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NCLEX > Surgery and test nursing care > Flashcards

Surgery and test nursing care Flashcards

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1
Q

Post op care for breast surgery

A

Check dressing/bleeding–>hemovac, Jackson-Pratt drain
Elevate affected arm
No work on that arm; no BP, watches, etc.

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2
Q

Bronchoscopy precautions?

A

NPO before surgery and until gag reflex returns

Watch for resp depression, hoarseness, dysphagia, SQEmphysema

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3
Q

When is best to collect sputum?

What should client do

A

In morning and it is sterile

Client should rinse mouth first with water

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4
Q

What precautions should you take for a lobectomy

A

Affected side up/ surgical side up

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5
Q

What precautions should you take for a pneumonectomy

A

Good lung up, non-affected side up
Avoid severe lateral positioning-> mediastinal shift
Never have chest tubes cause theres no pleural space

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6
Q

What position do you have a client post total Laryngectomy

A

Semi-fowlers

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7
Q

When do you change appliance from an ileal conduit

A

In the morning

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8
Q

What position do you put someone after a gastrectomy

A

Fowler’s position

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9
Q

What would the thyroxine level do in a patient with hyperthyroidism

A

it will be increased

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10
Q

What tests determine hyperthyroid

A

T4- increase

Thyroid scan

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11
Q

What should clients discontinue when going for a thyroid scan

A

They should discontinue any iodine containing medication

Amiodarone (Cordarone) - antiarrhythmic drug containing iodine

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12
Q

What precautions do you take with thyroidectomy

A 
Teach to support neck
Put personal items close
Elevate HOB
check for bleeding behind the neck
Nutrition needs more calories
Assess for laryngeal nerve damage listen for hoarseness
Trach if there is vocal cord paralysis
Teach to report any c/o pressure
Trach set at bedside
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13
Q

What is important with a client who has hyperthyroidism

A

Eye care

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14
Q

What is important for pre- cardiac catherization procedure

A
  1. Ask for allergies to shelfish/iodine
  2. Check kidney function because dye will excrete through there
  3. tell the pt. they will feel hot shot
  4. Palpitations are normal
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15
Q

What is important for post-op cardiac catherization

A
  1. Monitor Vs
  2. Watch puncture site for bleeding and hematoma formation
  3. Assess extremity for 5 P’s: pain, pallor, pulse, parasenthesis, paralysis.
  4. Bed rest, FLAT, leg straight for 4-6 hours
    5 Report pain
  5. Hold Glucophage (Metformin) for 48 hours post procedure due to kidney fxn
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16
Q

What is the major complication with a cardiac catherization

A

Bleeding

17
Q

What are the dx labs that confirm an MI

A

CPK-MB- increases
Troponin- increases
Myoglobin- increases

18
Q

Name some bleeding precautions we can take

A 
Watch for bleeding gums
Hematuria and black stool
Use of an electric razor
Soft toothbrush
No IMs
19
Q

When a person goes for a PCI which includes angioplasty what’s a major complication involved

A

An MI- they could either bleed from that site or it could re-occlude.

20
Q

For Cardiac Rehab what are some lifestyle changes to adhere to

A
  • Smoking cessation
  • stepped-care plan (increase activity gradually)
  • Low Fat, Low Salt, Low cholesterol diet
  • No Isometric exercise
  • No Valsalva
  • No Straining, no supps; docusate
  • Sex only if they can walk comfortably
  • Best time for sex in am
  • walking and swimming is the best exercise
  • Teach s/s of heart failure: Weight gain, ankle edema, SOB, Confusion
21
Q

What do you use to diagnose Heart Failure

A
  • BNP: B-type Natriuretic peptide (Nesiritide can give a false high, turn it off 2 hours prior to drawing BNP)
  • CXR
  • Echocardiogram
  • New York Association Functional Classification of persons with HF (1-4, 4 being the worst)
22
Q

What is important Post-op pacemaker

A

Immobilize arm
monitor incision
watch out for electrole dysplacement
Assistive passive ROM to preven frozen shoulder
keep client from raising arm higher than shoulder

23
Q

What do we teach patients who have a pacemaker

A 
Check pulse daily in am 
ID card or bracelet
Avoid electromagnetic fields
Avoid MRI
Avoid contact sports
Airport alarm
24
Q

What is an Implantable cardiac device ICD used for

A

Used to pace heart or to defibrillate people with V Fib

25
Q

Prior to and ECT what should we make sure for our clients

A

Know that it could indcue a grand mal seizure
it is used to treat depression and manic disorders
Be NPO Pre-op
Signed permit is necessary
Series of treatment depends on client response
use Succinylcholine chloride (Anectine) to relax muscles

26
Q

What do you do Post- ECT

A

Position patient on side
stay with the client
the client may have a temporary memory loss
reorient the client
and involve the client in day to day activities asap

NCLEX (21 decks)

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