Prep U Chapter 17
At what time does the nurse realize it is best to begin teaching about the care needed during the postoperative period?
During the preoperative period
The nurse concludes that further teaching about diaphragmatic breathing is needed when the client:
Exhales forcefully with a sharp exhalation
When caring for a patient with alcoholism, when should the nurse assess for symptoms of alcoholic withdrawal?
On the 2nd or 3rd day
A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?
Use diaphragmatic breathing
Which nursing statement would best decrease a client's anxiety before an emergency operative procedure?
"let me explain to you what will happen next."
You are the nurse working in an ambulatory surgery center. A teenage son of your clients ask you why so many people have surgery. What would be your best reply?
Many people have diagnostic or short therapeutical surgical procedures.
When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as
Emergency
The nurse is reviewing the pre-admission laboratory findings of the client scheduled for surgery. Which of the following values would be of greatest concern to the nurse? Calcium: 9.8 Sodium: 138 Potassium: 6.2 WBC: 7.2
Potassium 6.2
The nurse is triaging surgical clients. Which client would the nurse document as in need of urgent surgical care?
A client with an acute galbladder infection (NOT the severe bleeding answer)
A patient preparing for a surgical procedure is taking corticosteroids for Crohn's disease. What should the patient be monitored for?
Adrenal insufficiency
Which domain of perioperative nursing practice focuses on clinical processes and outcomes?
Health care systems
The nurse concludes that teaching about pain management was effective when the client states:
I will support my incision with my hands when I do coughing and deep breathing exercises.
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
During the admission history the client reports to the nurse of taking the usual dose of warfarin (Coumadin) the previous day. The appropriate nursing action is:
Notify the surgeon that the client took Warfarin the day before surgery.
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.
Nutritional status, age, physical condition, health status
A client continuously repeats, "I know all will go well." What cognitive coping strategy should the nurse document?
Optimistic self-recitation
When assessing a postoperative patient, the nurse is correct to assume that keeping blood glucose levels below 150 would decrease what surgical risk factor?
Wound healing
You are physically preparing a client for surgery and instruct the person to remove all jewelry. The client refuses to remove a wedding band. What should you do if your facility allows it?
Place gauze above and beneath the band and secure with adhesive tape
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 their questions.
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?
The repair of multiple stab wounds
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
When does the nurse understand that the patient is knowledgeable about the surgical procedure they are about to undergo?
When the patient is involved in their presurgical preparation.
What action by the nurse best encompasses the preoperative phase?
Educating the patient on the s/sx of infection.
Informed consent from the surgical client is essential in all of the following categories of surgery except:
Emergent surgery (may not be conscious)
For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery?
7 days
A patient is taking 325 milligrams of aspirin each day. When should the patient stop taking the aspirin before surgery?
7-10 days before.
What is the blood glucose level goal for a diabetic patient who will be having a surgical procedure?
80-110
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
When a client with chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the client may show signs of alcohol withdrawal delirium during which time period?
After 72 hours
A 17-year-old client is having same-day surgery. Solely during the intraoperative phase of perioperative care, the nurse:
Continuously monitors the sedated patient
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?
My nurse will explain all the details of the surgery to me before I sign my consent
A client is scheduled for a cholecystectomy. Which one of these conditions would create the least surgical risk?
Osteoporosis
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.
The nurse expects informed consent to be obtained for insertion of:
a gastrostomy tube
