Chapter 37 - deWit - Care of the Surgical Patient - Nov 22 test Flashcards
voluntary
elective
This surgery is to relieve pain or complications
Palliative surgery
This type of surgery is often necessary in trauma cases in which serious consequences will occur if surgery is not done immediately
Emergency surgery
This type of surgery is done to provide data for a diagnosis of a problem
Diagnostic surgery
This type of surgery alleviates a problem
Curative surgery
This type of surgery is done to restore appearance or function
Reconstructive surgery
Which age groups are at higher risk for complications of surgery because of either immature body systems or a decline in function of various body systems?
Infant and elderly persons
This type of nursing refers to care of the patient from the time of the decision to have surgery through recovery from the procedure
Perioperative nursing
The loss of sensory perception
Anesthesia
What are the goals of anesthesia?
1) To prevent pain
2) To achieve adequate muscle relaxation
3) To calm fear, ease anxiety, and induce forgetfulness of an unpleasant experience
Incapable of responding to sensory stimuli
Unconscious
Awareness of one’s surroundings
Conscious
What does PACU stand for?
Postanesthesia care recovery unit
Who is responsible for obtaining an informed surgical consent?
The surgeon
If the patient does not understand the procedure or has further questions, who should the nurse refer back to?
The surgeon
Stoppage of flow
stasis
Blood clot causing inflammation of a vessel
thrombophlebitis
How often should vital signs and careful assessment be perfomed? (1st hour, next 2 hours, next 4 hours, until patient is totally recovered)
- 1st hour - every 15 minutes
- next 2 hours - every 30 minutes
- next 4 hours - every hour
- Until patient is totally recovered - every 4 hours
What is always a priority measure to prevent the patient from injury?
Maintaining an open airway
Collapse of alveoli in the lungs
Atelectasis
What type of instrument is used to determine blood oxygenation?
A pulse oximeter
If the patient has an indwelling catheter, the urine in the bag should be observed ______ in the early postoperative period
every hour
If the urine flow is less than __mL/kg/hr, report it to the charge nurse
5 mL/kg/hr
Blood clot
thrombosis
Failure of forward movement of bowel contents
Paralytic ileus
Clot that travels and lodges in a vessel
embolus
Inflammation and consolidation of the lung with exudate
Pneumonia
Separation of the layers of the surgical wound
Dehiscence
Extrusion of the viscera through the surgical incision
Evisceration
What are the 3 types of anesthesia used for many surgical procedures?
Regional anesthesia, moderate sedation, or local anesthesia
When witnessing the signing of an informed surgical consent form, the nurse is verifying that:
1) the correct operation is entered on the form
2) the risks and alternatives for the surgical procedure have been explained
3) all possible consequences of having or not having the procedure are understood
4) the patient noted on the form has signed it
4) the patient noted on the form has signed it
Your patient had an appendectomy 2 days ago. To properly auscultate for bowel sounds you would:
1) listen in the lower right quadrant for 2 minutes
2) listen in all four quadrants for at least 1 minute each
3) listen in each quadrant for 3 minutes
4) listen in both lower quadrants for 2 minutes
2) listen in all four quadrants for at least 1 minute each
A similarity of roles for the scrub person and the circulating nurse is that they both:
1) set up initial sterile instruments and supplies
2) position lights and step stools
3) are communication links with personnel outside the room
4) advise the team of breaks in sterile technique
4) advise the team of breaks in sterile techniques
When a patient arrives in the PACU with a surgical dressing, an intravenous infusion, and a urinary catheter. The priority action of the nurse is assessment of:
1) urine output
2) IV line patency
3) airway patency
4) wound drainage
3) airway patency
As part of a patient’s immediate care in the PACU, the nurse would: (select all that apply)
1) check vital signs every 15 minutes
2) assess adequacy of respirations
3) monitor the dressing
4) observe the drainage from the NG tube
5) note the amount of urine output
all
A patient returns to his room after surgery. When he arrives, you notice that he is still groggy from anesthesia and that he has an IV running in one arm. As you help settle him in bed, you: (select all that apply)
1) assess the IV for patency and correct fluid and rate
2) position to prevent aspiration while still groggy
3) quickly medicate for pain
4) take his vital signs every 15 minutes for 1 hour
5) reassure him that the surgery is over
1, 2, 4, 5
If your fresh postoperative patient has not voided within 8 hours of the end of surgery, you would FIRST:
1) seek an order to catheterize the patient
2) assist the patient to attempt to void using measures to encourage voiding
3) allow another hour in which the patient might spontaneously void
4) obtain catheterization equipment and bring it to the bedside
2) assist the patient to attempt to void using measures to encourage voiding
Since your surgery patient returned to her room, you have assisted her in turning and encouraged her to breathe deeply, to cough, and to move her legs at least every 2 hours. By deep breathing and coughing, the patient will be less likely to develop the postoperative complication of _______
atelectasis
The second day after surgery , the nasogastric tube is removed and an order is written for fluids as tolerated and a liquid diet. The patient is eager to try taking fluids. What should the nurse recommend that he do?
1) What until his liquid diet tray arrives at mealtime
2) Start with small sips of water at first to see if they are retained
3) Take in a variety of fluids totaling 3000 mL/day
4) Go ahead and drink all the water he wants
2) Start with small sips of water at first to see if they are retained
The patient has a PCA pump to be used for pain control. Should his pain not be adequately controlled with the use of the pump, the nurse would first: (select all that apply)
1) administer an oral analgesic in addition to the pump medication
2) seek a medication order change from the physician
3) use nonpharmacologic comfort measures
4) be certain that none of the drainage tubes are kinked
5) encourage the use of distraction
3, 4, 5
On his third postoperative day, a patient states that he does not feel well and that he has a lot more pain in the incision area. You inspect the incision and notice that the lower end of it is very red. From these symptoms, you suspect that this patient has developed:
1) an embolus
2) an ileus
3) a wound infection
4) an evisceration
3) a wound infection
On the sixth postoperative day, a patient complains of malaise and pain in her lower right leg. The lower leg is warm to the touch and slightly swollen. You suspect that she may have ______
a DVT (deep vein thrombosis)
