MedSurg: Perioperative
The nurse is reviewing the surgeon's prescription sheet for a preoperative client, which states that the client must NPO (nothing by mouth) after midnight. Which medication should the nurse clarify to be given and not withheld?
Atenolol
The nurse is caring for a 25-year old client who will undergo bilateral orchidectomy for testicular cancer. Which statement by the nurse would be helpful in exploring the client's concerns about loss of reproductive ability?
"Can you share with me any concerns about how this surgery will affect you in the future?
A preoperative client expresses anxiety to the nurse about upcoming surgery. Which response by the nurse is most likely to stimulate further discussion between the client and the nurse?
"Can you share with me what you've been told about your surgery?"
The nurse cares for a client prior to surgery. The client asks the nurse, "what is the advantage of spinal anesthesia over general anesthesia for controlling my pain?" Which is the best response by the nurse?
"Your pain can be managed without making you as sleepy."
The nurse is creating a plan of care for a client scheduled for surgery. The nurse should include which activity in the nursing care plan for the client on the day of surgery?
Have the patient void immediately before going into surgery
Which type of anesthesia would be used for a colonoscopy in the endoscopy clinic?
Monitored anesthesia care
Which statement is accurate regarding the hydration status of an older adult being prepared for surgery?
There is a narrow margin of safety between overhydration and underhydration in elderly patients
A client has received atropine sulfate intravenously during a surgical procedure. The nurse should monitor the client for which side effect of the medication in the immediate postoperative period?
Urinary retention
The nurse is conducting preoperative teaching with a client about the use of an incentive spirometer. The nurse should include which piece of information in discussions with the client?
-The best results are achieved when sitting up or with head of the bed elevated 45 to 90 degrees
what does a preoperative informed consent disclose?
-medical diagnosis and reason for treatment -procedure to be performed -name of the person performing the procedure -qualifications of the person performing the procedure -names of individuals assisting with the procedure -risks and benefits of the procedure -alternative treatments -the right to refuse or withdraw consent at a later date
A patient with diabetes who takes insulin is scheduled for surgery. Which instruction would the nurse tell the patient about insulin injections around the time of the surgery?
-An adjusted insulin dose may be given before surgery based on the patient's history of glucose control.
Which collecting a preoperative history, the patient reports to the nurse a history of diffuse skin rashes when hospitalized in the past as well as food allergies to bananas and avocados. Which action would the nurse take?
-Ask additional questions to asses for a possible latex allergy
The nurse is developing a plan of care for a preoperative client who has a latex allergy. Which intervention should be in the plan?
Apply a cloth barrier to the client's arm under a blood pressure cuff when taking the blood pressure
The nurse prepares a client 1 hour prior to surgery. Which assessment finding does the nurse need to communicate to the surgeon at this time?
Daily garlic capsules, last dose yesterday morning
Scopolamine is an anticholinergic medication that causes the frequent side effects?
Dry mouth, urinary retention, decreased sweating, and dilation of the pupils
A preoperative client has received a dose of Scopolamine as prescribed by the anesthesiologist. The nurse should assess the client for which anticipated side effect of this medication?
Dry oral mucous membranes
The nurse is preparing a preoperative client for transfer to the operating room. The nurse should take which action in the care of this client at this time?
Ensure that the client has voided
A client who is being treated for AML has bruises on both legs. What is the nurse's most appropriate action?
Evaluate the client's platelet count
A client who has undergone preadmission testing has had blood drawn for serum laboratory studies, including a complete blood count, coagulation studies, and electrolyte and creatinine levels. Which lab result should be reported to the surgeon's office by the nurse, knowing that it could cause surgery to be postponed?
Hemoglobin, 8.0g/gL (80mmol/L)
Which step occurs in the initial stage when a patient receiving general anesthesia?
Induction is performed with an IV agent
A patient going for surgery today informs the nurse she they took Kava last night to help her sleep. Which nurse action would the nurse take?
Inform the Anesthesiologist of the patient's recent use of kava
A patient is scheduled for surgery in one week and reports that he takes a fish oil capsule daily. Which intervention would be the priority?
Inform the health care provider because the procedure may need to be rescheduled.
A patient begins having hallucinations and agitation after receiving dissociative anesthesia. Which anesthetic agent is associated with this complication?
KETAMINE
A public health nurse is advising a group of patients to regularly exercise and take multivitamin tablets. What should the nurse tell them about multivitamin use if they need a surgical intervention?
Multivitamin tablets can be taken until the day before surgery
When reviewing preoperative forms, the nurse notices that the patient's informed consent is not signed. Which action would the nurse take?
Notify the health care provider to obtain consent for surgery
The nurse is providing preoperative teaching to a client scheduled for a cholecystectomy. Which intervention would be on highest priority in the preoperative teaching plan?
Teaching coughing and deep-breathing exercises
A patient scheduled for surgery asks the nurse where his or her family can be in the surgical suite. Which response by the nurse is accurate?
The family can be with patient in the preoperative holding area.
An older adult patient is being prepared for a cholecystectomy, which patient information would the nurse include as part of the preoperative assessment?
-Fluid balance history -Current mobility problems -Current cognitive function
During the preoperative nursing assessment of a patient, which questions would the nurse ask to determine fi the patient has a latex allergy?
-Have you ever had hay fever or asthma? -Do you work or have you worked in the rubber industry? -Are you allergic to food items like eggs and chestnuts?
A patient is instructed not to have anything to eat or drink eight hours prior to surgery. When arriving to the preoperative holding area, the patient informs the nurse they ate eggs and toast about two hours ago. Which response by the nurse is most appropriate?
-I will inform the anesthesia care provider and surgeon to see what the options are.
The nurse has instructed a preoperative client using an incentive spirometer to sustain the inhaled breath for 3 seconds. When the client asks about the rationale for this action, the nurse explains that this action achieves which function?
-Maintains inflation of the alveoli
Which type of anesthesia is a nurse able to administer without the presence of an anesthesia care provider (ACP)?
-Moderate sedation
Prior to a first-ever surgery, a patient reports taking alprazolam the night before for anxiety. Preoperative vital signs include BP 158/88, heart rate (HR) 96, and respiratory rate (RR) 24. Which action would the nurse take?
-Notify the anesthesia care provider (ACP)
Which patients would require administration of preoperative antibiotics?
-Patient undergoing gastrointestinal surgery -Patients undergoing joint replacement surgery -Patients with a history of valvular heart diseases.
A patient scheduled for heart valve replacement surgery voices general concern about the surgery. Which method would be useful to help decrease this patient's anxiety?
-Provide web-based and audio-visual teaching materials about the surgery
The patient scheduled for surgery asks the nurse why Cefazolin has been prescribed by the health care provider. Which response by the nurse is accurate?
"Cefazolin is an antibiotic given for two days to prevent postoperative infection."
The nurse is preparing a client for surgery scheduled in 2 hours. Which interventions are appropriate in the preoperative period?
-Assist the client to void before transfer to the operating room -Check all surgeon's prescriptions to ensure they have been carried out -Review the client's record for a history and physical report and lab reports
The nurse is reviewing the blood tests of a generally healthy client who is scheduled for Orthopedic surgery under general anesthesia. Besides a complete blood count (CBC), what preadmission blood tests would the preoperative nurse expect to be prescribed?
-Clotting studies -Glucose fasting -Electrolyte levels -Serum creatinine and blood urea nitrogen (BUN) levels
A client scheduled for surgery receives a dose of scopolamine. The nurse expects to note which side effects of the medication?
-Dry mouth -Pupillary dilation -Urinary retention -Decreased sweating
