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Question 1

Increased Band Cells

Answer 1

Indication of infection
(immature neutrophils)
in the WBC differential count.
The increase is termed "Left Shift"
(aka bandemia)

Question 2

Dehiscence

Evisceration

Answer 2

dehiscence- partial separation-
action–>Apply sterile non-adherent bandage (ex. tefla) or saline dressing to wound

evisceration- total separation and organ protruding
apply saline soaked sterile bandage

action–> SURGICAL EMERGENCY
One nurse attends to the patient while the other nurse immediately notifies surgeon

Question 3

what day is highest risk for hypoxemia

Answer 3

2nd day Postop

Question 4

What type of diet promotes wound healing?

Answer 4

High in
protein
calories
vitamin C

Question 5

When does the Intraoperative phase begin?

Answer 5

When patient enters the OR and ends with admission to the PACU

Question 6

Check List WHO

world health organization

Answer 6

Before anesthesia “sign in”
Before incision “time out”
Before leaves OR “sign out”
Check list verifies –> pts identity
allergies
surgical site is marked
pt has nay questions
“time out” is immediately before conducting any invasive procedure/incision

Question 7

RNFA

Answer 7

Registered nurse first assistant

Helps with the surgery cutting tissue ect……

Question 8

Sponge count

Answer 8

circulating nurse and scrub nurse count (3)

1) before incision
2) at beginning of wound closure
3) at end of surgical procedure

Question 9

preoperative begins and ends

Answer 9

Begins when scheduled for surgery and ends at the time of transfer to the surgical suite.

Question 10

Normal size catheter

Answer 10

14-16Fr

woman 14 Fr 5 mL balloon–> filled with 10 mL water

Question 11

Surgery temperature

Answer 11

96.8-100.4 maintained

Question 12

Prophylactic antibiotics

Answer 12

recommended only 60 minutes before and no longer than 24 hrs after

Question 13

Beta Blocker

Answer 13

Surgery Patients on Beta-Blocker Therapy Prior to Arrival Who Received a Beta-Blocker during the Perioperative Period
The purpose is to ensure that patients with specific medical conditions receive beta-blocker therapy before surgery and continue the therapy in the immediate postoperative period. This evidence-based action has resulted in a significant reduction in coronary events, cardiovascular mortality, and overall mortality.

Question 14

verifications of surgical sites

Answer 14

1) Verified at the time of scheduling
2) On admission
3) And each time the responsibility of care transfers to another caregiver. (preop-holding area-OR)
4) Final in “Time Out”

Question 15

Nursing care for a post op patient
2 Phases

Immediate recovery
Post op convalescence

Answer 15

Phase I level of care (immediate recovery)–> Extends from the time a pt leaves the OR to the time he is stabilized in PACU, meets the discharge criteria, and has been transferred to the nursing unit or Phase II level of care

Phase II (Post op convalescence)–> Focuses on preparation for care in the home or extended facility. Extends from discharge from PACU to the time he is discharge form In patient hospital.

• Out patient clients undergo convalescence at home.
• *During convo. you begin prepar. for discharge & include the pt and family

Question 16

Discharge form Phase I depends on?

Answer 16

Not a time limit but certain criteria:
Airway patency
oxygenation
hemodynamic stability
thermoregulation
neurologic stability
I&O, dressing, tube patency, pain & comfort management
& post anesthesia scoring system

Question 17

Phase II

Answer 17

a) Obtain a phone report from the PACU giving status–> allow time to prepare room and equipment
* Do all the rest

Question 18

Beta Blockers

Answer 18

Have evidence that reduces coronary events
cardiovascular mortality
overall mortality

Question 19

Autologous donation

Answer 19

giving your own blood for a future surgery
can be given up to 5 weeks in advance IF–>
“If they are infection free–Have a HGB of 11g/dL or higher– And a physicians prescription

Question 20

Nutritional status and surgery

Answer 20

Increase risk surgery–> malnutrition, obesity.

Surgery increases metabolic rate and deplete Potassium, Vit C and B vitamins. All of which is needed for wound healing

Question 21

Lab tests before surgery

Answer 21

• Urinalysis (abnormal–protein-glucose-blood-bacteria)
• Blood type and screening
• CBC-HGB & HCT
• Clotting studies– PT-INR-aPTT-Platelet count
• Electrolyte level
• Serum Creatinine
• Pregnancy test

Hypolkalemia–(decrease potassium)
Increase risk for toxicity if pt taking Digoxin, slows recovery form anesthesia, and increases cardiac irritability
Hyperkalemia–(increase potassium) Increase risk of Dysrhythmias, especially with anesthesia

Question 22

what test before surgery if patient has Chronic pulmonary problem?

Answer 22

ABG’s

Question 23

Drugs allowed before surgery

Answer 23

1) Seizure
2) Cardiac
3) HTN
4) Respiratory disease

Question 24

Temp in OR

Answer 24

68-73

Question 25

3 zones in the OR

Answer 25

Unrestricted
semi restricted
restricted

Question 26

Team members who are non sterile

Answer 26

circulating nurse and anethesiologist