NSG320 Topic 2 Chapter 18 NCLEX
A 75-year-old patient is being prepared for surgery. What assessment data needs to be included for this patient (select all that apply)? A. Fluid balance history B. Attitude about surgery C. Foods the patient dislikes D. Current mobility problems E. Current cognitive function F. Patient's opinion about the surgeon
A,D,E. Preoperative fluid balance history is especially critical for older adults as they have reduced adaptive capacity that puts them at greater risk for over- and under-hydration. Mobility problems must be assessed to assist with intraoperative and postoperative positioning and ambulation. Preoperative assessment of the older person's baseline cognition function is especially crucial for intraoperative and postoperative evaluation as they are more prone to adverse outcomes during and after surgery from the stressors of the surgery, dehydration, hypothermia, and anesthesia. Attitude about surgery and opinion or faith in the surgeon is important for all patients. Foods the patient dislikes are not important unless the patient is allergic to them, but this is no more important for older patients than it is for all patients.
A 17-year-old patient with a leg fracture is scheduled for surgery. She reports that she is living with a friend and is an emancipated minor. She has a statement from the court for verification. Which intervention is most appropriate? A. Witness the permit after consent is obtained by the surgeon. B. Call a parent or legal guardian to sign the permit, since the patient is under 18. C. Obtain verbal consent, since written consent is not necessary for emancipated minors. D. Investigate your state's nurse practice act related to emancipated minors and informed consent.
A.
A 59-year-old man is scheduled for a herniorrhaphy in 2 days. During the preoperative evaluation he reports that he takes ginkgo daily. What is the priority intervention? A. Inform the surgeon, since the procedure may need to be rescheduled. B. Notify the anesthesia care provider, since this herb interferes with anesthetics. C. Ask the patient if he has noticed any side effects from taking this herbal supplement. D. Tell the patient to continue to take the herbal supplement up to the day before surgery.
A.
An overweight patient (BMI 28.1 kg/m2) is scheduled for a laparoscopic cholecystectomy at an outpatient surgery setting. The nurse knows that A. surgery will involve multiple small incisions. B. this setting is not appropriate for this procedure. C. surgery will involve removing a portion of the liver. D. the patient will need special preparation because of obesity.
A.
The patient is having a mole removed that has changed appearance. What does the nurse teach the patient about the rationale for this surgical procedure? A. It is to prevent malignancy. B. It is to alleviate symptoms. C. It is to cure the malignancy. D. It is to provide cosmetic improvement.
A. Removing a mole that is changing is to prevent as well as diagnose malignancy. There are no symptoms to alleviate mentioned or cosmetic problems for this patient.
A 58-year-old man with a recent diagnosis of prostate cancer is scheduled for a radical prostatectomy. Before signing the consent, the patient tells the nurse, "I am not sure if this surgery is safe." Which response by the nurse is the most appropriate? A. "Tell me what you know about your surgery and the risks involved." B. "Any surgery has risks, but we will be here to take good care of you." C. "You seem anxious. Once you sign the consent, I can give you a sedative." D. "You do not need to be concerned. Your surgeon has not had any complaints."
A. The health care provider performing the surgery is responsible for obtaining the patient's consent. The nurse may witness the patient's signature on the consent form. As a patient advocate, the nurse should verify that the patient understands the surgery and the risks involved. If the nurse determines that the patient is unclear about operative plans, the nurse should contact the health care provider about the patient's need for more information. The other options provide false reassurance or do not respond to the patient's concern.
An alert male patient needs a tracheostomy because he has been intubated for 7 days with an endotracheal tube and cannot be weaned from the ventilator. The patient does not want the tracheostomy, but his family insists that the surgery be performed. What is the best action for the nurse to take? A. Advocate for the patient's rights. B. Try to change the patient's mind. C. Call surgery to cancel the procedure. D. Tell the family they cannot interfere.
A. The nurse must act as the patient's advocate and assist the patient with fulfilling his wishes. However, as the patient's advocate the nurse must be sure he knows the risks and benefits of refusing a tracheostomy. Trying to change the patient's mind is unethical because it is contrary to acting as an advocate. As long as the patient is lucid, he retains the right of self-determination. Canceling the procedure is not indicated until discussion with the patient and surgeon has occurred. Telling the family they cannot interfere can aggravate or escalate the situation.
An alert male patient needs a tracheostomy because he has been intubated for seven days with an endotracheal tube and cannot be weaned from the ventilator. The patient does not want the tracheostomy but his family insists that the surgery be performed. What is the best action for the nurse to take? A. Advocate for the patient's rights. B. Try to change the patient's mind. C. Call surgery to cancel the procedure. D. Tell the family they cannot interfere
A. The nurse must act as the patient's advocate and assist the patient with fulfilling his wishes. However, as the patient's advocate, the nurse must be sure he or she knows the risks and benefits of refusing a tracheostomy. Trying to change the patient's mind is unethical because it is contrary to acting as an advocate. As long as the patient is lucid, he or she retains the right of self-determination. Canceling the procedure is not indicated until discussion with the patient and health care provider has occurred. Telling the family they cannot interfere can aggravate or escalate the situation. Text Reference - p. 326
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? A. Notify the health care provider about the conversation with the patient and delay the signature B. Ask family members to clarify the information for the patient C. Have the patient sign the form and explain the procedure to the patient D. Have the patient sign the consent form and ask the health care provider to discuss again before surgery
A. The patient should not be asked to sign a consent form unless the procedure has been explained to his or her satisfaction. The nurse should notify the health care provider, who has the responsibility for obtaining consent. The health care provider must provide the information and clarify any confusion. It is not acceptable for the family to explain the procedure. The nurse cannot explain the procedure or ask the patient to sign the form without proper instruction and information. Text Reference - p. 326
Five minutes after receiving a preoperative sedative medication by 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? A. Offer the patient to use the urinal/bedpan after explaining the need to maintain safety. B. Assist the patient to the bathroom and stay next to the door to assist patient back to bed when done. C. Allow the patient to go to the bathroom since the onset of the medication will be more than 5 minutes. D. Ask the patient to hold the urine for a short period since a urinary catheter will be placed in the operating room.
A. The prime issue after administration of either sedative or opioid analgesic medications is safety. Because the medications affect the central nervous system, the patient is at risk for falls and should not be allowed out of bed, even with assistance. The other options would not be safe for the patient.
A patient is scheduled for a gastrectomy. During the preoperative evaluation, the patient reports taking ginseng regularly. What should the nurse do? A. Inform the surgeon. B. Advise the patient to take vitamin E in addition to the ginseng. C. Advise the patient to decrease the dose of ginseng. D. Advise the patient to replace the ginseng with another herbal drug
A. The priority intervention is to inform the surgeon. The gastrectomy needs to be rescheduled. The next priority is to suggest that the patient discontinue the use of ginseng, because ginseng increases blood pressure before and during surgery. Vitamin E should not be taken, because it can increase bleeding. Decreasing the dose of ginseng will not remove the risk. Use of any herbal product should be discontinued 2 to 3 weeks before surgery, because such medicines may increase the risk of postoperative bleeding. Text Reference - p. 320
The patient tells the nurse in the preoperative setting that she has noticed she has a reaction when wearing rubber gloves. What is the most appropriate intervention? A. Notify the surgeon so the case can be cancelled. B. Ask additional questions to assess for a possible latex allergy. C. Notify the OR staff immediately so that latex-free supplies can be used. D. No intervention is needed because the patient's rubber sensitivity has no bearing on surgery.
B.
A patient asks the nurse whether he can take his regularly scheduled insulin on the morning of surgery. What is the most appropriate nursing action? A. Tell the patient to take the same dose as he or she is currently taking every day. B. Inform the surgeon of the patient's insulin use and ask whether the dose needs to be adjusted. C. Inform the patient to skip the insulin dose on the morning of surgery. D. Tell the patient to take half the usual dose on the morning of surgery
B. If the patient is taking insulin for diabetes, the nurse should inform the surgeon in order to obtain prescriptions concerning the insulin dose to be given on the day of surgery. Low or high blood sugar can lead to complications during surgery; therefore, blood sugar should be strictly controlled. The patient should not skip or reduce the dose himself or herself but should consult the surgeon and adjust the dose, if advised. Text Reference - p. 322
This will be the patient's first surgical experience and the patient states, "I am nervous about this." The vital signs show BP 158/88, HR 96, RR 24. In the assessment, the nurse finds that the lungs are clear, bowel tones are evident, peripheral pulses are strong, and the patient is fidgeting nervously. The patient took alprazolam (Xanax) at bedtime last night and takes acetaminophen (Tylenol) for tension headaches. Related to this assessment information, what should the nurse do before the patient goes to surgery? A. Review the surgery with the patient. B. Notify the anesthesia care provider (ACP). C. Administer another dose of alprazolam (Xanax). D. Tell the patient that everything will be okay with the surgery.
B. In determining the psychologic status of the patient, the nurse notes the patient's anxiety, which is supported by the elevated BP and heart rate and fidgeting. The nurse should notify the anesthesia care provider (ACP) after assessing the cause of the anxiety or fear the patient is experiencing. The patient may only need to talk about the surgery related to the situation, concerns with the unknown or body image, or past experiences to relieve the anxiety, but the nurse cannot assume that lack of knowledge is the cause of the anxiety. Medication administration will be prescribed by the ACP if needed, but medications can also be administered during surgery. Reassuring the patient is not taking the patient's needs into account.
The nurse is admitting a patient to the same-day surgery unit. The patient tells the nurse that he was so nervous he had to take kava last evening to help him sleep. Which nursing action would be most appropriate? A. Tell the patient that using kava to help sleep is often helpful. B. Inform the anesthesiologist of the patient's recent use of kava. C. Tell the patient that the kava should continue to help him relax before surgery. D. Inform the patient about the dangers of taking herbal medicines without consulting his health care provider.
B. Kava may prolong the effects of certain anesthetics. Thus the anesthesiologist needs to be informed of recent ingestion of this herbal supplement. Patients should not take anything before surgery without the health care provider's knowledge.
The nurse is admitting a patient to the same-day surgery unit. The patient tells the nurse that the patient was so nervous that the patient took kava last evening to help with sleep. Which nursing action would be most appropriate? A. Tell the patient that using kava to help sleep often is helpful. B. Inform the anesthesiologist of the patient's recent use of kava. C. Tell the patient that the kava should continue to help with relaxation before surgery. D. Inform the patient about the dangers of taking herbal medicines without consulting a health care provider.
B. Kava may prolong the effects of certain anesthetics. Thus the anesthesiologist needs to be informed of recent ingestion of this herbal supplement. Patients should not take anything before surgery without the health care provider's knowledge. Text Reference - p. 320
The nurse is providing preoperative teaching to the following patients. To which patient should the nurse plan to teach coughing and deep breathing exercises? A. A 20-year-old man who is scheduled for a tonsillectomy B. A 40-year-old woman who is scheduled for an open cholecystectomy C. A 30-year-old woman who is scheduled for a transsphenoidal hypophysectomy D. A 50-year-old man who is scheduled for an evacuation of a subdural hematoma
B. Patients with abdominal surgeries should be taught how to cough and deep breathe to prevent pulmonary complications such as atelectasis and pneumonia. Coughing and deep breathing is contraindicated in cranial surgeries (e.g., subdural hematoma evacuation or transsphenoidal hypophysectomy) and tonsillectomies.
Lorazepam (Ativan) 1 mg IV is ordered for a 45-year-old male patient before a scheduled surgery. Which of the following is the most appropriate action for the nurse to take before the administration of this medication? A. Ask the patient about an allergy to iodine or shellfish. B. Encourage or assist the patient to the bathroom to void. C. Explain that the medication is used to prevent postoperative nausea. D. Check the laboratory results for the most recent serum potassium level.
B. The nurse should instruct the patient to void before administering preoperative medications that may interfere with balance and increase the fall risk when ambulating to the bathroom. Lorazepam is a benzodiazepine that may be used for sedation and amnesia before surgery. Lorazepam does not affect serum potassium, is not contraindicated in patients with allergies to iodine or shellfish, and is not indicated to prevent or treat nausea.
When administering a preoperative medication orally (PO), what is the most important nursing action, assuming that no special instructions were given? A. Give the medicine with a glass of milk. B. Give the medicine with a small sip of water. C. Give the medicine 5 minutes before going to the operating room. D. Give the medicine the night before surgery
B. The preoperative medication should be given with a small sip of water 60 to 90 minutes before shifting the patient to the operating room. The medication should not be given only 5 minutes before going to the operating room, because effects of the medication will not begin to potentiate yet. The patient should not be given large amounts of fluid or milk orally, because it can increase the chances of regurgitation and asphyxia during surgery under the effects of anesthetics. Test-Taking Tip: Attempt to select the answer that is most complete and includes the other answers within it. For example, a stem might read, "A child's intelligence is influenced by:" and three options might be genetic inheritance, environmental factors, and past experiences. The fourth option might be multiple factors, which is a more inclusive choice and therefore the correct answer. Text Reference - p. 328
A patient has taken nothing by mouth (NPO) for eight hours before a surgery. After reaching the operating room (OR), the patient says, "I am hungry; can you bring me something to eat? And I am cold; can I have a blanket?" How should the nurse respond to the requests? A. Give the patient a cup of coffee and toast. B. Give the patient a blanket. C. Provide the patient with a glass of hot water. D. Arrange for a room heater in the operating room for the patient.
B. Warm blankets are available in operating rooms (OR) for patients when they feel cold. Oral feeding is not allowed before surgery, so the nurse should not offer coffee, toast, or hot water to the patient. If required, nutrients or fluids should be given intravenously. Room heaters can increase the room temperature but also can increase the growth of microorganisms, so a room heater should not be provided even if patients feel cold. Text Reference - p. 324
Preoperative considerations for older adults include (select all that apply) A. only using large-print educational materials. B. speaking louder for patients with hearing aids. C. recognizing that sensory deficits may be present. D. providing warm blankets to prevent hypothermia. E. teaching important information early in the morning.
C,D.
A patient is scheduled for surgery requiring general anesthesia at an ambulatory surgical center. The nurse asks him when he ate last. He replies that he had a light breakfast a couple of hours before coming to the surgery center. What should the nurse do first? A. Tell the patient to come back tomorrow, since he ate a meal. B. Proceed with the preoperative checklist, including site identification. C. Notify the anesthesia care provider of when and what the patient last ate. D. Have the patient void before administering any preoperative medications.
C.
As the nurse is preparing a patient for outpatient surgery, the patient wants to give his hearing aid to his wife so it will not be lost during surgery. Which action by the nurse should be taken in this situation? A. Give the hearing aid to the wife as he wishes. B. Tape the hearing aid to his ear to prevent loss. C. Encourage the patient to wear it for the surgery. D. Tell the surgery nurse that he has his hearing aid out.
C. Although jewelry is removed before surgery, hearing aids should be left in place to allow the patient to better follow instructions given in the surgical suite and the postanesthesia care unit (PACU), as well as the dismissal instructions that will be given before he returns home for recovery.
Which preoperative patient has the greatest risk of bleeding as a result of his or her medication? A. A woman who takes metoprolol (Lopressor) for the treatment of hypertension B. A man whose type 1 diabetes is controlled with insulin injections four times daily C. A man who is taking clopidogrel (Plavix) after the placement of a coronary artery stent D. A man who recently started taking finasteride (Proscar) for the treatment of benign prostatic hyperplasia
C. Any drug that inhibits platelet aggregation, such as clopidogrel (Plavix), represents a bleeding risk. Insulin, metoprolol (Lopressor), and finasteride (Proscar) are less likely to contribute to a risk for bleeding.
What is the primary reason for accurately recording the patient's current medications during a preoperative assessment? A. Some medications may alter the patient's perceptions about surgery. B. Many anesthetics alter renal and hepatic function, causing toxicity of other drugs. C. Some medications may interact with anesthetics, altering the potency and effect of the drugs. D. Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after surgery.
C. Drug interactions may occur between prescribed medications and anesthetic agents used during surgery. For this reason, it is important to take a careful medication history and check that they have been communicated to the anesthesia care provider. Routine medications may or may not be prescribed for use the day of surgery.
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? A. Inform the patient to discontinue the herb and return the next day. B. Tell the patient that the herb is safe and continue with surgery preparation. C. Inform the surgeon, because the surgery would need to be rescheduled. D. Tell the patient that consuming herbs is an unhealthy practice
C. Ginkgo tends to cause increased bleeding; therefore, the nurse should inform the surgeon if the patient has been using it so that the surgery can be rescheduled. Any herb should be discontinued 2 to 3 weeks before the surgery, because it may have adverse effects. The nurse should not comment on whether the practice of taking the herb is healthy or not. Text Reference - p. 324
The nurse is assigned to provide preoperative teaching to a 54-year-old man who is scheduled for coronary artery bypass surgery. The patient speaks only Spanish but the nurse only speaks English. What is the best method for the nurse to teach the patient how to use an incentive spirometer? A. Give the patient a pamphlet written in Spanish with directions on the use of the incentive spirometer. B. Ask another Spanish-speaking patient in the preoperative area to translate as the nurse describes the procedure. C. Have the hospital translator available while the nurse demonstrates the procedure and the patient returns the demonstration. D. Notify the postoperative unit to have a Spanish-speaking nurse provide education on the incentive spirometer after surgery.
C. If the patient does not speak English, it is essential that the services of a competent translator be obtained. Hospitals are required to provide translators for common languages other than English. Demonstration and return demonstration is the most effective teaching method for use of equipment such as the incentive spirometer and should be done in the preoperative period if possible.
While performing preoperative teaching, the patient asks when she needs to stop drinking water before the surgery. Based on the most recent practice guidelines established by the American Society of Anesthesiologists, the nurse tells the patient that A. she must be NPO after breakfast. B. she needs to be NPO after midnight. C. she can drink clear liquids up to 2 hours before surgery. D. she can drink clear liquids up until she is moved to the OR.
C. Practice guidelines for preoperative fasting state the minimum fasting period for clear liquids is 2 hours. Evidence-based practice no longer supports the long-standing practice of requiring patients to be NPO after midnight.
When reviewing the preoperative forms, the nurse notices that the informed consent form is not present or signed. What is the best action for the nurse to take? A. Have the patient sign the consent form. B. Have the family sign the form for the patient. C. Call the surgeon to obtain consent for surgery. D. Teach the patient about the surgery and get verbal permission.
C. The informed consent for the surgery must be obtained by the physician. The nurse can witness the signature on the consent form and verify that the patient (or caregiver if patient is a minor, unconscious, or mentally incompetent to sign) understands the informed consent. Verbal consents are not enough. The state's nurse practice act and agency policies must be followed.
The patient has a prescription for cefotetan 1 g intravenous piggyback (IVPB) q12h for six doses for cellulitis. Available is a vial filled with 1 g of cefotetan powder. The instructions state to "dilute each 1 g with 5 mL of sterile water." After reconstituting the medication, how many milliliters of solution should the nurse draw up for dosage preparation? A. 0.1 mL B. 1 mL C. 5 mL D. 6 mL
C. The nurse initially adds 5 mL of sterile water to the vial of powder on the basis of the direction to add 5 mL of sterile water per gram of medication; the vial contains 1 g. Once reconstituted, the concentration of the solution is 1 g/5 mL. Using ratio and proportion, multiply 1 by x and multiply 5 × 1 to yield 1x = 5. Divide 5 by 1 to yield 5 mL. STUDY TIP: Record the information you find to be most difficult to remember on 3" × 5" cards and carry them with you in your pocket or purse. When you are waiting in traffic or for an appointment, just pull out the cards and review again. This "found" time may add points to your test scores that you have lost in the past. Text Reference - p. 327
The nurse in an ambulatory surgery center has administered the following preoperative medications to a 42-year-old female patient scheduled for general surgery: diazepam (Valium), cefazolin (Ancef), and famotidine (Pepcid). What mode of transportation to the operating room (OR) would be the most appropriate for the nurse to arrange for this patient? A. Seated in a wheelchair accompanied by a responsible family member B. Ambulatory and accompanied by a hospital escort and a family member C. Stretcher with side rails up and accompanied by OR transportation personnel D. Ambulatory accompanied by an OR staff member or transportation personnel
C. The patient has received a sedative (diazepam) and should be transported either by stretcher (with side rails raised) or wheelchair and accompanied by either OR staff, OR transport personnel, or the nurse.
The nurse is doing a preoperative assessment on a male patient who has type 2 diabetes mellitus, weighs 146 kg, and is 5 feet 8 inches tall. Which patient assessment is a priority related to anesthesia? A. Has hemoglobin A1C of 8.5% B. Has several seasonal allergies C. Has body mass index of 48.8 kg/m2 D. Has history of postoperative vomiting
C. The patient's body mass index is the priority because it indicates the patient is severely obese. The patient's size may impair the anesthesiologist's ability to ventilate and medicate the patient properly, as well as the surgery room staff's ability to position the patient safely. The other factors are not the priority.
A 70-year-old woman has been admitted prior to having surgery for a bilateral mastectomy and breast reconstruction. What should the nurse include in the patient's preoperative teaching (select all that apply)? A. Information about various options for reconstructive surgery B. Information about the risks and benefits of her particular surgery C. Information about risk factors for breast cancer and the role of screening D. Information about where in the hospital she will be taken postoperatively E. Information about performing postoperative deep-breathing and coughing exercises
D,E. During preoperative teaching, it is important to introduce the role of deep-breathing and coughing exercises and to inform the patient about the different locations involved in her hospital stay. The specific risks and benefits of her surgery and reconstruction options should be addressed by her surgeon. Teaching about breast cancer screening would be inappropriate, and likely insensitive, at this point in her disease trajectory.
A patient who normally takes 40 units of glargine insulin (long acting) at bedtime asks the nurse what to do about her dose the night before surgery. The best response would be to have her A. skip her insulin altogether the night before surgery. B. take her usual dose at bedtime and eat a light breakfast in the morning. C. eat a moderate meal before bedtime and then take half her usual insulin dose. D. get instructions from her surgeon or health care provider on any insulin adjustments.
D.
A priority nursing intervention to assist a preoperative patient in coping with fear of postoperative pain would be to A. inform the patient that pain medication will be available. B. teach the patient to use guided imagery to help manage pain. C. describe the type of pain expected with the patient's particular surgery. D. explain the pain management plan, including the use of a pain rating scale.
D.
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? A. It may increase the risk of infections. B. It may cause atelectasis postoperatively. C. It may cause clotting of blood in the deep veins of legs. D. It may increase risk of postoperative bleeding
D. Although pain killers are required for surgical patients, the use of NSAIDS should be stopped before surgery, because these drugs are associated with increased postoperative bleeding. NSAIDS do not increase the risk of infections. NSAIDS do not cause atelectasis postoperatively. NSAIDS do not increase blood clotting. Text Reference - p. 320
During a preoperative assessment, the nurse places the highest priority on determining the patient's current medications with the understanding that: A. All medications are held on the day of surgery B. Medications may cause the patient to be unable to make informed decisions C. The patient's healing may be delayed if medications are taken before surgery D. Some medications are contraindicated for use with anesthetics
D. Drug interactions may occur between prescribed medications and anesthetic agents used during surgery. For this reason, it is important to take a careful medication history and check that it has been communicated to the anesthesiologist. Although most medications are not administered on the day of surgery, and some medications (mainly steroids) may delay healing, the greatest priority is to ensure prescribed medications will not interact with anesthesia used. Test-Taking Tip: Avoid looking for an answer pattern or code. There may be times when four or five consecutive questions have the same letter or number for the correct answer. Text Reference - p. 320
A 52-year-old female patient has come to the ambulatory surgery center for surgery. When reviewing the assessment record, what test should the nurse seek an order for before this patient has surgery? Tab 1 Tab 2 Tab 3 Past Health History Laboratory and Diagnostic Results Medications Smoker for past 25 years, last cigarette yesterday Has hypertension CBC within normal limits Chest X-ray clear UA within normal limits No other lab work drawn Takes hydrochlorothiazide 50 mg every morning A. Blood glucose B. Pregnancy test C. Serum albumin D. Serum potassium
D. The nurse should seek a serum potassium level as the patient takes a diuretic. An ECG would also be appropriate to seek with the history of hypertension and cigarette smoking. There are not indications for the need of a blood glucose, pregnancy, or serum albumin test.
It is 6:00 AM. The anesthesiologist prescribes preoperative medications for a patient who is scheduled for surgery at 7:30 AM: cefazolin (Ancef) IV to be infused 30 minutes before surgery; midazolam (Versed) before surgery and scopolamine patch (Transderm Scop) behind the ear. Which medication should the nurse administer first? A. Cefazolin (Ancef) B. Fentanyl (Sulimaze) C. Midazolam (Versed) D. Scopolamine (Transderm Scop)
D. The scopolamine patch (Transderm Scop) will be administered first to allow enough time for the serum level to become therapeutic. The cefazolin (Ancef) will be given at 7:00 AM to allow infusion 30 minutes before surgery. Fentanyl (Sulimaze) is a narcotic and was not ordered preoperatively. The midazolam (Versed), a short-acting benzodiazepine, is used as a sedative.