Surgical Care Dynamic Quiz

why is it preferable to offer a choice of clear liquids rather than water to a postoperative patient following a vaginal hysterectomy?

Water provides hydration but no other nutrients; clients often experience nausea and vomiting after surgery because of delayed gastric emptying time or decreased peristalsis. the nurse should auscultate the client's abdomen to determine the presence of bowel sounds before clear liquids can be administered

A nurse is reinforcing preoperative teaching with a client who is scheduled to undergo a pneumonectomy. the client states he is scared it will hurt to cough after the surgery. what should the nurse respond?

a client who had a pneumonectomy must cough to clear secretions from the remaining lung. the nurse should show the client hot to splint the incision to reduce pain when coughing.

calcium

administered to prevent osteoporosis when used with vitamin D

vitamin k

allows normal clotting of blood and treats impaired intestinal synthesis caused by antibiotics. Iron is needed to rebuild RBCs

warfarin

anticoagulant that is indicated to prevent thrombosis, however is has a delayed onset and is prescribed for long-term prophylaxis

ticagrelar

antiplatelet agent indicated thrombotic events in clients who have acute coronary syndrome by inhibiting platelet aggregation

aspirin

antipyretic and a nonopiod analgesic that suppresses platelet aggregation, not anticoagulation. can be used as a prophylactic therapy for ischemic stroke, transient ischemic attack, chronic stable angina, and coronary stenting

preoperative care

begins when the client agrees to have surgery and ends when the client is transferred to the surgical suite table

postoperative care

begins when the client is admitted to the PACU and ends when healing is complete

intraoperative care

begins with transferring the client to the surgical suite table and ends with the transfer to PACU

vitamin c and zinc

both vitamin C and zinc help fight a wound infection, client's should receive a multivitamin plus a mineral supplement

what symptom is an indication of a postoperative complication?

clients who have had abdominal surgery should have an oxygen saturation above 95% a client whose oxygen saturation is 85% has hypoxemia and requires immediate intervention clients who are recovering from abdominal surgery should have a urinary output that exceeds 30ml/hr Drainage of 10ml of bright red fluid immediately following surgery is an expected finding for an adult

what is a fistula

complication of wound healing that involves the formation of an abnormal passageway within or from a wound. a common sign of fistula development is chronic drainage of fluids from the wound

a nurse is assisting in teaching a group of nurses about the effects of a client receiving spinal anesthesia. which of the following pieces of information should the nurse include in the teaching?

hypotension is an adverse effect of spinal anesthesia. if hypotension occurs, the nurse should lower the head of the client's bed, increase fluids if applicable, and administer vasoconstrictive medication as indicated by the provider

enoxaparin

is a low-molecular-weight heparin that is used to prevent a DVT by inhibiting the effects of antithrombin and thrombin

vitamin d

maintains normal calcium and phosphorus levels in the blood, is important when used with calcium to prevent osteoporosis; might protect against cancer

a nurse is caring for a client who reports feeling a pop after coughing without properly splinting an abdominal incision. The nurse finds the client's wound has eviscerated. Which of the following actions should the nurse take?

place the client in a supine position with hips and knees flexed leave the room to call the surgeon cover the wound and intestine with a sterile, moistened dressing monitor the client for manifestations of shock

A nurse finds an incision that has separated and intestinal tissue is protruding, after calling for help, which of the following actions should the nurse take?

position the client supine with the knees in flexion because it reduces any strain that could cause further opening of the incision and worsening of the evisceration.. wearing a binder can help prevent, not treat an evisceration

signs of healing wound without complications

slightly edematous, appears pink with crusting edges and is draining serosanguinous fluid

what should the nurse reinforce when teaching a client how to use an incentive spirometer?

the nurse should instruct the client to hold their breath for 3-5 seconds after reaching maximal inspiratory volume. This decreases the collapse of alveoli, which helps prevent the risk of atelectasis and pneumonia

why should the RN intervene the new nurse when they maintain a client on bed rest while the PCA pump is in use?

use of the PCA pump does not prevent ambulation following surgery. Early ambulation should be encouraged. the nurse should instruct the client to sit at the side of the bed prior to standing to reduce the risk of orthostatic hypotension and falls

signs of wound infection

warmth, erythema, and purulent drainage