perioperative nursing

Place the client in a flat position with legs elevated 45 degrees -this position uses gravity to help direct blood to the vital organs

A nurse caring for clients in a PACU assesses a client who is displaying signs and symptoms of shock. What is the priority nursing intervention for this client?

altered mood -conscious sedation is a type of anesthesia used for short procedures -the IV administration of sedatives and analgesics raises the pain threshold and produces an altered mood and some degree of amnesia, but the client maintains cardiopulmondary function and can respons to verbal commands

A nurse explain explains the effect of conscious sedation to a client undergoing a colonoscopy. which of the following occurs with conscious sedation?

Void Normally -The client should be able to void normally before discharge

A nurse from the ambulatory surgical center is preparing discharge instructions for a client who has had a pelvic surgery. Which criterion would the client need to demonstrate to ensure that she is ready for discharge?

administering supplementary oxygen, as needed -

A client has been admitted to the surgical recovery unit following abdominal surgery. Which nursing intervention occurs during this phase of the surgical experience(post operative phase)?

place the client in semi-fowler's position -Nursing interventions include notifying the physician immediately, calling the medical intervention team, maintaining the client on bed rest in the semi-Fowler's position, assessing vital signs frequently, administering oxygen, administering medications (e.g., anticoagulants, analgesics), and instructing the client to avoid Valsalva maneuver (this prevents increased intrathoracic pressure and, possibly, increased emboli).

A nurse is assessing a client who is experiencing pulmonary embolus. What would be the priority nursing intervention for this client?

implement leg exercises and tunr the client in bed every 2 hrs

A nurse is monitoring a client post cardiac surgery. What action would help to prevent cardiovascular complications for this client?

implement leg exercises and turn the client in bed every 2 hours -ambultion and leg exercises increase circulation, which prevents cardiovascular complication.

A nurse is monitoring a client post cardiac surgery. What action would help to prevent cardiovascular complications for this client?

raising the stretcher side rails when administering a sedative -making sure of a clients safety with raising the side rails of the clients ben up when administering a sedative is the most important.

A nurse is working with a group of clients in the preopertive area. Which client taks would be highest proority?

-Decreased peripheral circulation -increased vascular rigidity -decreased thermoregulation ability older adults have decreased cardiac output, decreased peripheral circulation, decreased oxygenation of blood, decreased thermoregulation ability, and decreased skin moisture and elasticity, and increased vascular rigidity

A nurse preparing an older adult client for hip replacement surgery is aware of the surgical risks related to the clients age. Related risks are?

"The operating table is a firm surface; we need to be sure your skin looks okay." -The client who has been on the operating table should be examined to ensure skin breakdown hasnt occured. Initial assessment should have been done during admission

A postoperative client states "I don't understand why you are checking my skin on my back. My surgery was on my stomach." What is the nurse's best response?

assure that diagnostic testing has been completed and results are available

The acute care nurse is preparing a client for surgery. Which action is essential to complete before transferring the client to surgery?

massages legs prior to application -massaging the legs can dislodge clots.

The nurse has delegated to the unlicensed assistive personnel (UAP) the application of antiembolism stockings to a client who had an endarterectomy earlier in the day. Which UAP action requires the nurse to immediately intervene?

respiratory obstruction (most common complication) -respiratory obstruction may occur as a result of secretion accumulation, obstruction by the tongue, laryngospasm (a sudden, violent contraction of the vocal cords), or laryngeal edema. -cardiac distress, wound infection, and dehydration are all possible post op complications but not resp. obstruction is the most common.

The nurse is assessing clients for postoperative complications. What is the most commonly assessed postanesthesia recovery emergency?

"while my pneumatic compression device is on, I dont need to do leg exercises" -compression stockings and pneumatic compression devices help to decrease the formation of thrombus by helping to promote venous return to the heart. The nurse needs to clarify that the pneumatic compression device does not replace leg exercises because the exercises help keep the joints flexible and help strengthen muscles while the client is in bed.

The nurse needs to evaluate the effectiveness of a preoperative teaching session with a client scheduled for abdominal surgery. Which client statement indicates the need for further clarification?

keep the client in the preoperative area and inform the surgeon that it is the health care provider's responsibility to obtain consent for surgery -If a consent form is not signed, the nurse should notify the surgeon. It is the health care provider's responsibility to obtain consent for surgery and anesthesia. Preoperative medications cannot be given until the consent form is signed. The client should not proceed to surgery without a signed consent form (unless it is an emergency)

The preoperative nurse is reviewing the chart of a client whose surgery is scheduled to begin in the next 15 minutes and notices that the consent form is not signed. The nurse contacts the surgeon who states, "We have already reviewed this procedure extensively, so ask the client to sign the consent form and I will verify it in the operating room." Which action by the nurse is appropriate?

spinal block nerve block epidural block -regional anesthesia occurs when an anesthetic agent is injected near a nerve or nerve pathway in or around the operative site, inhibiting the transmission of sensory stimuli to central nervous system receptors. -regional anesthesia includes spinal, erve, and epidural blockers.

Which methods would the nurse anesthetist use when administering regional anesthesia to surgical clients?

type of surgery -the type of surgery is the most important influence on what type of care the client will require after surgery

Which factor is most important in the nurse's decision on assessment data, outcomes, and the monitoring needs of a client in preparing for surgery?

the surgeon

Who is legally responsible for obtaining the clients informed consent for a surgical procedure?

administered through inhalation and intravenous

general anesthesia

begins when the patient is transferred to the postanesthesia care unit (PACU) -putting in IV lines and administering fluids occurs here

intraoperative phase

begins with the decision to have surgery, lasts until patient is transferred to operating room or procedural bed -oxygen therapy may be needed in this phase

postoperative phase

lasts from admission to the PACU or other recovery area to complete recovery from surgery and last follow-up health care provider visit -teaching deep-breathing exercises and reviewing the meaning of PRN (as needed) orders for medications occur here

preoperative phase

Notify the physician of the oversight -Do not administer any medications that might alter judgment or perception before the client signs the consent form because many drugs commonly administered before preoperative medications can alter cognitive abilities and invalidate informed consent.

the FIRST action a nurse should do when noticing the consent form was not signed by the client prior to surgical procedure

ileostomy -Permanent changes in the client's activity level may occur as a result of surgery. The client with an ileostomy will encounter the greatest changes in lifestyle.

which client will see the greatest permanent changes in lifestyle following surgery?