Chapter 16, 17, 18 Key Points

Question 1

Key Point

Answer 1

Ask patient if an advance directive has been completed

Question 2

Key Point

Answer 2

Ask patient to explain in his or her own words what surgical procedure is being done and why.

Question 3

Key Point

Answer 3

If the patient’s explanation of the procedure is not consistent with theKey Point documentation, notify the surgeon and request that he or she speak to the patient

Question 4

Key Point

Answer 4

Use at least TWO appropriate identifiers to identify the patient. DO NOT USE ROOM NUMBER OR BED NUMBER TO IDENTIFY PATIENT.

Question 5

Key Point

Answer 5

Ensure that the patient is wearing proper id

Question 6

Key Point

Answer 6

Ensure that the patient is not asked to sign an operative permit or any other legal document after the preoperative drugs have been given. They cannot sign if they are drugged up. It doesn’t count.

Question 7

Key Point

Answer 7

After the patient has received preoperative drugs, keep the side rails up and the bed in low position.

Question 8

Key Point

Answer 8

Communicate to the surgeon and anesthesia personnel any physical or laboratory change that may alter the patient’s response to drugs, anesthesia, or surgery.

Question 9

Key Point

Answer 9

Teach the patient specific interventions to perform after surgery to prevent complication (incision splinting, deep breathing exercises, ROM exercises)

Question 10

Key Point

Answer 10

Pace your interview to match the learning needs and style of individual patient

Question 11

Key Point

Answer 11

Encourage the patient to express his or her feelings regarding the surgical procedure or its possible outcome.

Question 12

Key Point

Answer 12

Explain and provide written information for all diagnostic procedures, restrictions, and follow up care to the patient and his or her family.

Question 13

Key Point

Answer 13

Check that documentation for any procedure to be performed on one of a paired organ or extremity clearly indicates which organ or extremity is involved.

Question 14

Key Point

Answer 14

If required, ensure that dentures and any other personal items are removed from the patient before he or she is transferred to the surgical site.

Question 15

Key Point

Answer 15

If someone breaks the sterile field or sterile technique, inform the OR staff.

Question 16

Key Point

Answer 16

Report to the surgeon any discrepancy between what type of surgery the patient says is going to be performed and what the informed consent form indicates.

Question 17

Key Point

Answer 17

Use a highlighter and highlight any known allergies.

Question 18

Key Point

Answer 18

Always perform an accurate sharps and sponge count with the scrub nurse or surgical technologist.

Question 19

Key Point

Answer 19

Use aseptic technique during all dressing changes.

Question 20

Key Point

Answer 20

Use established criteria to determine when a patient is ready to leave the post anesthesia care unit for discharge to home or a med surg nursing unit.

Question 21

Key Point

Answer 21

Allow the patient to express feelings about any change in physical appearance or lifestyle as a result of surgery.

Question 22

Key Point

Answer 22

Reassure patients that taking pain medication when needed, even opiods, does not make them drug abusers

Question 23

Key Point

Answer 23

Offer alternative therapies for relaxation, pain reduction and distraction, such as massage, music therapy and guided imagery.

Question 24

Key Point

Answer 24

Begin EVERY assessment of the patient after surgery by checking the airway and breathing effectiveness.

Question 25

Key Point

Answer 25

The incision site should be inspected each shift

Question 26

Key Point

Answer 26

In the event of dehiscence or evisceration, have the patient lie flat (supine) with knees bent to reduce intra-abdomional pressure; apply sterile, nonadherent dressing materials to the wound; and follow steps outlined in chart 18-5

Question 27

Key Point

Answer 27

Teach patient about any drugs to be continued after discharge from the facility.

Question 28

Key Point

Answer 28

Instruct the patient and family about the clinical manifestations of complications and when to seek assistance.