Pre, Intra, Postoperative Nursing Flashcards
A nurse is caring for a client prescribed the IV morphine via PCA with a demand of 1 M every 15 minutes and a 4 mg for our lock out. The client reports unbearable pain after attempting 6 demand doses within the last hour. After assessing the clients pain, which of the following actions should the nurse take?
Check the IV site and PCA pump for proper functioning.
A nurse is caring for two clients who are two hour post-operative following the same procedure. Which of the following factors should the nurse expect to be similar for both client?
Prescriptions containing guidelines for pain medication administration
A nurse is caring for a client who was admitted to the emergency department for severe pain following a fall from a ladder. The client reports taking an opioid prescription for chronic pain. Which of the following provider prescriptions for initial pain relief should the nurse question?
Naloxone
Opioid antagonist agent, NOT an analgesic
A nurse is planning to administer a dose of morphine sulfate IV for a client who is post-operative. Which of the following pain management controls should the nurse use when caring for this client?
Have an opioid antagonist available during their ministration
Medications that primarily used to treat something other than pain, but that improve pain relief when used in combination with a pain medicatio
Check the IV site and PCA pump for proper functioning.
Pain relieving medications that do not contain what has traditionally been called a narcotic component
Non-opioid
Examples: aspirin, acetaminophen, and NSAIDs
A nurse is completing the preoperative teaching for a client who is to undergo a gastrectomy. Which of the following information should the nurse include in prevention of postoperative complications?
apply a sequential compression device
A nurse is assisting a client who is postoperative following abdominal surgery with morning care and identifies a loop of bowel through an opening in the surgical incision. After calling for help, which of the following actions should the nurse take first?
apply moistened sterile gauze to the site
A nurse is providing preoperative teaching for a client who is scheduled for a gastrectomy. Which of the following information regarding prevention of postoperative complications should the nurse include in the teaching?
A. Teach the client how to use the PCA pump
B. Instruct the client about the use of a sequential compression device
C. Discuss the visitation policy
D. Review the pain scale
B. Instruct the client about the use of a sequential compression device
A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4mg IV bolus every 6 hours as needed. Before administering this medication, the nurse should complete which priority assessment? A. Blood pressure B. Apical heart rate C. Respiratory rate D. Temperature
C. Respiratory rate
A nurse is administering morphine 2mg IV every 2 to 4 hr to a client who has an abdominal incision. The nurse should monitor the client for which of the following adverse effects? A. Diarrhea B. Heartburn C. Hiccups D. Orthostatic hypotension
D. Orthostatic hypotension
A nurse is providing preoperative teaching for a client who will undergo surgery. The nurse explains that the client will wear antiembolism stockings during and after the procedure. When the client asks what the stockings do, which of the following responses should the nurse make?
A. “They protect your legs and heels from skin breakdown.”
B. “They help keep you warm after you’re surgery.”
C. “They improve your circulation to keep blood from pooling in your legs.”
D. “They make it easier for you to do leg exercises after your surgery.”
C. “They improve your circulation to keep blood from pooling in your legs.”
A nurse on a medical-surgical unit is caring for four clients who are 24 to 36 hr postoperative. Which of the following surgical procedures places the client at risk for deep-vein thrombosis? A. Myringotomy B. Laparoscopic appendectomy C. Hip arthroplasty D. Cataract extraction
C. Hip arthroplasty
A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions? A. Elevating the feet B. Massaging her legs C. Flexing her ankles D. Ambulating soon after surgery
B. Massaging her legs
A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
A. “Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.”
B. “I will call the provider to get a prescription for discontinuing the IV heparin today.”
C. “Both heparin and warfarin work together to dissolve the clots.”
D. “The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.”
A. “Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.”
A postoperative client is prescribed an IV infusion of D5 Ringer’s Lactate at 120 mL/hr. The tubing has a drop factor of 20 gtt/mL. The nurse should set the IV flow rate to how many gtt/min?
40 gtt/min
A nurse in a postanesthesia recovery unit is admitting a client who is postoperative following a tonsillectomy. Which of the following actions should the nurse take to prevent aspiration?
withhold fluids until the client demonstrates a gag reflex
A nurse is teaching a client who is preoperative how to do deep breathing exercises and cough effectively after surgery. Which client statement indicates to the nurse that the teaching has been effective?
“I’ll splint my incision with a pillow to cough.”
A nurse is caring for an elderly client who is scheduled for surgery. Which of the following should the nurse be aware that the client is at risk for? (Select all that apply.)
- a decrease in the ability to communicate
- a decrease in skin elasticity
A nurse is caring for a client who is postoperative following vascular surgery. Which of the following signs should indicate to the nurse that the client has developed a thrombus?
dull, aching calf pain
A nurse is caring for a client who is 1 day postoperative following a left radical mastectomy for breast cancer. Which of the following behaviors should alert the nurse to the possibility that the client is having difficulty adjusting to the loss of her breast?
refusing to look at the sign or surgical incision
A nurse is providing teaching for a client who is in the immediate postoperative period and has a PCA pump. Which of the following statements should the nurse include in the teaching?
Do not allow your family to push the PCA button if you are sleeping
A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following nursing interventions should the nurse perform to prevent respiratory complications?
Advise the client to splint the surgical incision when coughing and deep breathing
A nurse is assessing a client who is 2 days postoperative following a total prostatectomy. The nurse notes the client’s right calf is red, edematous, and warm to the touch. Which of the following actions should the nurse take?
Elevate the client’s right extremity
A nurse is reviewing the medical record of a client who is to undergo general anesthesia for surgery. The nurse should report which of the following findings to the provider?
Potassium level 2.8 mEq/L
A nurse is providing preoperative teaching for a client. Which of the following prescribed medications should the nurse instruct the client to discontinue 48 hr prior to the surgery?
warfarin
A nurse is completing a preoperative assessment for a client who is a Jehovah’s Witness. Which of the following should the nurse recognize as a situation that could pose special care needs for this client?
Providing informed consent to receive blood products
A nurse is conducting a preoperative interview with a client that is scheduled for surgery. The client states that he takes acetylsalicylic acid (Aspirin) 81 mg by mouth daily. Prior to the client’s upcoming surgery, the nurse should instruct the client to do which of the following?
discontinue the dose 2 weeks before surgery
A nurse is caring for a client who is postoperative and has developed pneumonia. Which of the following is a possible complication of the pneumonia?
atelectasis
A nurse is providing preoperative teaching for a client who will undergo abdominal surgery. The nurse explains that the client will wear antiembolism stockings after the procedure. When the client asks what the stockings do, which of the following is an appropriate nursing response?
“They’ll improve your circulation to keep blood from pooling in your legs”
A nurse is caring for a client on the second day following abdominal surgery and observes wound evisceration. Which of the following is the first action by the nurse?
cover the area with a sterile dressing, moistened with saline.
A nurse is caring for a client who is scheduled to have surgery. In preparing the client for surgery, which of the following actions is considered outside the responsibility of the nurse?
explain the operative procedure, risks, and benefits
A nurse is completing discharge teaching to a client about nutrition therapy for wound healing following major surgery. Which of the following vitamins promote wound healing and should be included in the teaching? (Select all that apply.)
Vitamin A
Vitamin C
A nurse is caring for a client who is immediately postoperative following thoracic surgery. The nurse administers a narcotic analgesic to the client frequently for pain. Which of the following should the nurse recognize as the primary reason for this action?
It facilitates the client’s deep breathing
A nurse is providing preoperative teaching to a client who is scheduled for a gastrectomy in 1 week. The client is anxious about the upcoming surgery. Which of the following is an appropriate action for the nurse to take?
Provide concise, factual information.
