Chapter 17 Med Surg
The physician schedules an elective surgical procedure for patient who smokes cigarettes. When should the patient cease smoking before the surgical procedure to minimize risks associated with cigarette smoking?
1 to 2 months
A patient having a surgical procedure takes aspirin 325 mg daily for privation of platelet aggregation. When should the patient stop taking the aspirin before the surgery?
7 to 10 days
Aspirin is withheld _________ days prior to surgery, if possible, because it acts by _______________
7 to 10 days; inhibiting platelet aggregation
The on call preoperative team is called for an urgent surgery to be performed as soon as they arrive. What surgical procedure is considered urgent?
A repair of multiple stab wounds
The nurse assesses an older adult patient who complains of dimmed vision. What does this alert the nurse to plan for?
A safe environment
A patient preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What should the patient be monitored for?
Adrenal insufficiency
What assessment of dentition is important in the patient preparing to have a surgical procedure with general anesthesia?
Decayed teeth or dental prosthesis can become dislodged during intubation
List three significant nutritional concerns for the elder surgical patient:
Dehydration, hypovolemia, electrolyte imbalances
The nurse is monitoring a presurgical patient for electrolyte imbalance. Which classification of mediation may cause electrolyte imbalance?
Diuretics
A patient with uncontrolled diabetes is scheduled for a surgical procedure. What chief life threatening hazard should the nurse monitor for?
Hypoglycemia
When caring for patient with alcoholism, when should the nurse assess for symptoms of alcoholic withdrawal?
On the second or third day
A patient is scheduled for a reduction mamoplasty. What classification of surgery does the nurse understand that this is?
Optimal
Allows for collagen deposition to occur
Protein
How doe stye nurse determine that the patient may have hidden fears about the impending surgical procedure? (Select all that apply)
The patient avoids communication with the nurse - The patient repeatedly asks questions that have previously been answered - The patient talks incessantly
When does the nurse understand the patient is knowledgeable about the impending surgical procedure?
The patient participates willingly in the preoperative preparation
The patient is NPO prior to having a colonscopy. The patient is to take a daily blood pressure pill prior to the procedure. Until when may water be given prior to the procedure?
Up to 2 hours before surgery
Increases inflammatory response in wounds
Vitamin A
Vital for capillary formation
Vitamin C
Essential for normal blood clotting
Vitamin K
Necessary for DNA synthesis
Zinc
Diabetics undergoing surgery are at risk for four complications:
hypoglycemia, hyperglycemia, acidosis, glucosuria
Name three primary goals necessary to promote postoperative mobility:
improve circulation, prevent venous stasis, promote optimal respiratory function
The intraoperative phase begins when the patient _______ and ends when _______
is transferred to the operating table; the patient is admitted to the PACU
The leading causes of postoperative morbidity and mortality in older adults are ________ and ____________ complications
respiratory and cardiac
The hazards of surgery for the elderly are directly proportional to ______________ and _______________
the number and severity of coexisting health problems, the nature and duration of the operative procedure
Informed consent for a surgical procedure is necessary when a procedure meets any of the following:
- it is invasive - it requires sedation or anesthesia - it involved radiation - it has a slight or risk of potential harm
What is the blood glucose level goal for a diabetic patient who will be having a surgical procedure?
80 - 110 mg/dl
A patient with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to laboratory results?
A blood urea nitrogen level of 42 mg/ dl
A patient is scheduled for a surgical procedure. For which procedure should the nurse prepare an informed consent form for the surgeon to sign?
An open reduction of a fracture
The patient asks the nurse why food is withheld before surgery. What is the best response by the nurse?
Aspiration is a concern and can be complication if food or fluid is taken close to the surgery time
The preoperative phase begins ________ and ends when he patient __________
When the decision to do surgery is made; is transferred onto the operating room table
The nurse is caring for patient with liver disease who had a surgical procedure. When should the nurse alert the physician?
When the patient's blood ammonia concentration reaches 180 mg/dl
What is the best response by the nurse when the patient states, "I'm so nervous about my surgery?"
Would you like to discuss the concerns that you have?
The nurse is caring for patient who is obese prior to a surgical procedure. What surgical complications positively correlated with obesity should the nurse monitor for? (Select all that apply)
- Cardiovascular system - Gastrointestinal system - Pulmonary system