Exam 4: Chapter 17 - Preoperative Nursing Management

Question 1

Preoperative phase begins when

Answer 1

the decision to proceed with surgical intervention is made and ends with the trasnfer of the patient onto the operating room bed

Question 2

Intraoperative phase begins when

Answer 2

the patient is transferred onto the OR bed and ends with admission to the PACU

Question 3

Postoperative phase begins with

Answer 3

the admission of the patient to the PACU and ends with a follow-up evaluation in the clinical setting or home

Question 4

Examples of surgeries to facilitate a diagnosis?

Answer 4

Diagnostic procedure such as a biopsy, exploratory laparotomy, or laparoscopy

Question 5

Examples of surgeries for cures?

Answer 5

Excision of a tumor or an inflamed appendix

Question 6

Examples of surgeries for repair?

Answer 6

Multiple wound repair

Question 7

Examples of reconstructive or cosmetic surgeries?

Answer 7

Mammoplasty or a facelift

Question 8

Examples of Palliative surgeries?

Answer 8

To relieve pain or corect a problem - such as debulking a tumor to achieve comfort, or removal of a dysfunctional gallblader

Question 9

Examples of rehabilitative surgeries?

Answer 9

Total joint replacement surgery to correct crippling pain or progression of degenerative osteoarthritis

Question 10

Surgeyr can also be classified upon the degree of urgency involved:

Answer 10

Emergent, Urgent, Required, Elective, and Optional

Question 11

What is Emergent Surgery?

Answer 11

Patient requires immediate attention; disorder may be life threatening

Question 12

Emergent Surgery Indications?

Answer 12

Without delay

Question 13

Examples of Emergent Surgery

Answer 13

Severe Bleeding

Bladder Obsturction

Gunshot

Question 14

What is Urgent Surgery?

Answer 14

Patient requires prompt attention

Question 15

Urgent Surgery Indication?

Answer 15

Within 24-30 hours

Question 16

URgent Surgery Examples

Answer 16

Acute gallbladder infection

Kidney or ureteral Stones

Question 17

What is required surgery?

Answer 17

Patient needs to have surgery

Question 18

Required Surgery Indications?

Answer 18

Plan within a few weeks or months

Question 19

Required Surgery Examples?

Answer 19

Prostatic Hyperplasia without Bladder Obsturction

Thyroid Disorders

Cataracts

Question 20

What is Elective Surgery?

Answer 20

Patient should have surgery

Question 21

Elective Surgery Indications?

Answer 21

Failure to have surgery not catastrophic

Question 22

Elective Surgery Examples

Answer 22

Repair of Scars

Simple Hernia

Vaginal Repair

Question 23

What are Optical Surgery?

Answer 23

Decision rests with patient

Question 24

Optional Surgery Indication

Answer 24

PErson Preference

Question 25

Optional Surgery Example

Answer 25

Cosmetic Surgery

Question 26

The nurse may ask the patient to sign the consent form and witness the signature; however it is

Answer 26

the surgeons responsibility to provide a clear and simple explanation of what surgery will ential prior to the patient giving consent

Question 27

If a patient states that they are allergic to _____ there may be an association with an allergy to latex

Answer 27

kiwi, avocado, or banana, or cannot blow up balloons

Question 28

What can lead to significant problems in patients with comorbid medical condition or in older adults?

Answer 28

Dehydration, Hypovolemia, and Electrolyte Imbalance

Question 29

Why is Dentition important?

Answer 29

Decayed teeth or dental prostheses may become dislodged during intubation Condition of mouth important because this can become a source of postoperative infection

Question 30

Alcohol can do what to the body post-surgery?

Answer 30

Ingesting even moderate amount of alcohol can weaken patietns immune system and increase chance of postoperative complications

Question 31

Drugs can do what to the body?

Answer 31

Impede the effectiveness of some medications

Question 32

REspiratory Status: Patient educated about

Answer 32

breathing exercises and use of an incentive spirometer to achieve optimal respiratory function prior to surgery

Question 33

REspiratory Status: Surgery postponed for

Answer 33

elective cases if the patient has a respiraotry infection.

Question 34

REspiratory Status: Patients who smoke are urged to stop

Answer 34

30 days before surgery to significantly reduce pulmonary adn wound healing complications

Question 35

REspiratory Status: Patients who smoke are likely to experience

Answer 35

poor wound healing, a higher incidence of SSI, and complications that include VTE and Pneumonia

Question 36

CArdiovascular Status: Preparation includes

Answer 36

ensuring that the cardiovacular system can support the oxygen , fluid, and nutriitonal needs of the perioperative period

Question 37

CArdiovascular Status: If patietn has uncontrolled hypertension,

Answer 37

surgery may be postpond until the blood pressure in udner control

Question 38

Hepatic and Renal Function: Presurgical goal is

Answer 38

optimal function of the liver and urinary systems os the medications, anesthetic agents, body wastes, adn toxins are adequately metabolized and removed from the body

Question 39

CArdiovascular Status: Disorders of the liver may substantially affect how

Answer 39

anesthetic agents are metabolized

Question 40

CArdiovascular Status: Acute liver disease associated with

Answer 40

high surgical mortality;preoperative improve in liver function is a goal

Question 41

CArdiovascular Status: Kidneys involved in excreting

Answer 41

anesthetic medications and their metabolites; therefore, surgery is contradicted when patient has acue nephritis, acute renal insufficiency with oliguria or anuria

Question 42

Endocrine Function: Patient undergoing surgery is at risk for both

Answer 42

hypoglycemia and hyperglycemia

Question 43

Endocrine Function: Hypoglycemia may develop during

Answer 43

anesthesia or postoperatively from inadequate carbohydates or excessive administration of insulin

Question 44

Endocrine Function: Hyperglycemia can

Answer 44

increase the risk of surgical wound infection, and may result from the stress of surgery which can trigger increased levels of catecholamine

Question 45

Endocrine Function: Patients with uncontrolled thyroid didsorders are at risk for

Answer 45

thyrotoxicosis or respiraotry failure

Question 46

Immune Function: Lab tests used to test infection include

Answer 46

WBC and the Urinealysis

Question 47

Immune Function: Immunosuppression is common with

Answer 47

corticosteroid therapy , organ transplation, radiation therapy, chemotherapy, and disorders affected the immune system

Question 48

What should not be used 7-10 ddays before surgery?

Answer 48

Aspirin. It inhibits platelet aggregation and increases the risk of bleeding

Question 49

What occurs during PAT?

Answer 49

REsources made available related to patient education such as audiovisual resources, written instructions, telephone numbers

Question 50

Education should go beyond descriptions of the procedure and should include

Answer 50

explanations of the sensations the patient will experience.

Question 51

Nursing Interventions: Providing Psychosocial Inerventions Examples

Answer 51

REducing Anxiety, Decreasing Fear Respecting Cultural, Spirtual, Religious Beliefs

Question 52

What should the pt do if thoracic or abdominal incision is anticipated and they want to minimize pressure and control pain?

Answer 52

Patient should put palms of both hands together , interlacing fingers snugly

Question 53

If the ptient does not cough effectively, what can occur

Answer 53

Atelectasis (Collapse of the Alveoli), Pneumonia, or other lung complications may occur

Question 54

Preoperative Instructions to Prevent Postoperative Complications

Answer 54

``` Diaphragmatic Breathing Coughing Leg Exercises Turning to the side Getting Out of Bed ```

Question 55

What is Imagery?

Answer 55

The patient concentrates on a pleasant experience or restful scene

Question 56

What is Distraction?

Answer 56

Patient thinks of a enjoyable story or recites a favorite poem or song

Question 57

What is Optimistic Self-REcitation:

Answer 57

Patient recites optimistic thoughts "I know all will go well"

Question 58

What is a Music Coping Strategy?

Answer 58

Patient listens to soothing music

Question 59

Protecting patients from injury is one of the major roles of the periopertive nurse. Adherence to what is crucial?

Answer 59

AORN-recommended practices and the Joint Commission's National Patient SAfety Goals

Question 60

Summary of the 2016 National Patieetn Safety Goals

Answer 60

Identify Pts Correctly Improve Staff Communication Use Medicines Safely Prevent Infection IDENTIFY PATIENT SAFETY RISKS Prevent mistakes in surgery

Question 61

The purpose of withholding food and fluid before surgery is to prevent

Answer 61

aspiration

Question 62

For Example Adults may be advised to fast for

Answer 62

8 hours after eating fatty food and 4 hours after ingesting milk products

Question 63

Healthy patients are allowed clear liquids up to

Answer 63

2 hours before an elective procedure

Question 64

Enemas are not commonly prescribed preoperatively unless the patient is undergoing

Answer 64

abdominal or pelvic surgery

Question 65

A cleansing Enema or Laxative may be prescribed at what time?

Answer 65

The eveneing before surgery and may be repeated the morning of surgery

Question 66

A dressing is place on what during surgery?

Answer 66

The Coccyx, because they want to prevent a pressure ulcere. This is taken off in the recovery room

Question 67

All patients should ___ immediately before going to the OR

Answer 67

Void

Question 68

Expected Patient Outcomes

Answer 68

Decrease Anxiety and Fear Understanding Intervention No Evidence of Preoperative Complications