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adult health 1 > surgical nursing study deck > Flashcards

surgical nursing study deck Flashcards

1
Q

what is our top priority with surgery?

A

safety. we must always try to keep the patient safe

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2
Q

is suicide something we assess for?

A

yes, we assess for suicide in the preop period

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3
Q

what are some things that may be included in the preop checklist?

A

VS, hx, full head to toe, npo

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4
Q

what are some things that you are supposed to take off of the pt prior to surgery?

A

dentures, jewlery, contacts

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5
Q

why are older clients at a higher risk of compliction with surgery?

A

they have decreased functions in things like abdominal, renal, cv systems, they also have less fat, on average high blood pressure, and low skin mass

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6
Q

what are some populations of clients that we have to pay special attention to?

A

older, pregnant, chronic conditions, immunocompromised, disability, etc

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7
Q

what test do we have to do to all women before surgery?

A

urine pregnancy test

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8
Q

what protien in blood is necessary for good healing?

A

albumin!

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9
Q

what are some types of meds we need to be cautious of pre surgery?

A

steroids, antibiotics, anticoags, insulin, etc

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10
Q

what happens when a client is taking garlic and ginko as it relates to surgery?

A

they are at an increased risk for bleeding

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11
Q

what must the pt do as it pretains to their anticoagulant medicines?

A

they must stop taking it 48 hours before

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12
Q

what must the surgeon obtain prior to surgery?

A

informed consent

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13
Q

what is the RN’s role in informed consent?

A

witnessing the surgeon explain the procedure and answering questions the pt has

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14
Q

can the RN do the informed consent?

A

no this is the job of the physician

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15
Q

what must the RN assess before signing a witness agreement?

A

that the pt does not have altered mental status

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16
Q

can a patient with altered mental status consent to surgery?

A

no

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17
Q

if the pt has CLARIFYING questions, can the RN clarify?

A

yes, but the RN can not explain any new information

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18
Q

when should the RN do the teaching and why?

A

in pre op because post op, the pt may not be in a space to recieve teaching

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19
Q

what does an allergy to bananas and kiwi indicate?

A

allergy to latex

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19
Q

what does allergy to eggs indicate?

A

allergy to anesthesia

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20
Q

when should we have the client void?

A

before the procedure

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21
Q

what is a measure we use to prevent VTE, DVT?

A

apply compression stockings before surgery

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22
Q

A nurse is conducting a preoperative assessment on a client scheduled for surgery the next morning. The client reports taking warfarin (Coumadin) daily. What is the priority action for the nurse?

A) Notify the surgeon immediately.
B) Instruct the client to stop taking warfarin the night before surgery.
C) Administer vitamin K as prescribed.
D) Document the medication in the client’s chart.

A

Answer: A) Notify the surgeon immediately.

Rationale: Warfarin increases the risk of bleeding, and this information must be communicated to the surgeon.

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23
Q

The nurse is explaining the importance of preoperative fasting to a patient scheduled for surgery. What is the recommended minimum fasting time for clear liquids before surgery?

A) 2 hours
B) 4 hours
C) 6 hours
D) 8 hours

A

Answer: A) 2 hours

Rationale: Clear liquids can usually be consumed up to 2 hours before anesthesia.

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24
Q

A client scheduled for surgery is anxious and asks the nurse if complications can arise from the procedure. What is the most appropriate response?

A) “It’s rare for complications to occur during surgery, so don’t worry.”
B) “Let me call the surgeon to explain the risks in more detail.”
C) “All surgeries have risks. Let’s talk about your concerns.”
D) “Everything will be fine. The surgical team is very experienced.”

A

Answer: C) “All surgeries have risks. Let’s talk about your concerns.”

Rationale: Addressing the patient’s concerns directly and providing an opportunity for them to discuss their fears is part of holistic nursing care.

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25
Q

A nurse is preparing a client for surgery. The client states they do not understand the procedure and are unsure about proceeding. What is the nurse’s best action?

A) Explain the procedure to the client in simple terms.
B) Cancel the surgery.
C) Notify the surgeon and delay signing of the consent.
D) Reassure the client that everything will be okay.

A

Answer: C) Notify the surgeon and delay signing of the consent.

Rationale: The surgeon is responsible for explaining the procedure, and informed consent must be obtained prior to surgery.

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26
Q

The nurse is reviewing a client’s lab results prior to surgery. Which of the following lab results would most likely require immediate attention?

A) Potassium 3.5 mEq/L
B) Hemoglobin 10 g/dL
C) White blood cell count 12,000/mm³
D) Blood glucose 230 mg/dL

A

Answer: D) Blood glucose 230 mg/dL

Rationale: Elevated blood glucose levels can increase the risk of infection and delay wound healing. It requires immediate attention before surgery.

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27
Q

A nurse is reinforcing instructions about deep breathing and coughing exercises for a preoperative patient. Which statement by the patient indicates the need for further teaching?

A) “I will take a deep breath and then cough forcefully.”
B) “I should do this every 1-2 hours after surgery.”
C) “I should avoid deep breathing if I experience pain.”
D) “I can use a pillow to support my incision while coughing.”

A

Answer: C) “I should avoid deep breathing if I experience pain.”

Rationale: The patient should still perform deep breathing exercises postoperatively, and pain management should be addressed to facilitate this.

28
Q

During the preoperative assessment, the nurse notes the patient has a latex allergy. What should be the nurse’s priority action?

A) Inform the surgical team and place an allergy alert bracelet on the patient.
B) Ask the patient if they have any other allergies.
C) Notify the pharmacy to ensure no latex-containing medications are used.
D) Document the allergy in the chart.

A

Answer: A) Inform the surgical team and place an allergy alert bracelet on the patient.

Rationale: Latex allergies are significant, and the surgical team must be made aware to avoid any latex-containing materials.

29
Q

The nurse is preparing a client for abdominal surgery. Which of the following is most important to include in preoperative teaching?

A) How to manage postoperative pain
B) The type of anesthesia used during surgery
C) How to perform leg exercises and use an incentive spirometer
D) The estimated length of the procedure

A

Answer: C) How to perform leg exercises and use an incentive spirometer

Rationale: Preoperative teaching that focuses on preventing complications, such as respiratory and circulatory issues, is most important.

30
Q

A nurse is providing instructions to a client scheduled for surgery the following morning. The client asks when they should take their routine medications. What is the nurse’s best response?

A) “You should take all your medications as usual.”
B) “You will need to stop all medications tonight.”
C) “You may take most medications with a sip of water, but let me check with your provider.”
D) “Take your medications with a full glass of water.”

A

Answer: C) “You may take most medications with a sip of water, but let me check with your provider.”

Rationale: Certain medications may need to be adjusted, so the provider should give the final decision.

31
Q

A client is scheduled for surgery in a few hours and asks if they will be able to eat afterward. What is the nurse’s best response?

A) “Yes, you’ll be able to eat as soon as you wake up from surgery.”
B) “Your ability to eat depends on the type of anesthesia and your postoperative condition.”
C) “You’ll be on a liquid diet for the next 24 hours.”
D) “You won’t be able to eat until your first bowel movement.”

A

Answer: B) “Your ability to eat depends on the type of anesthesia and your postoperative condition.”

Rationale: The patient’s ability to eat depends on multiple factors, including the type of surgery and anesthesia.

32
Q

what should we focus on after we focus on after the airway?

A

the pain and nausea/vominting

33
Q

what is the nurses number 1 priority when caring for the post op patient?

A

maintaining a patent airway

34
Q

how do we maintain a patent airway?

A

feel the breath with your hand, understand that there may be an artificial airway (intubation) after surgery, give supplemental oxygen if needed, elevate HOB

35
Q

if vomiting occurs, what do we do to the patient?

A

we position them on their side

36
Q

should the RN perform an IV assessment?

A

yes, this is important to ensure good access for meds, fluids

37
Q

what are going to be some things that can indicate our need for fluids? (think definitive)

A

vital signs (blood pressure) if it is hypotensive, if they are in fluid volume deficit (high heart rate but low bp)

38
Q

should the pt be doing breathing excercises post op?

A

yes, they should be doing excercises even if they are in pain

39
Q

what to do if there is a drop in 20mmhg of bp in the pacu?

A

alert surgeon immideatly

40
Q

what are some signs of hypovolemic shock?

A

weak, thready pulse, palor, cyanosis, low urine output

41
Q

how should we manage opiods for clients post op (think common user vs opiod naive)

A

those who arent used to opoids should get short acting ones first (they may experience adverse affects), those who are used to opoids may need more than the standard doseage because they may have tolerance

42
Q

when can a pt be discharged?

A

when they have a gag reflex, can swallow, can ambulate

43
Q

why do we check peripheral pulses?

A

to ensure blood flow is getting to all sides of extremities

44
Q

how often are we turning our pts?

A

q2

45
Q

if the pain is worsening, who is the person/team who manages that?

A

CRNA,MD (anesthesia)

46
Q

do we put pillows under knees?

A

no

47
Q

when you get a patient from the pacu, what is your first thing you do?

A

a full head to toe assessment(focus on airway, breathing, circulation) though

48
Q

what should urine output after surgery be?

A

30ml/hr (if this is low, they may be in fluid volume deficit)

49
Q

what does the RN assessment for wound site need to be?

A

the incision should be pink, NOT red, slight swelling, and slight crust

50
Q

when are we assessing the wound drain?

A

each vital sign assessment

51
Q

when to use an abdominal binder?

A

when the pt has had abdominal surgery or is obese

52
Q

what type of diet should the pt be eating after surgery (when able to)?

A

high in protein, high in calorie

53
Q

what types of patients are at risk for low wound healing?

A

diabetic, malnourished

54
Q

what is a parylitic ileus?

A

when gi movement is parylised and peristalsis can not occur

55
Q

what are nursing interventions we can do to combat parylitic ileus?

A

encourage ambulation, listen to bowel sounds

56
Q

what can abdominal distension be a sign of (espicially if they didnt have abdominal surgery)?

A

hypervolemia

57
Q

how should the drainage color be progressing?

A

sanguenous to serosangueneous

58
Q

A nurse is caring for a client who is 2 hours postoperative following abdominal surgery. Which of the following assessments should be the nurse’s priority?

A) Pain level
B) Respiratory rate
C) Bowel sounds
D) Urinary output

A

Answer: B) Respiratory rate

Rationale: In the immediate postoperative period, airway and breathing are the highest priority due to the potential for respiratory complications from anesthesia.

59
Q

A client is 8 hours post-op after a total hip replacement. The nurse notes the client has not voided since surgery. What is the nurse’s best action?

A) Encourage the client to drink more fluids.
B) Assess the client’s bladder for distention.
C) Notify the surgeon immediately.
D) Document the finding and continue to monitor.

A

Answer: B) Assess the client’s bladder for distention.

Rationale: Urinary retention is common postoperatively due to anesthesia and immobility. Assessing for bladder distention is the first step.

60
Q

The nurse is caring for a postoperative client receiving opioid analgesics for pain control. Which of the following findings is the most concerning?

A) The client reports feeling drowsy.
B) The client’s respiratory rate is 8 breaths per minute.
C) The client’s pain is rated 5/10.
D) The client has not had a bowel movement in 2 days.

A

Answer: B) The client’s respiratory rate is 8 breaths per minute.

Rationale: A respiratory rate of 8 is below the normal range, indicating possible opioid-induced respiratory depression, which is a medical emergency.

61
Q

A nurse is caring for a client who is 24 hours postoperative from bowel surgery. The client reports nausea and has absent bowel sounds. Which of the following complications should the nurse suspect?

A) Bowel obstruction
B) Paralytic ileus
C) Peritonitis
D) Constipation

A

Answer: B) Paralytic ileus

Rationale: Paralytic ileus is a common postoperative complication where the bowel is temporarily paralyzed, leading to absent bowel sounds and nausea.

62
Q

The nurse is caring for a client postoperatively after abdominal surgery. The client coughs and the wound edges separate, exposing underlying tissue. What is the nurse’s priority action?

A) Apply a dry, sterile dressing.
B) Notify the surgeon.
C) Cover the wound with a sterile saline dressing.
D) Encourage the client to avoid coughing.

A

Answer: C) Cover the wound with a sterile saline dressing.

Rationale: Wound dehiscence (separation) or evisceration requires immediate coverage with sterile saline dressings to prevent tissue drying and infection, followed by notifying the surgeon.

63
Q

A client is postoperative from a hip replacement and is at risk for deep vein thrombosis (DVT). Which intervention should the nurse include in the plan of care to prevent DVT?

A) Place pillows under the knees to elevate the legs.
B) Instruct the client to flex and extend the feet every 2 hours.
C) Encourage bed rest for 24 hours postoperatively.
D) Apply cold compresses to the legs.

A

Answer: B) Instruct the client to flex and extend the feet every 2 hours.

Rationale: Flexing and extending the feet promotes venous return and reduces the risk of DVT. Bed rest increases the risk of DVT.

64
Q

A client 12 hours post-op from a bowel resection has a nasogastric tube (NGT) in place to low intermittent suction. The nurse notices the client’s NGT has stopped draining. What is the nurse’s priority action?

A) Irrigate the NGT with normal saline as prescribed.
B) Reposition the NGT.
C) Notify the surgeon immediately.
D) Remove the NGT.

A

Answer: A) Irrigate the NGT with normal saline as prescribed.

Rationale: Irrigating the tube helps ensure patency, which is important to prevent complications such as abdominal distension and nausea.

65
Q

The nurse is reviewing the vital signs of a client who is 4 hours post-op from a laparoscopic appendectomy. The client’s blood pressure is 90/60 mm Hg, heart rate is 120 bpm, and skin is cold and clammy. Which complication should the nurse suspect?

A) Hypovolemic shock
B) Pulmonary embolism
C) Infection
D) Atelectasis

A

Answer: A) Hypovolemic shock

Rationale: The client’s low blood pressure, high heart rate, and cold, clammy skin suggest hypovolemic shock, possibly from blood loss.

66
Q

A nurse is caring for a client following abdominal surgery. The client is hesitant to ambulate due to pain. What is the best action by the nurse?

A) Encourage the client to rest and ambulate when ready.
B) Administer pain medication 30 minutes before ambulation.
C) Explain that ambulation will reduce pain.
D) Wait until the client has less pain before ambulating.

A

Answer: B) Administer pain medication 30 minutes before ambulation.

Rationale: Administering pain medication prior to activity helps promote movement and prevents complications like atelectasis or DVT.

67
Q

The nurse is caring for a postoperative client with an indwelling urinary catheter. Which finding requires immediate intervention?

A) Urine output of 20 mL/hr
B) Clear, yellow urine
C) Urinary catheter secured to the thigh
D) Urine output of 350 mL over 4 hours

A

Answer: A) Urine output of 20 mL/hr

Rationale: A urine output of less than 30 mL/hr may indicate kidney dysfunction or inadequate fluid status and requires immediate intervention.

adult health 1 (6 decks)

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