Mod 8 practice Q's Flashcards
healing requires increased vitamin ? and ? for collagen formation, vitamin ? for blood clotting, and ? for tissue growth, skin integrity, and cell mediated immunity.
A and D;
K;
zinc;
? are essential for controlling fluid balance and manufacturing antibodies and white blood cells. Hypoalbuminemia, a low ? albumin, impedes the return of interstitial fluid to the venous return system, ? the risk of shock. A serum ? level is a useful measure of protein status
Proteins;
serum;
increasing;
albumin;
most ? need to be stopped before surgery
anticoagulants such as warfarin (coumadin) - the surgeon determines if they are needed to be stopped or not (mostly are)
what is ordered to be monitored for diabetic pts on admission
blood glucose monitoring
what therapy can NOT be abruptly stopped when NOP is ordered.
And by what route would you give this is pt is NPO
chronic oral steroid therapy;
via the parenteral route
what can develop if steroids are stopped abruptly
circulatory collapse
time frame, wound healing, and pt effect for phase I
incision to 2nd post op day, inflammatory response, fever and malaise
time frame, wound healing, and pt effect for phase II
3rd - 14th post op day, granulation tissue forms, feeling better
time frame, wound healing, and pt effect for phase III
3rd - 6th post op week, collagen deposited, raised scar formed,
time frame, wound healing, and pt effect for phase IV
months to 1 year, collagen deposited, flat and thin scar
why would a pt go in for a pre admission testing
nursing interview, diagnostic testing, anesthesia interview, preoperative teaching to ensure pt is in the best possible condition for surgery
what pre admission testing may be done for someone scheduled for a total hip replacement that has osteoarthritis
blood glucose, creatinine, blood urea nitrogen (BUN), electrolytes, complete bloom count (CBC), prothrombin time (PT), partial thromboplastin time (PTT), bleeding time, type and screen, and urinalysis are some common tests; oxygen saturation, electrocardiogram(ECG), chest x ray
what teaching should the nurse do in pre admission testing?
explain what is to be done in pre admission testing; explain pre admission prep: bathing, scrubs, preps, medications, nil per os (NPO) time, no nail polish or makeup;
admission procedures the day of surgery: registration, nursing unit, emotional support, consent signed, prep checklist completion
Intravenous(IV) line insertion, medications, surgery, post anesthesia care unit and family waiting locations, surgery time frames
post op care: pain control, deep breathing and coughing, leg exercises, activity, leg abduction, drains
what are the responsibilities of the admitting nurse to prepare pt for surgery
explain admission procedures; get consent signed, preoperative checklist completion; iv insertion; give medications
what is the role of the holding area nurse
greeting the pt; verifying pts name, age and allergies;
surgeon performing the surgery, consent, surgical procedure and if left or right, med history, answering q’s, and alleviating anxiety.
Explain what to expect in surgery.
what is the role of the LPN in the operating room?
may scrub in surgery to hand instruments, must know sterile technique, surgical instruments, and medications placed in the sterile field for use during surgery
what are the two prioritized primary responsibilities of the perianesthesia care nurse
maintaing the pt’s airway and safety
which of the following is an LPN pt care role in the preoperative phase?
offering emotional support
when the pts signature is witnessed by the nurse on the surgical consent, what does the nurses signature indicate?
the nurse verified that the pt signed the consent
what is an introperative outcome for a pt underling an inguinal hernia repair
maintains skin integrity
what is a discharge criterion from the PACU for a pt following surgery?
oxygen saturation above 90%
what is one of the discharge criteria from ambulatory surgery for pts following surgery
understands discharge instructions
the LPN is caring for a pt in the preoperative period who even after verbalizing concerns and having questions answered, states “i know i am not going to wake up after surgery” what action should the LPN take
inform the registered nurse so the surgeon can be notified
what is the reason that long term steroid therapy cannot be used?
higher steroid levels are needed during stress to the body, which surgery produces
what complications would the nurse correctly explain to a pt can be prevented with early post op ambulation
pneumonia can be prevented with lung expansion promoted by ambulation
after surgery the nurse notes that the pts urine is dark amber and concentrated. what does the nurse understand may be the reason for this
the sympathetic nervous system saves fluid in response to stress of surgery, which reduces urine output initially
the pt develops a low grade fever 18 hours post operatively and has diminished breath sounds. what actions are most appropriate for the nurse to take to prevent complications?
a fever occurring shortly after surgery is often due to atelectasis because infection takes longer to develop, so encouraging coughing and deep breathing and ambulating to expand lungs can help recent pneumonia `
what nursing actions would reduce surgical risk factors for preoperative pts?
playing music of pts choice, reinforcing pain control methods, showing use of incentive pyrometer, monitoring blood glucose for a pt with diabetes, and teaching to perform leg exercises hourly while awake. All of these will calm the pt, place the pt in a healthier state, or teach the pt ways to promote recovery
what is the pt care role in the pre-op phase
assisting in data collection
what is within the LPN’s scope of practice related to the pt providing consent for surgery?
requesting pt questions be referred to physician, witnessing the pts signature on the consent, and reading the consent to a pt prior to signing
what interventions would help prevent atelectasis in a post-op pt?
coughing and deep breathing, pain control, and ambulation. controlling pain allows the pt to cough and deep breath more comfortably, which expands the lungs, as does ambulation.
what findings would the nurse recognize as being the earliest indicator of hemorrhage or shock that should be reported to the physician?
tachycardia - is a compensatory sign to maintain cardiac output for fluid volume loss, as in hemorrhage
what criterion would a nurse use to determine pt readiness for discharge from ambulatory surgery?
nausea and vomiting must be controlled before discharge.
what is the role of the home health nurse in caring for post-op pts?
to assist the pts recovery
A patient is having surgery to remove a metastatic tumor causing severe pain in the abdomen. The purpose of the surgery is to relieve pain. What is the type of surgery called?
curative
An epidural block used in an obstetric patient is a type of:
regional anesthesia
Diagnostic test data usually required before surgery include:
chest radiograph
Which pain medication is most likely to cause confusion in the elderly if used continuously?
Meperidine (Demerol)
In the post-anesthesia care unit (PACU), the nurse should:
position the patient to prevent aspiration and promote lung expansion.
The most appropriate outcome for the nursing diagnosis Risk for infection related to surgical wound is which of the following?
Promote wound healing
To promote respiratory function in a postoperative patient, a nurse should:
notify the physician if the patient reports shortness of breath (SOB) and pain on inspiration.
A nurse caring for a postoperative patient reports separation of the layers of the surgical abdominal wound. This finding is called:
dehiscence.
The goals of anesthesia administration include: (Select all that apply.)
prevent pain.
calm fear.
achieve adequate muscle relaxation.
? is a blood clot causing inflammation of a vessel.
Thrombophlebitis
what surgery is performed to make a patient more comfortable. what surgery alleviates a problem. what surgery is voluntary. what surgery is done as soon as possible to avoid serious medical problems.
Palliative
Curative
Elective
Emergency
a client who had a hysterectomy resumed a regular diet earlier in the day. now the client is reporting nausea and has vomited once. which of the following actions should the nurse take First?!
monitor for bowel sounds
a nurse is caring for a client who had abdominal surgery 7 days ago. the nurse observes serosanguineous drainage from the incision site. what are the appropriate nursing actions at this time
report finding to charge nurse, reinforce coughing, but avoid forceful coughing, splint the incision upon movement
a nurse is caring for a client who is postoperative gastric resection. what actions should the nurse take
apply pneumatic compression stocking bilaterally, administer pain meds 30 mins prior to ambulation, encourage the client to perform leg exercises every 1 - 2 hours
68 yr old client is undergoing an endoscoy, which will require moderate sedation what findings in the clients history indicates the need for further data colleciton
chronic obsturctive pulmonary disease poses a risk for possible airway compromise indicating a need to collect more data.
