NU 310 Chapter 17: Preoperative Nursing
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."
Which nursing statement would best decrease a client's anxiety before an emergency operative procedure?
"Let me explain to you what will happen next."
The nurse has provided preoperative instructions to a client scheduled for surgery at an ambulatory care center. Which statement, made by the client, would indicate that further instruction is needed?
"The nurse will explain the details of the surgery before I sign a consent."
The nurse is starting preoperative teaching. What is the best response by the nurse when the client states, "I'm so nervous about my surgery"?
"Would you like to discuss the concerns that you have?"
The parent of a 16-year-old client asks the nurse, "How could the surgeon operate without my consent?" What is the best response by the nurse?
"Your child had life-threatening injuries that required immediate surgery."
For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery?
7
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 to 10 days
What is the therapeutic range of glycemic blood levels?
80-110 mg/dL
A client refuses to remove her wedding band when preparing for surgery. What is the best action for the nurse to take?
Allow the client to wear the ring and cover it with tape.
A patient is scheduled for a surgical procedure. For which surgical procedure should the nurse prepare an informed consent form for the surgeon to sign?
An open reduction of a fracture
The client is scheduled for a biopsy for suspected cancer of the prostate. The nurse recognizes the purpose of this surgical procedure is:
Diagnostic
What action by the nurse best encompasses the preoperative phase?
Educating clients on signs and symptoms of infection
A patient with uncontrolled diabetes is scheduled for a surgical procedure. What chief life-threatening hazard should the nurse monitor for?
Hypoglycemia
A client is undergoing preoperative assessment. During admission paperwork, the client reports having enjoyed a hearty breakfast this morning to be ready for the procedure. What is the nurse's next action?
Notify the surgeon.
A client is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications? A. pregnancy B. osteoporosis C. diabetes D. UTI
Osteoporosis
When is the ideal time to discuss preoperative teaching?
Preadmission visit
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.
This type of surgery means that the client needs to have surgery, and it should be planned within a few weeks or months.
Required
As a nurse working in an ambulatory surgery center, you are admitting a client who is going to have a biopsy of a skin lesion. What is an important part of the preoperative process?
Review preoperative instructions.
A client is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications?
Splint the incision site using a pillow during deep breathing and coughing exercises.
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
Which client would the nurse recognize as having the greatest risk for complications during the intraoperative or postoperative period?
The 35-year-old client with non-insulin dependent diabetes.
The nurse is caring for the client in the preoperative period and documenting rationale for a palliative surgical procedure. Which rationale is most appropriate?
The client and physician are focusing on symptom relief not a cure.
A nurse is teaching a client about diaphragmatic breathing. What client action indicates that further teaching is needed?
The client exhales forcefully with a short expiration.
When does the nurse understand the patient is knowledgeable about the impending surgical procedure?
The patient participates willingly in the preoperative preparation.
The nurse is educating a community group about types of surgery. A member of the group asks the nurse to describe a type of surgery that is curative. What response by the nurse is true?
Tumor excision
The nurse would identify which vitamin deficiency to prevent hemorrhaging during surgery?
Vitamin K
Which nutrient plays an important role in normal blood clotting?
Vitamin K
The nurse expects informed consent to be obtained for insertion of:
a gastrostomy tube (Informed consent is required for invasive procedures that require sedation and are associated with more than usual risk to the client.)
A nurse is caring for a bariatric client prior to a surgical procedure. What surgical complications would the nurse monitor the bariatric client for postoperatively? Select all that apply. A. gastrointestinal complications B. cardiovascular complications C. pulmonary complications D. nervous system complications E. renal system complications
cardiovascular complications pulmonary complications
A 17-year-old client is having same-day surgery. Solely during the intraoperative phase of perioperative care, the nurse:
continuously monitors the sedated client.
A physically fit older adult is scheduled for right knee replacement. What factor for the client creates an increased risk for postoperative complications?
current smoking history
This type of surgery means that there is an indication for surgery, but failure to have surgery will not be catastrophic.
elective
When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as:
emergency.
A fractured skull would be classified under which category of surgery based on urgency?
emergent
Informed consent from the surgical client is essential in all of the following categories of surgery except:
emergent
Which health care profession has the ultimate responsibility to provide appropriate information regarding a nonemergent surgery?
physician
The nurse is reviewing the pre-admission laboratory findings of the client scheduled for surgery. Which laboratory value would be of greatest concern to the nurse? A. white blood cell count 7.2 cells/mm B. calcium 9.8 mg/dL C. potassium 6.2 mEq/L D. sodium 138 mEq/L
potassium 6.2 mEq/L
In which phase of perioperative care will the nurse prepare the client's skin, encourage the client to void, and remove the client's dentures?
preoperative
This type of surgery means that the client requires prompt attention within 24 to 30 hours.
urgent
A nurse is assessing a postoperative client with hyperglycemic blood glucose levels. Which post-surgical risk factor would decrease if the surgical client maintained strict blood glycemic control?
wound healing
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
At which time does the nurse realize that it is best to begin teaching about care needed during the postoperative period?
During the preoperative period
An anxious client being prepared for surgery is encouraged to concentrate on a pleasant experience or restful scene. What cognitive coping strategy would the nurse document as being used?
Imagery
Clients who have received corticosteroids preoperatively are at risk for which type of insufficiency?
adrenal
A client is preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What is most important for the nurse to monitor during the operative experience with the client?
adrenal insufficiency
In preparing the client for transfer to the operating room, which of the following actions by the nurse is inappropriate?
allow the client to wear dentures
A nurse evaluates the potential effects of a client's medication therapies before surgery. Which drug classification may cause respiratory depression from an associated electrolyte imbalance during anesthesia?
diuretics
Once the operating team has assembled in the room, the circulating nurse calls for a "time out." What action should the nurse take during the time out?
Review the scheduled procedure, site, and client.
The nurse assesses a client to determine if there is increased risk for complications intraoperatively or postoperatively. Which are general risk factors? Select all that apply. A. gender B. nutritional status C. age D. physical condition E. ethnicity F. health status
nutritional status age physical condition health status
A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?
use diaphragmatic breathing