Perioperative Care

Question 1

List five variables that increase surgical risk.

Answer 1

Age - very young or very old
obesity and malnutrition
preoperative dehydration/hypovolemia
preoperative infections
use of anticoagulants preoperatively

Question 2

Why is a client with liver disease at risk for operative complications?

Answer 2

Impairs ability to detoxify medications used during surgery.
Impairs ability to produce prothrombin to reduce hemorrhage.

Question 3

Preoperative teaching should include demonstration and explanation of expected postoperative client activities. What activities should be included?

Answer 3

Respiratory activities - coughing, breathing, use of spirometer
Exercises - ROM, leg exercises, turning
Pain management - medications, splinting
Dietary restrictions - NPO evolving to progressive diet
Dressing and drains
Orientation to recovery room environment

Question 4

What items should the nurse assist the client in removing before surgery?

Answer 4

Contacts, glasses, dentures, partial plates, wigs, jewelry, protheses, makeup, nail polish

Question 5

How is the client positioned in the immediate postoperative period, and why?

Answer 5

Usually on the side or with head to side to prevent aspiration of any emesis.

Question 6

List three nursing actions that prevent postoperative wound dehiscence and evisceration.

Answer 6

Teaching client to splint incision when coughing.
Encouraging coughing and deep breathing in early postoperative period when sutures are strong.
Monitoring for signs of infection, malnutrition, and dehydration.
Encouraging high protein diet.

Question 7

Identify three nursing interventions that prevent postoperative urinary tract infections.

Answer 7

Avoiding postoperative catheterization.
Increasing oral fluid intake.
Emptying bladder every 4-6 hours.
Early ambulation.

Question 8

Identify nursing/medical interventions that prevent postoperative paralytic ileus.

Answer 8

Early ambulation
Limiting use of narcotic analgesics
NG tube decompression

Question 9

List four nursing interventions that prevent postoperative thrombophlebitis.

Answer 9

Teaching performance of in bed leg exercises.
Encouraging early ambulation
Applying antiembolus stockings
Teaching avoidance of positions and pressures that obstruct venous flow

Question 10

During the intraoperative period, what activities should the OR nurse perform to ensure safety during surgery?

Answer 10

Ascertain correct sponge, needle, and instrument count
Position client to avoid injury
Apply ground during electrocautery use
Apply strict use of surgical asepsis