Surgery Prep U

The nurse is preparing to change a client's abdominal dressing. The nurse recognizes the first step is to provide the client with information regarding the procedure. Which of the following explanations should the nurse provide to the client?

"During the dressing change, I will provide privacy at a time of your choosing, it should not be painful, and you can look at the incision and help with the procedure if you want to."

What measurement should the nurse report to the physician in the immediate postoperative period?

A systolic blood pressure lower than 90 mm Hg

The nurse is assigned a client scheduled for an outpatient colonoscopy in an ambulatory care setting. During which phase of perioperative care would the nurse document the admission vital signs in the recovery room?

During the postoperative phase

The intraoperative nurse is transferring a client from the OR to the PACU after replacement of the right knee. The client is an 83-year-old woman. The nurse should prioritize which of the following actions?

Keeping the client warm

The nurse in the preoperative area has just medicated her client according to the anesthesiologist's orders. What is the nurse's priority action at this time?

Place the side rails in the up position and make sure the call button is in reach.

The nurse knows that elderly clients are at higher risk for complications and adverse outcomes during the intraoperative period. What is the best rationale for this phenomenon?

Reduced ability to adjust rapidly to emotional and physical stress

A postanesthesia care unit (PACU) nurse is preparing to discharge a client home following ankle surgery. The client keeps staring at the ceiling while being given discharge instructions. What action by the nurse is appropriate?

Review the instructions with the client and an accompanying adult.

The nurse is performing a preadmission assessment of a client scheduled for a bilateral mastectomy. The nurse should be aware of what purpose of the preadmission assessment?

Verifies completion of preoperative diagnostic testing

A nurse is caring for a client who underwent a skin biopsy and has three stitches in place. This wound is healing by:

first intention.

The nurse is caring for a client needing emergency surgery. Which preoperative teaching is least important to prepare the client for surgery?

Post-discharge diet

A client is being prepared for a same-day surgical procedure and is discussing with the nurse what potential ramifications this type of surgery has. Which of the following would the nurse correctly identify? Select all that apply.

•The client will leave the hospital sooner than in the past. •Need for teaching is increased. •The client must be prepared to take on more self-care than he or she may have done in the past.

The nurse is admitting a client who is to undergo an open reduction with internal fixation for a fractured femur. About which comment by the client should the nurse be most concerned?

"I was worried I would have an incision and scar."

The nurse is working in the preoperative area with a client going to surgery for a cholecystectomy. The client has histamine2-receptor antagonists ordered preoperatively. The client asks the nurse why these medications are needed. What would be the nurse's best answer?

"These medications decrease gastric acidity and volume."

The nurse is concerned that a postoperative patient may have a paralytic ileus. What assessment data may indicate that the patient does have a paralytic ileus?

Absence of peristalsis

Which intervention should the nurse plan to implement to decrease the client's risk for injury during the intraoperative period?

Assess the client for allergies.

A PACU nurse is caring for a postoperative client who received general anesthesia and has a hard, plastic oral airway in place. The patient has clear lung sounds, even and unlabored respirations of 16, and 98% oxygen saturation. The client is minimally responsive to painful stimuli. What action by the nurse is most appropriate?

Continue with frequent client assessments.

What complication is the nurse aware of that is associated with deep venous thrombosis?

Pulmonary embolism

The perioperative nurse is constantly assessing the surgical client for signs and symptoms of complications of surgery. Which symptom should first signal to the nurse the possibility that the client is developing malignant hyperthermia?

Tachycardia

The nurse is assessing the postoperative client on the second postoperative day. Which assessment finding requires immediate physician notification?

The client has an absence of bowel sounds.

The nurse is caring for an unconscious trauma victim who needs emergency surgery. The client is a 55-year-old man with an adult son. He is legally divorced and is planning to be remarried in a few weeks. His parents are at the hospital with the other family members. The physician has explained the need for surgery, the procedure to be done, and the risks to the children, the parents, and the fiancé. Who should be asked to sign the surgery consent form?

The son

The nurse is teaching the client about patient-controlled analgesia. Which of the following would be appropriate for the nurse to include in the teaching plan?

Therapeutic drug levels can be maintained more evenly with patient-controlled analgesia.

The perioperative nurse has a number of major responsibilities when a patient is admitted to a surgical unit or center. Which of the following is the most important function?

Verifies that operative consent is signed

When the nurse observes that a postoperative client demonstrates a constant low level of oxygen saturation via the O2 saturation monitor despite the client's breathing appearing normal, what action should the nurse take first?

Assess the client's heart rhythm and nail beds.

The nurse is physically preparing a client for surgery. What area does the nurse know needs to be addressed before the client is taken to the operating room?

Elimination

During the preoperative assessment, the client mentions allergies to avocados, bananas, and hydrocodone. What is the priority action by the nurse?

Notify the surgical team to remove all latex-based items.

A client is administered succinylcholine and propofol for induction of anesthesia. One hour after administration, the client demonstrates muscle rigidity with a heart rate of 180. What should the nurse do first?

Notify the surgical team.

What is the priority action when the circulating nurse is completing a second verification of the surgical procedure and surgical site?

Obtain the attention of all members of the surgical team.

The nurse observes bloody drainage on the surgical dressing of the client who has just arrived on the nursing unit. Which intervention should the nurse plan to do next?

Outline the drainage with a pen and record the date and time next to the drainage.

An unconscious patient with normal pulse and respirations would be considered to be in what stage of general anesthesia?

Surgical anesthesia

The nurse is discharging a client home from an outpatient surgery center. The nurse has reviewed all of the discharge instructions with the client and her caregiver. What else should the nurse do before discharging the client from the facility? Select all that apply.

•Provide all discharge instructions in writing. •Provide the nurse's or surgeon's contact information. •Give prescriptions to the client.