Exam 2: Preoperative Nursing

Question 1

The Preoperative Assessment of a Patient Includes?

Answer 1

Data Collection (health history), Medications, alcohol and tobacco use, date of LMP for female, Review of all body systems (resp, GI, CV, MS, GU, check for dentures, caps or loose teeth, check for presence of acute infections.

Question 2

A patient preparing for surgery, expresses to you they are fearful about going under anesthesia and worry they will not wake up. What would your nursing dx be for this patient?

Answer 2

Fear related to fear of death and anesthesia.

Question 3

As you are going through the preoperative assessment with your patient they are very anxious about having to have surgery and be cut open, what would your nursing dx be for this patient?

Answer 3

Anxiety related to the surgical experience.

Question 4

As you prepare your patient for surgery to remove a tumor from their hippocampus, they are upset and crying that they’re memory will be altered and they will loss portions of their memory after the surgery, what would your nursing dx be for this patient?

Answer 4

Grieving related to the possible loss of function.

Question 5

What are some risk factors for surgery?

Answer 5

Diabetes Mellitus, CAD, Alcoholism, COPD, Obesity, Electrolyte imbalance, medications, smoking, DVT

Question 6

What is informed consent in surgery?

Answer 6

Grants permission for a specific surgical procedure. It is a legal document, is voluntary. No meds can be given before signing. It can be withdrawn at any time.

Question 7

What is an anesthesiologist

Answer 7

a physician who specializes in administering anesthesia and supervises certified registered nurse anesthetists (CRNAs) in the operating room.

Question 8

What does preoperative mean?

Answer 8

begins with the decision for surgery and ends with the transfer to the OR

Question 9

What is debridement?

Answer 9

necrotic and infected tissue is removed before infected wounds are closed

Question 10

What does intraoperative mean?

Answer 10

begins with the transfer to the OR and ends with admission to perianesthesia care unit (PACU)

Question 11

What does postoperative mean?

Answer 11

begins with the admission to the PACU and continues until recovery is complete.

Question 12

What is general anesthesia?

Answer 12

causes the patient to lose sensation, consciousness, and reflexes, acts directly on the central nervous system.

Question 13

What is evisceration?

Answer 13

When viscera spills out of the abdomen

Question 14

What is serosanguineous?

Answer 14

consisting of blood and serous fluid

Question 15

What is adjunct?

Answer 15

an adjunct agent is a medication used with the primary anesthetic agents, these include opioids to control pain, or muscle relaxers to avoid movement of muscles during surgery, antiemetics to control nausea or vomiting, and sedatives to supplement anesthesia.

Question 16

What is local anesthesia?

Answer 16

blocks nerve impulses along the nerve where it is injected. Results in a lost of sensation to a region of the body. There is no loss of consciousness

Question 17

Topical anesthetic

Answer 17

something that is sprayed down the throat, applied to mucus membranes, numbs mucus membranes

Question 18

IOA

Answer 18

Very rare condition. Intraoperative awareness. Put under general anesthesia , few days later report they remember the conversation the surgical team was having

Question 19

Conscious sedation

Answer 19

Patient is not asleep and can respond to verbal stimulation, numb and have no sensation of the procedure-used during a colonoscopy procedure.

Question 20

Malignant hyperthermia

Answer 20

rare, life threatening complication, person has a reaction to anesthetic agent, considered genetic transmitted trait. Body temp rapidly climbs and they can’t control it. Dantrolene is given (only drug that can reverse this condition)

Question 21

Who is the only person that can explain a procedure to a patient?

Answer 21

A surgeon

Question 22

If a patient suffers from a life threatening injury and requires surgery so they will not die do you need informed consent?

Answer 22

No

Question 23

Before anesthesia what is the most important vital signs?

Answer 23

Height and weight, this will determine the amount and type of anesthesia the patient will get

Question 24

How many witnesses do you need for telephone consent?

Answer 24

Two witnesses

Question 25

how often should you turn your patient and have them cough and do deep breathing exercises?

Answer 25

every two hours

Question 26

What two ways can you prevent wrong site for surgery?

Answer 26

surgeon marking the site area and multiple ID checks and verification.

Question 27

What does NPO mean

Answer 27

nothing by mouth

Question 28

How can you prevent DVTs

Answer 28

leg exercises

Question 29

What is a time out for surgery?

Answer 29

This is when the whole surgical team agrees on the patients name, the procedure they are having and the operation site

Question 30

Are you awake during local anesthesia?

Answer 30

Yes

Question 31

What does regional anesthesia mean?

Answer 31

numbed specific area, possibly awake, example is an epidural or spinal block

Question 32

How does an incentive spirometer help?

Answer 32

Expands lungs and increases a patients lung volume

Question 33

What is coumadin and what are the instructions for use before surgery?

Answer 33

A blood thinner, it is held 24-72 hours before surgery

Question 34

Who determines the final type of anesthesia you will receive?

Answer 34

The final decision is made by the surgeon based on the recommendations by the anesthesiologist.

Question 35

What is conscious sedation?

Answer 35

The patient is awake and monitored during this time

Question 36

What are the two most common types of drugs used for conscious sedation

Answer 36

Versed (Midazolam) and Propofol

Question 37

Does Versed cause amnesia

Answer 37

Yes

Question 38

Does Propofol cause amnesia?

Answer 38

no

Question 39

What is an emancipated minor?

Answer 39

Under the age of 18 but not subject to parental consent

Question 40

If a patient requires a narcotic before surgery when should they sign the informed consent?

Answer 40

Before the medication is given.