Med Surg CH 17
The on-call perioperative team is called for an urgent surgery to be performed as soon as they arrive. What surgical procedure is considered emergent?
A repair of multiple stab wounds
You are caring for a client preoperatively who is very anxious and fearful about their surgery. You know that this client's anxiety can cause problems with the surgical experiences. What type of problems can this client have because of their anxiety and fear?
Anxious clients have a poor response to surgery and are prone to complications.
At which time does the RN realize that it is best to begin teaching about care needed during the postoperative period?
During the preoperative period
What action by the RN best encompasses the preoperative phase?
Education clients on signs and symptoms of infection
A nurse is teaching a client about pain management after surgery. Which client statement indicates the teaching was effective?
I will support my incision with my hands when I cough and do my deep breathing exercises
The nurse is conducting a preoperative assessment on a client scheduled for gallbladder surgery. The client reports a frequent cough producing green sputum for 3 days and denies fever. Upon auscultation the nurse notes rhonchi throughout the right lung, with an occasional expiratory wheeze. Resp rate is 20, temp is 99.8 (oral), HR is 87 and BP is 124/70. What is best action for the nurse?
Notify the surgeon to possibly delay the surgery.
An elderly pt is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?
Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients.
Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery?
Physician
The nurse in the pre-op area has just medicated her pt according to the anesthesiologist's orders. what is the nurse's priority action at this time?
Place the side rails in the up position and make sure the call button is in reach
A nurse is witnessing a client sign the consent form for surgery. After signing the consent form, the client starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate?
Request that the surgeon come and answer the questions
A pt is undergoing thoracic surgery. What priority education should the RN provide to assist preventing respiratory complications?
Splint the incision site using a pillow during deep breathing and coughing exercises.
The nurse has provided pre-op instructions to a pt scheduled for surgery at an ambulatory care center. Which statement, made by the pt would indicate that further instruction is needed?
The nurse will explain the details of the surgery before I sign a consent.
A perioperative nurse is assigned to complete a pre-op assessment on a pt who is scheduled for surgery for kidney stones the next day. What category of surgery does this procedure fall into?
Urgent
The perioperative nurse has a number of major responsibilities when the pt is admitted to the surgical unit or center. Which of the following is the most important function?
Verifies that operative consent is signed
The RN would identify which vitamin deficiency to prevent hemorrhaging during surgery
Vitamin K
The RN is completing a pre-op assessment. The RN notices the client is tearful and constantly wringing their hands. The pt states "I am really nervous about this surgery. Do you think I will be ok?" what is the nurse's best response
What are your concerns?
Considered to require an urgent surgical procedure
acute gallbladder infection
A pt is preparing for a surgical procedure is taking corticosteriods for Crohn's disease. What is most important for the nurse to monitor during the operative experience with the client?
adrenal insufficiency
A pt is scheduled for a surgical procedure. For which surgical procedure should the RN prepare and informed consent form for the surgeon to sign?
an open reduction of a fracture
A physically fit older adult is scheduled for right knee replacement. What factor for the client creates an increased risk for post-op complications?
current smoking history
When the indication for surgery is without delay, the nurse recognizes that the surgery was classified as
emergency
A fractured skull would be classified under which category of surgery bases on urgency?
emergent
A gunshot wound would be classified as
emergent surgery
A pt is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications?
osteoporosis
The nurse assesses a pt to determine if there is increased risk for complications intraoperatively or postoperatively. What are general risk factors?
physical condition health status age nutritional status
When is the ideal time to discuss preoperative teaching
preadmission visit
A pt is scheduled to have surgery to address a cleft palate. what type of surgery would the nurse be preparing the client for?
reconstructive
A client is scheduled for a surgical procedure. When planning the client's care, the nurse should consider that which of the following conditions will increase the client's risk of complications after surgery?
a history of diabetes
The nurse is evaluating the client's understanding of diet teaching aimed at promoting wound healing following surgery. The nurse would conclude teaching was ineffective if the client selects which of the following?
cheeseburger, french fries, coleslaw and ice cream
Nursing assessment findings reveal that the client is afraid of dying during the surgical procedure. Which surgical team member would be most helpful in addressing the client's concern?
surgeon
The nurse discovers that the client did not sign the operative consent before receiving the preoperative medication. The appropriate nursing action is:
to notify the surgoen
A RN is teaching a pt with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?
use diaphragmatic breathing
A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which client surgical risk factor would decrease if the surgical client maintained strict blood glycemic control?
wound healing
A client having a surgical procedure takes aspirin 325 mg daily for prevention of platelet aggregation. When should the client stop taking the aspirin before the surgery?
7-10 days
What is the blood glucose level goal for a diabetic pt who will be having a surgical procedure?
80-110mg/dL
A pt with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to lab results?
blood urea nitrogen (BUN) level of 42mg/dl
Why is assessment of dentition important in the patient preparing to have a surgical procedure with general anesthesia?
decayed teeth or dental prosthesis can become dislodged during intubation.
You are physically preparing a client for surgery and instruct the person to remove any jewelry. The client refuses to remove a wedding band. What should you do in this situation with approval from your facility?
place gauze under and over the ring and apply adhesive tape over it
An obese pt is scheduled for open abdominal surgery. What priority education should the RN provide to this pt?
prevention of respiratory complications
