SAQs

Question 1

Surgical scenario:

- Perioperative assessments w reasoning

Answer 1

1. Health hx: bio info, additional considerations (e.g. visual/hearing/mobility disability/impairment(s), mobility devices), allergies, next of kin, cultural needs, emotional status
2. Body systems:
   A) Cardiac assessment: bloods, cardiac enzymes, CXR/ echocardiography, telemetry, stress test, cardiac catheterization and invasive monitoring. End of bed-o-gram = colour, peripheral perfusion, skin, speech.
   B) Respiratory assessment: part 1- health hx, family health hx, smoking hx, current management/ meds and DNR. Part 2- inspection (RR, depth, WOB), vital signs (BP, HR, SPO2, peak flow), Auscultation (breath sounds – wheezing), palpation (warmth/ perfusion), and presence of dyspnoea, cough, sputum, haemoptysis and chest pain.
   C) Musculoskeletal assessment: posture, gate, bone integrity, joint function, muscle strength and size, skin, neuromuscular status. Soft tissue injuries (contusion, strain, sprain, dislocation) – treat with RICE (rest, ice, compression, elevation).
3. Baseline observations (including pain) so the patient’s normal can be used as a comparison
4. Assessment for risks of PO complications (e.g. pressure injury, haemorrhage, falls)
5. Nutritional assessment: nutritional status, fasting status, BGL, BMI/height/weight
6. Assess surgical site, side, procedure
7. Fluid balance, if necessary
8. Emotional status, i.e. anxiety

PACU

9. Assess airway, breathing circulation
10. Assess pain + response
11. Assess dressing, drains, drips, drugs

Question 2

Immediate PO nursing interventions w rationale

Answer 2

1. Assess breathing and administer supplemental O2 if necessary/prescribed; provides baseline and helps identify s+s of resp. distress early
2. Monitor vital signs and note skin warmth, moisture and colour; baseline and helps to identify s+s of shock early
3. Assess surgical site and wound drainage systems; baseline and helps identify s+s of haemorrhage early
4. Assess LOC, orientation and ability to move extremities (neuro obs); baseline and identify s+s of neurological complications
5. Assess pain level, characteristics (location, quality) and timing, type and route of administration of last dose of analgesic; baseline of current pain level and effectiveness of pain management
6. Assess IV site for patency and infusions for correct rate and solution; helps to detect phlebitis and prevents errors in rate and solution type
7. Assess urine output; helps identify signs of urinary retention
8. Assess GI function

Question 3

ID:

1. What is it?
2. Impact?
3. What can we do?
4. Additional considerations for people with ID.

Answer 3

1. What?
   - IQ<70
   - Decr. ability to understand complex info and learn new skills
   - decr. ability to cope independently
2. Impact?
   - Difficulty understanding/responding to Qs
   - Difficulty recalling and processing info
   - Incr. vulnerability
   - Difficulty understanding social cues
   - Difficulty understanding social cues
   - Difficulty reading/writing, filling forms, concentrating for long periods of time
3. Interventions
   - Sit w them to fill out forms instead of just giving to them
   - listen
   - take lead from them
   - take time to work out their preferred methods of communication
   - don’t make assumptions
   - involve them in decision making
4. Considerations
   - behavioural assessment incl. developmental stage
   - level of independence
   - screening (hearing loss/impairment, vision test, oral health, developmental)

Question 4

This deck isn’t complete, sorry I swapped to just doing the deck with all the lecture content

Answer 4

Sorry, ignore this deck :)