Care of the Surgical Patient ( ch 2 adlt hlth) Flashcards
The patient is 38 years old and is in her second postoperative day after placement of an intramedullary rod in her left femur. She is receiving analgesia via a patient-controlled analgesia (PCA) device. The inappropriate intervention related to caring for a patient with a PCA is:
Administering the analgesia to the patient.
-With the PCA system of medication administration, the patient can self-administer an analgesic by pressing a control button. The nurse should not give medication doses by pushing the control button.
A 73-year-old patient with diabetes was admitted for below-the-knee amputation of his right leg. Removal of his right leg is an example of which type of surgery?
Ablative
The Patient’s Bill of Rights states that a patient must give his or her permission for any specific test or procedure to be performed. What is the legal term for this permission?
Informed consent
An informed consent was to be obtained from the patient for his scheduled open cholecystectomy. Which circumstance could prevent the patient from signing his informed consent?
An injection of Demerol, 75 mg IM, 1 hour ago
The anesthesiologist provides ____ anesthesia by inhalation and IV administration routes.
general
A type of anesthesia that requires a depressed level of consciousness is
conscious sedation.
The older adult patient may not respond to surgical treatment as well as a younger adult because of
his or her body’s response to physiological changes.
A 45-year-old patient has had a repair of a cerebral aneurysm and is presenting signs of increased intracranial pressure (ICP). Which postoperative nursing interventions would be contraindicated?
Coughing every 2 hours
A male patient, age 80, has had a total hip replacement. Anxiety, hypotension, and jarring during transfer from the recovery room to his room can cause a postoperative increase in which of his vital signs?
Pulse rate
A patient, age 65, underwent a right hemicolectomy. On postoperative day 4, her surgical wound dehisced. This means that
there is partial or complete wound separation.
A patient is on postoperative day 2 after a nephrectomy. The nurse is aware that the most effective way to increase her peristalsis is
ambulation.
A patient is transferred from the operating room to the recovery room after undergoing an open reduction and internal fixation (ORIF) of his left ankle. Which is the first assessment to make?
Check airway for patency.
Frequent assessment of a postoperative patient is essential. One of the first signs and symptoms of hemorrhage may be
restlessness.
Frequent monitoring of the postoperative patient’s vital signs assesses which body system?
Cardiovascular
Decreased activity in an obese surgical patient predisposes the patient to which complication?
Hypoventilation
The nurse acknowledges that all preoperative nursing interventions have been performed by signing which document?
Preoperative checklist
Which nursing interventions would be appropriate after a wound evisceration?
Apply a warm, moist normal saline sterile dressing.
When should the nurse offer prescribed analgesics to a patient who is 24 hours postoperative?
Regularly every three to four hours before pain gets severe.
What nursing interventions will minimize the effects of venous stasis?
Early ambulation
Serum potassium levels are usually determined before surgery to
prevent dysrhythmias related to anesthesia.
The nurse is assisting with the sponge and instrument count in the operating room. The operative phase in which the nurse is assisting is called the
intraoperative phase.
Which early postoperative observation is abnormal and should be reported immediately?
Emesis that is red
Sudden chest pain combined with dyspnea, cyanosis, and tachycardia is an indication of
pulmonary embolus.
An appendectomy during a hysterectomy would be classified as
minor, elective, ablative.
Which patients would be at greatest risk during surgery?
27-year-old taking an anticoagulant agent
A patient will have an incision in the lower left abdomen. Which intervention by the nurse will help decrease discomfort in the incisional area when she coughs postoperatively?
Apply a splint directly over the lower abdomen.
Although informed about the proposed surgical procedure, the patient has only vague responses about the postoperative period. A nursing diagnosis at this time would be
Deficient knowledge, postoperative
A patient and a nurse develop a preoperative teaching plan. In teaching the patient to cough effectively after surgery, the nurse should tell her to practice
taking three deep breaths and coughing from the chest.
What is the responsibility of the nurse regarding informed consent?
Obtain the patient’s signature.
On the patient’s return to the medical-surgical unit, the nurse performs an abdominal assessment. To assess bowel sounds, the nurse auscultates the lower abdomen for
1 minute.
Which preoperative fear is linked to postoperative behavior?
Fear of anesthesia and death
Ideally, preop teaching should be done
1 to 2 days before the surgery when anxiety is not as high.
In preparation for the return of the surgical patient, the patient’s bed and equipment should be in what position?
Highest position with the side rails down on receiving side and up on opposite side
Southeast Asian and Native American patients often do not make eye contact when preoperative teaching is being performed because
they believe eye contact is disrespectful.
What are the high-risk conditions that may affect perioperative procedures? (Select all that apply):
Age, mental state, nutritional status, health
A postoperative patient who had a left inguinal hernia repair is ready for his discharge instructions. Which information should the nurse provide? (Select all that apply.)
Care of the wound site and any dressing
When he may operate a motor vehicle
Signs and symptoms to report to the physician
Actions and side effects of any medications
Two considerations for the older adult surgical patient include (Select the two that apply.)
pre- and postoperative teaching.
surgery causes much physiological stress.
In preparing the patient for abdominal surgery, the Assistive Personnel (AP) can perform which interventions? (Select all that apply.)
Vital signs
Enema
Height and weight
_____ therapy is performed to alleviate or decrease uncomfortable symptoms without curing the problem.
Palliative
Discharge planning for a surgical procedure begins in the ______________ period and continues through the _____________ period.
preoperative, recuperative
A patient is transferred from the operating room to the recovery room after undergoing an amputation of his left foot. Place the interventions in the correct order for immediate assessment once the patient enters the PACU. Place a comma between each answer choice (a, b, c, d, etc.).
Airway Breathing Level of consciousness Circulation System review
Anastamosis
Surgical joining of two ducts or blood vessels to allow flow from one to another
