Foundations Week 9 Exam Study Flashcards
When is a patient permitted to eat following surgery
When the gag reflex returns
When bowel sounds return
When the Pt passes gas.
After the patient’s first bowel movement
Answer- When bowel sounds return
Which of the following tests are routinely ordered prior to surgery?
Check all that apply
CBC
Type and Cross
Blood Cultures
EKG
Answer- CBC, Type and Cross, and EKG
A heavy smoker who undergoes a surgical procedure has an increased risk of what?
Check all that apply.
Thrombophlebitis (swelling and inflammation in a vein, often due to a blood clot)
Atelectasis ( partial or complete collapse of a lung, or a section of the lung called a lobe)
Pneumonia (Serious lung infection that causes air sacs in the lungs to fill with fluid or pus and become inflamed)
Constipation (unable to have a bowel movement)
Answer is Pneumonia
A patient with diabetes who undergoes a surgical procedure has an increased risk for what?
Check all that apply.
Infection
Fluid volume excess
constipation
delayed wound healing
Answer is infection and delayed wound healing
Stages of wound healing in order from first to last
-Inflammation-platelet aggregation, fibrin clot formation, homeostasis.
-Proliferation-new connective tissue forms and epithelium covers the wound.
-Maturation-collagen lysis and synthesis, scare formation
-Wound is healed.
Which of the following are the duties of the scrub nurse?
Select all that apply.
Answer is
-Monitors for breaks in sterility and points them out
-Labels and handles surgical specimens correctly, hands instruments and supplies to the team during surgery
-Maintains an accurate count of sponges, sharps, and instruments
Which of the following are ways to prevent wrong site surgical errors?
Select all that apply.
Correct Answer
-Completing a pre-op checklist
-Having a “time out” prior to surgery to ensure correct Pt, procedure, and site
-Having medical records and imaging studies available during the procedure
-involve the Pt in the site marking process.
What does the LPN need to do immediately prior to surgery to prepare their patient?
Select all that apply.
Correct Answer
-Remove any jewelry, glasses, contacts, etc, and ensure they are secure
-Have the Pt void
-Dress the Pt in a clean gown without underwear
-Secure the Pt’s hair in a surgical cap
All women of childbearing age should have a pregnancy test prior to surgery?
True or false.
True
What information should your discharge instructions include for the surgical patient?
-Info about all meds, including when to take and why
-Discuss any limitations in activity and instructions for use of equipment
-Alcohol should be avoided in the first 24 hours after surgery
- Discuss diet, any restrictions and guidelines on fluid intake.
Stages of anesthesia in order from first to last
-Anesthesia-administration of anesthesia agent and Pt becomes unconscious
-Excitement-muscles tense, but swallowing and vomiting reflexes are present
-Surgical anesthesia -pupils are fixed and reflexes absent
-Complete respiratory depression-spontaneous respirations are absent.
Your confused Pt needs surgery, but their POA is out of the country. Surgical consent can be obtained over the phone.
True or false
True
Which of the following factors are considered surgical risk factors?
Select all that apply.
-Obesity
-Malnutrition
-Very young or very old age
-Peripheral vascular disease
Which of the following are risk factors for delayed wound healing?
Select all that apply
-Diabetes
-Obesity
-Protein deficiency
-PVD
Which of the following are recommended measures to prevent surgical site infections?
Select all that apply
-Administer prophylactic antibiotics as ordered
-Maintain glycemic control for the first 48 hours post-op
-Maintain body temp b/t 96.8 - 100.4 during and after surgery.
The suffix -otomy means to cut out or off
True or false
False. It means to cut or make an incision into a body part.
Your Pt in the ER was cutting up food and sliced the tip of their finger off. How would you chart this?
Avulsion - The action of pulling or tearing away.
Which medications can impair wound healing?
-Immunosuppressants/ steroids
-Anticoagulants
-Antineoplastic agents
-Anti-inflammatory drugs
High sensory input seems to close the pain gate, while a lack of this input allows the gate to open
True or false
True
Which of the following are critical to monitor when your post-op Pt has a negative pressure drain in place?
-Ensure the drainage device is compressed to drain fluid
-Monitor the site surrounding the drain for infection
-Ensure there are no kinks in the drain tubing
It is appropriate to use the spreader bar of a hip spica cast to help turn and move the patient
True or false
False
Demonstrate proper cast care
-Elevate the cast above the heart to decrease edema
-Cover the cast during showering to prevent it getting wet
-Use a hair dryer on the cool setting to decrease itching
-Not bearing weight on the cast to prevent damage to it
Which type of bandaging technique is commonly used on elbows, knees, and ankles?
Figure-of-eight
Which of the following interventions help prevent pressure injuries in immobilized Pts
-AROM or PROM exercises
-Keeping skin clean and dry
-Adequate nutritional and fluid intake
-Utilizing a specialty mattress to prevent the occlusion of blood vessels
What should the nurse be sure to include in the assessment of a client’s pain?
-Precipitating events, Quality of pain
-Timing of Pain
-Radiation of pain, Severity of Pain
-Treatments used to help alleviate pain
What complimentary therapies utilizes sterile needles to help redistribute energy along meridians
Acupuncture
Your Pt is taking kava to manage their anxiety pre-operatively. What lab value is important to monitor?
AST and ALP
Referred pain felt between the shoulder blades originates from what site?
Abdomen
Which supplement can affect a patient’s blood glucose levels?
Ginko biloba
Which supplement should a patient with pre-existing cardiac arrhythmias avoid?
Ephedra
Referred pain from the bladder can be felt in the rectum and buttocks.
True or false
True
What is important to monitor when a Pt is taking opiates?
-Respiratory depression
-Pruritus
-Constipation and/or urinary retention
-Hypotension/ bradycardia
It is acceptable for a Pt’s family member to push the PCA button if the Pt is asleep so they don’t wake up in pain
True or false
False
Which type of analgesic works by blocking pain at the central nervous system level?
Opioids
What is considered adjuvant analgesics?
-Anticonvulsants
-Muscle relaxants
-Antidepressants
-Stimulants
Opioids are the best treatment for neuropathic pain
True or false.
False
Steps the LPN would follow immediately after discovering a Pt has an evisceration from first to last
-Place the Pt in a supine position
-Place sterile dressings soaked in normal saline over the wound
-Notify the provider
-Prepare the Pt to return to the operating room
Natural herbal supplements can interact with prescription medications
True or false
True
Place the phases of nociceptive pain in order from first to last
-Transduction: Tissue damage releases substances that stimulate nociceptors
-Transmission: Movement of pain along the spinal cord
-Perception: Pain impulses reach the brain and pain is recognized
-Modulation: Neurons in the brain send signals back down the spinal cord
What patient is most likely to suffer from nociceptor pain?
Pt in a motor vehicle accident
What patient(s) is/are most likely to suffer from neuropathic pain?
-Diabetic
-HIV positive
-Cancer
Acute pain can cause a decrease in HR, BP, and RR
True or false
False
What factors can cause acute pain to worsen?
Fear and anxiety
Complimentary therapies are used in replacement for traditional medical treatments
True or false
False
What are considered sleep disorders that can interfere w/ a Pt’s quality of life
-Insomnia
-Sleep apnea
-Narcolepsy
What are factors that can adversely affect sleep
-Alcohol consumption near bedtime
-Consuming caffeine prior to bedtime
-A rotating shift schedule
-Watching TV or playing video games in bed
High-frequency TENS therapy is most effective for chronic pain.
True or false
False
What interventions can help prevent thrombophlebitis in the post op patient
-Encourage leg exercises and ambulation when Pt is able
-Apply anti-embolism stockings
-Keep Pt well hydrated
What interventions can help prevent pneumonia in the post-op patient?
-Deep breathing and coughing
-Use of incentive spirometer
-Encouraging your Pt to ambulate as soon as they are able
