Preop, OR, Postop

Question 1

When should discharge planning begin?

Answer 1

Start preoperatively

Question 2

When is the preoperative phase?

Answer 2

Decision to incision

Question 3

What do you do if a patient is incapacitated and requires surgery?

Answer 3

Legal obligation to treat

Question 4

What if the consent form had not been signed and preoperative psychoactive medications had already been given?

Answer 4

Stop the procedure

Question 5

How to prevent aspiration during surgery?

Answer 5

NPO preoperatively, antiemetics, antacids, meds that decrease gastric acid production

Question 6

If hypothermic – warming must be accomplished ________

Answer 6

Gradually

Question 7

Results in rapid rise in body temp when they receive general anesthesia

Answer 7

Malignant hyperthermia

Question 8

When can malignant hyperthermia occur?

Answer 8

From 10 minutes after anesthetic is given to up to 24 hours post op

Question 9

Symptoms of malignant hyperthermia

Answer 9

Rise in CO2, decrease in O2 sat, tachycardia, muscle rigidity, tachypnea, respiratory & metabolic acidosis, rapid rise in temp, skin initially flushed but then cyanotic

Question 10

What do you administer during malignant hyperthermia?

Answer 10

Dantrolene sodium

Question 11

Management of malignant hyperthermia

Answer 11

Cooling blankets, 100% O2, cold NS IVF, ice packs

Question 12

Postoperative time frame

Answer 12

Closure to recovery

Question 13

Responsibilities of nurse in PACU

Answer 13

Vital signs, LOC, orientation, pain control, N/V, gag reflex, dressing, return of movement

Question 14

What is important before discharging a patient to home?

Answer 14

Make sure patient has urinated

Question 15

When would a patient transition to oral pain medication?

Answer 15

Bowel sounds returned, tolerating oral intake, gag reflex returned

Question 16

What to do in the event of evisceration?

Answer 16

CALL CODE, low fowler’s w knees up, sterile dressing over organs