med/surg chapter 16 Preop

The nurse has just completed preoperative teaching with a client who will be having surgery the following day. Which statement by the client indicates that additional teaching is needed?

"I will go to the bathroom as soon as I receive all my preoperative medications."

A client tells the nurse that he has an advance directive with durable power of attorney for health care. The client asks how the advance directive will affect the surgery. What is the nurse's best response?

"If you are unable to make a decision, your designee will be asked."

When the nurse brings a client's preoperative medications, the client responds, "I don't need that. I had a good night's sleep last night." What is the nurse's best response?

"Let me teach you about your medications for surgery."

A client will be undergoing palliative surgery. The client's daughter asks what this means. What is the nurse's best response?

"The surgery will relieve the symptoms but will not cure your father."

The nurse is conducting preoperative teaching with a client who will be undergoing pelvic surgery. What teaching is essential for this client? (Select all that apply.)

"Wearing elastic stockings and using pneumatic compression devices are essential after surgery.", "Coughing and deep breathing will help to decrease postoperative complications.", "Turning and moving your legs after surgery will help prevent clots from forming."

Four clients are scheduled for surgery. Which client does the nurse determine is at highest risk for postsurgical complications?

89-year-old scheduled for a knee replacement

The nurse is preparing to transfer a client to the operating room for surgery. Put the interventions in order for the nurse to perform. (List in order of priority.)

Ask the client to state his or her name and check the ID band, Have the client go to the bathroom to void, Take a full set of vital signs, Administer ordered preoperative sedation

The nurse reviews a client's laboratory results before surgery and notes a fasting blood glucose of 120 mg/dL, a prothrombin time (PT) of 25 seconds, and potassium (K+) of 3.8 mEq/L. Which action by the nurse is best?

Ask the surgeon for additional laboratory studies.

Twenty minutes after a client has received a preoperative injection of atropine and midazolam (Versed), the client tells the nurse that he must be allergic to the medication because his mouth is dry and his heart seems to be beating faster than normal. What is the nurse's priority action?

Assess the client's pulse and blood pressure.

The nurse is conducting preoperative assessments. Which client does the nurse teach about the possibility of developing a venous thromboembolism (VTE)?

Client undergoing hip replacement surgery

A client is brought to the hospital unconscious and needs emergency surgery. The client's only family member cannot come to the hospital before the surgery. Which is the best option for obtaining informed consent for the client's emergent surgery?

Contact the family member by phone and obtain verbal consent with two witnesses.

A client is brought to the emergency department (ED) after a motorcycle accident. The client has suffered a ruptured spleen. What is the immediate priority?

Emergent surgery to control bleeding

Which action is most appropriate during a preoperative chart review?

Ensure that the consent form is signed, dated, and witnessed.

A client receiving preoperative medication tells the nurse that she took all the following vitamins and herbs last night before going to bed. Which one does the nurse report to the surgical team as a priority?

Garlic

What recently learned information about a client who is scheduled to have surgery within the next 2 hours is the nurse certain to communicate to the surgical team?

Hearing problem

Which medications does the nurse correctly administer preoperatively? (Select all that apply.)

Hydroxyzine (Atarax, Vistaril) for sedation, Lorazepam (Ativan) for anxiety, Metoclopramide (Reglan) to increase stomach emptying

The nurse is caring for an older adult client with a history of chronic lung disease who will be undergoing surgery the following day. When postoperative care is planned, which potential problem is the highest priority for this client?

Maintaining oxygenation

When examining an adult client's preoperative laboratory results, the nurse notes that the potassium level is 2.9 mEq/mL. What is the nurse's priority action?

Notify the surgeon

The nurse is completing preoperative teaching for a client, and it becomes apparent that the client does not understand the surgery that will be performed. What is the priority action for the nurse?

Notify the surgeon and document the finding.

A client undergoing preoperative assessment informs the nurse that he takes medication for high blood pressure and for asthma. What is the nurse's best action?

Notify the surgeon and the anesthesiologist.

During the preoperative assessment, the client tells the nurse that he smokes three packs of cigarettes daily. Which action by the nurse is best?

Perform a respiratory assessment.

The nurse is assessing a client before surgery. Which assessments contraindicate the client having surgery as scheduled? (Select all that apply.)

Potassium level of 2.8 mEq/L, International normalized ratio (INR) of 4, Positive pregnancy test

A client voluntarily signed the operative consent form. What is the nurse's next action?

Sign under the client's name as a witness.

The nurse applies antiembolism stockings to a client preoperatively. When the client says that they are uncomfortably tight, what is the nurse's best action?

Teach the client the purpose of wearing the stockings.

The nurse is performing preoperative teaching with an older adult client who will be having colon resection surgery the following day. The surgeon has ordered bowel preparation the night before. Which action is a priority?

Tell the client not to get up and go to the bathroom alone.

What data are essential for the nurse to assess on a client who is scheduled for surgery? (Select all that apply.)

Use of tobacco, Current medications, Use of herbal or over-the-counter therapy, Mental status examination, Allergies

The nurse is caring for a client who will be undergoing emergency surgery as soon as possible. Which information is most important for the nurse to teach the client at this time?

What to expect in the operating and recovery rooms