 of 5 The nurse is completing the preoperative checklist for a patient scheduled to undergo knee replacement surgery. Which actions must the nurse take? Select all that apply. Obtain a full medical history Assess patient's current health status Give patient a copy of current lab work Hang prescribed intravenous antibiotic Perform a "time out" at the bedside

? Obtain a full medical history Assess patient's current health status Hang prescribed intravenous antibiotic Perform a "time out" at the bedside

Question 4 of 5 What is the nurse's highest priority of care during the preoperative phase of care? Teaching to prevent complications Ensuring the patient's physiological safety Explaining the 0-10 pain assessment scale Asking the patient about support system

? Teaching to prevent complications Ensuring the patient's physiological safety

Question 5 of 5 Can you identify appropriate nursing actions when providing care to a postoperative client? For each client scenario, drag and drop the correct nursing interventions to the box. Family care in the PACU entails: Making contact every 30 minutes Communicating plans for transfer or discharge Allowing visitation per hospital policy Providing discharge instructions

Allowing visitation per hospital policy Providing discharge instructions Communicating plans for transfer or discharge CORRECT. Caring for the family of the client in the PACU is an important nursing responsibility. The nurse should communicate plans for transfer or discharge, allow visitation per hospital policy, and provide discharge instructions. The nurse should ideally make contact with the family every hour, not every 30 minutes, when providing care to a client in the PACU.

Pre-Assessment Questions Question 1 of 5 Which action should the nurse take in the post-anesthesia care unit to prevent the complication of venous thromboembolism? Ambulate the patient around the unit. Apply compression stockings. Administer enoxaparin subcutaneously. Turn and reposition the patient often.

Apply compression stockings.

Question 3 of 5 Can you identify appropriate nursing actions when providing care to a postoperative client? For each client scenario, drag and drop the correct nursing interventions to the box. Pain management nursing actions include: Assessing for restlessness Monitoring for decreases in HR, RR, and BP Holding pain medications until the patient is alert and oriented Administering prescribed pain medication

Assessing for restlessness Administering prescribed pain medication CORRECT. Pain management in the PACU includes a thorough nursing assessment and administration of prescribed analgesics. The nurse should assess for physiological symptoms associated with pain, including restlessness. He or she should also monitor for increases, not decreases, in HR, RR, and BP.

Question 4 of 5 Can you identify appropriate nursing actions when providing care to a postoperative client? For each client scenario, drag and drop the correct nursing interventions to the box. Monitoring for potential complications in the PACU should include: Assessing level of consciousness Assessing vital signs Monitoring urine output Determining last bowel movement Medicating for pain and nausea

Assessing level of consciousness Assessing vital signs Monitoring urine output Medicating for pain and nausea CORRECT. Nursing actions appropriate when monitoring a client for potential complications in the PACU include assessing level of consciousness, assessing vital signs, monitoring urine output, and medication for pain and nausea. Determining the client's last bowel movement is not necessary.

Question 2 of 6 You are reviewing the lab work for Carlos, who is 12 hours post admission to the unit with a diagnosis of deep partial thickness burn. Which serum electrolyte finding do you expect to note? Elevated potassium and sodium levels Decreased potassium and sodium levels Elevated potassium and decreased sodium levels Decreased potassium and increased sodium levels

Decreased potassium and sodium levels CORRECT. You would expect both the potassium and sodium levels to be decreased due to the fluid shift that occurs after the initial burn. Potassium and sodium begin to leak out of the intravascular space with this fluid shift.

Question 3 of 5 The nursing student is observing in the burn unit. The student would expect to see which infection control measures implemented in the burn unit? Select all that apply. Contact precautions for all patient interactions Use of antibiotic coated intravenous and central line catheters Use of betadine hand scrub by nursing staff before and after caring for patients Changing Foley catheters every 72 hours Use of disposable equipment such as blood pressure cuffs and stethoscopes

Contact precautions for all patient interactions Use of antibiotic coated intravenous and central line catheters Use of disposable equipment such as blood pressure cuffs and stethoscopes

Question 2 of 5 The nurse is caring for a patient in the intensive care unit who is 36 hours post-deep partial-thickness burn to the left lower extremity. Which nursing interventions would be in place to decrease the development of compartment syndrome? Monitor pulses in both burned and unburned extremities every 8 hours. Elevation of the extremity and hourly assessment of pulses in burned and unburned extremities. Monitor sodium and potassium levels every 4 hours. Maintain the head of the patient's bed at 45 degrees.

Elevation of the extremity and hourly assessment of pulses in burned and unburned extremities.

Question 3 of 5 The patient undergoing a surgical procedure with general anesthesia needs to be repositioned by staff members. Which are the most important actions by the operating room nurse? Select all that apply. Notify the anesthesia provider Pressure points are padded and protected Note the time when moving the patient Gently cross the patient's legs calf over calf Arms should be supported by nearby Mayo stand

Notify the anesthesia provider Pressure points are padded and protected

Question 2 of 5 Which of these outcomes would be most appropriate to establish for a patient who is being discharged from an inpatient post-anesthesia care unit? Select all that apply. Patient able to tolerate liquids without nausea and vomiting No signs of bleeding from surgical site Patient monitor displays new onset atrial fibrillation Patient stable and able to walk Patient's abdominal dressing shows moderate amount of sanguineous drainage

Patient able to tolerate liquids without nausea and vomiting No signs of bleeding from surgical site Patient stable and able to walk

Question 3 of 5 Before a patient is discharged home following surgery, which criteria must be met? Select all that apply. Patient is awake and alert. Patient is voiding normally. Patient is eating and drinking normally. Surgical wound is clean and dry. Patient verbalizes understanding of instructions.

Patient is awake and alert. Patient is voiding normally. Patient is eating and drinking normally. Surgical wound is clean and dry. Patient verbalizes understanding of instructions.

Question 2 of 5 Which of these outcomes would be most appropriate to establish for a patient who is receiving warmed intravenous fluids during surgery? Patient's oxygen saturation level remains above 94% on continuous pulse oximetry. Patient remains slightly hypertensive throughout the entire surgical procedure. Patient does not develop a deep vein thrombosis in either lower extremity. Patient maintains body temperature between 97.0 - 99.0 degrees Fahrenheit.

Patient maintains body temperature between 97.0 - 99.0 degrees Fahrenheit.

Post-Assessment Questions Question 1 of 5 The nurse caring for the burn patient knows which factors may impact the severity of the burn injury? Select all that apply. Patient's age Patient's gender Physical location of the burn Patient's past medical history Involvement of an inhalation injury with the burn

Patient's age Physical location of the burn Patient's past medical history Involvement of an inhalation injury with the burn

Question 5 of 5 The post-anesthesia unit nurse is participating in handoff with the operating room team. What information should she expect to receive? Select all that apply. Patient's medical history Medications received Significant laboratory results Procedure performed Patient identification with one identifier

Patient's medical history Medications received Significant laboratory results Procedure performed

Question 5 of 8 You are reviewing Julie's allergies and document that she is allergic to penicillin. You review her preoperative medication list to ensure that Julie has not been prescribed a penicillin product. Drag and drop the medication the nurse should question based on the current data. cefazolin sodium culture and sensitivity DVT prophylaxis informed consent patient history preoperative checklist preoperative teaching respiratory depression time-out type and screen vancomycin HCL

cefazolin sodium CORRECT. Cefazolin sodium, a cephalosporin antibiotic, should be questioned by the nurse. A patient with a penicillin allergy is also likely to exhibit an allergic reaction to this drug classification.

Question 5 of 10 Claire must be repositioned to a jackknife position during a surgical procedure. The nurse monitors Claire's distal pulses before, during, and after repositioning. Drag and drop the risk the nurse is attempting to avoid with this intervention. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

deep vein thrombosis in lower extremities CORRECT. The jackknife position increases the patient's risk for DVT in the lower extremities; therefore, the nurse monitors distal pulses before, during, and after repositioning to check for this complication.

Question 2 of 10 Mark is placed in the Trendelenburg position for a surgical procedure. The nurse closely monitors Mark's respiratory status during the surgery. Drag and drop the risk the nurse is attempting to avoid with this intervention. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

diminished lung capacity CORRECT. The nurse should monitor the respiratory status of a patient in Trendelenburg position during a surgical procedure because of the increased risk for diminished lung capacity.

Question 10 of 10 A patient is given epidural anesthesia during a surgical procedure. The anesthesiologist requests that a vasopressor be administered. Drag and drop the complication the nurse should document in the patient's medical record. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

hypotension CORRECT. Hypotension is an adverse reaction that can occur with epidural anesthesia. It is often treated by administering a vasopressor to increase the patient's blood pressure.

Question 7 of 10 The nurse covers Shirley with warm blankets and suggests the use of warm irrigation solution during a surgical procedure. Drag and drop the complication the nurse is attempting to avoid with this intervention. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

hypothermia CORRECT. Hypothermia, or a decrease in body temperature, can occur during surgical procedures due to the anesthetic drugs used and prolonged exposure to lower temperatures in the surgical suite. Covering the patient with warm blankets and using warm irrigation solution during the surgical procedure can decrease this risk.

Question 9 of 10 Sylvia is placed in a reversible unconscious state for a surgical procedure. The anesthesiologist plans to administer a combination of volatile gases, intravenous agents, and muscle relaxants. Drag and drop the complication that you assessed which necessitates the administration of an increased amount of oxygen. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

hypoxia CORRECT. This patient is under general anesthesia. One adverse reaction to this type of anesthesia is hypoxia, which would be treated with an increased amount of oxygen.

Question 3 of 8 Julie's surgeon comes to the preoperative area to review the surgical procedure with her. He or she discusses the alternatives, benefits, and risks associated with breast reduction surgery. Julie signs the form provided, and you witness her signature. Drag and drop the name of the document you witnessed for the patient. cefazolin sodium culture and sensitivity DVT prophylaxis informed consent patient history preoperative checklist preoperative teaching respiratory depression time-out type and screen vancomycin HCL

informed consent CORRECT. Informed consent is when a patient autonomously grants permission to a provider to perform a surgical procedure, after understanding and considering all its alternatives, benefits, and risks. Although obtaining consent is the role of the provider, it is the nurse's responsibility to ensure that the patient has all information needed to make an informed decision about the procedure. In addition to reviewing the consent form with the patient and validating his or her understanding, nurses often serve as the witness to the consent. However, you are witnessing the physical signature, not the information provided. You should never sign as a witness if the patient has not signed the consent form in your presence. As part of preoperative procedures, the nurse is also responsible for documenting that a signed consent has been placed in the patient's chart.

Question 8 of 10 The nurse suctions Ted's airway during the emergence stage of anesthesia. Drag and drop the complication the nurse is attempting to avoid with this intervention. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

laryngospasm CORRECT. The airway is suctioned during the emergence stage of anesthesia to decrease the risk for laryngospasm and subsequent aspiration.

Question 4 of 8 You begin the physical assessment process as indicated on the presurgical checklist. Which information will you collect from Julie first? Drag and drop the priority assessment data for Julie at this time. cefazolin sodium culture and sensitivity DVT prophylaxis informed consent patient history preoperative checklist preoperative teaching respiratory depression time-out type and screen vancomycin HCL

patient history CORRECT. A detailed medical history and assessment is required to ensure a safe and successful surgery. The preoperative nurse is responsible for obtaining and documenting this history on admission.

Question 1 of 8 Julie, a 42-year-old female, is admitted to your facility for preparations for her breast reduction surgery. Julie's partner, Leeanne, is at the bedside. During your initial assessment, Julie informs you of her allergy to penicillin. She has smoked 10 cigarettes a day for the past 20 years. Vital signs are noted below: • BP: 144/88 mm HG • HR: 84 bpm • Respirations: 22/min • Temperature: 98.7º F • Pain Score: 0 out of 10 Drag and drop the action that the nurse should take first. cefazolin sodium culture and sensitivity DVT prophylaxis informed consent preoperative teaching respiratory depression patient history time-out vancomycin HCL type and screen preoperative checklist

preoperative checklist CORRECT. The nurse's priority activity is to initiate the preoperative checklist. Each facility's unique checklist will ensure that necessary documentation, admission assessment, physical preparation, and patient education have been completed before the patient enters the surgical suite.

Question 6 of 8 You note that Julie is a smoker and you document this for the surgical team to review. Drag and drop the complication that Julie is at increased risk for due to her smoking history. cefazolin sodium culture and sensitivity DVT prophylaxis informed consent patient history preoperative checklist preoperative teaching respiratory depression time-out type and screen vancomycin HCL

respiratory depression CORRECT. Julie is at an increased risk for experiencing respiratory depression as a result of her smoking history. It is important for the nurse to relay this information to the surgical team.

Question 3 of 10 Sarah is placed in Fowler's position for a surgical procedure. The nurse tilts the patient's torso slightly away from the OR bed to allow the skin to realign with skeletal structures. Drag and drop the risk the nurse is attempting to avoid with this intervention. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

shearing CORRECT. Tilting the patient's torso slightly away from the OR bed when she is in Fowler's position decreases the risk of shearing and skin breakdown.

Question 2 of 8 You place a wristband on Julie that is printed with her identifying information. Julie confirms that this information is correct. You review all the information on the wristband with Julie and ask her to name the procedure and surgical site. Drag and drop the action the nurse completed. cefazolin sodium culture and sensitivity DVT prophylaxis informed consent patient history preoperative checklist preoperative teaching respiratory depression time-out type and screen vancomycin HCL

time-out CORRECT. A time-out, or "pause for cause," starts when the patient enters the surgical facility. On admission, he or she receives a wristband printed with identifying information. After reviewing the wristband, the patient confirms all information is correct. The nurse then has the patient name the procedure and surgical site. This process is the first time-out before the patient enters the surgical suite.

Question 7 of 8 You continue with the physical assessment process in order to prepare Julie for the surgical procedure. You review the laboratory data at this time. Drag and drop the completed laboratory assessment you expect to find during this review. cefazolin sodium culture and sensitivity DVT prophylaxis informed consent patient history preoperative checklist preoperative teaching respiratory depression time-out type and screen vancomycin HCL

type and screen CORRECT. A type and screen to determine blood type and the presence of antibodies will be used to cross match blood in case the patient needs blood during the surgical procedure.

Question 4 of 10 Debbie is placed in a prone position during a surgical procedure. The nurse places Debbie's arms on an armboard to ensure that they are flexed and pronated. Drag and drop the risk the nurse is attempting to avoid with this intervention. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

upper extremity injury CORRECT. The nurse is attempting to avoid injury to Debbie's upper extremities. The nurse places Debbie in a prone position with her arms on the arm board, ensuring a flexion and pronation.

Question 1 of 10 The nurse places sequential compression devices (SCDs) on George's legs because he will remain in a supine position for a surgical procedure that is scheduled to last 12 hours. Drag and drop the risk the nurse is attempting to avoid with this intervention. venous pooling of blood diminished lung capacity shearing upper extremity injury deep vein thrombosis in lower extremities brachial plexus injury infection laryngospasm hypotension hypothermia hypoxia

venous pooling of blood CORRECT. SCDs are placed on the surgical patient in order to decrease the risk for venous pooling of blood in the legs, which increases the patient's risk for developing a blood clot.


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