Surgical Patient

Question 1

Action
Decrease anxiety and produce sedation
Induce amnesia

Nursing implications
Monitor for respiratory depression, hypotension, drowsiness, and lack of coordination

Answer 1

midazolam
diazepam (Valium)
lorazepam (Ativan)

(Benzodiazepines)

Question 2

Action
Decrease anxiety
Allow decreased anesthetics

Nursing implications
Monitor for respiratory depression, nausea, vomiting, orthostatic hypotension, and pruritus.

Answer 2

morphine
fentanyl citrate (Sublimaze)

(Opioid Analgesics)

Question 3

Action
Reduce gastric acid volume and concentration

Nursing implications
Monitor for confusion and dizziness in older adults.

Answer 3

famotidine (Pepcid)
ranitidine (Zantac)

(H2 Receptor Antagonists)

Question 4

Action
Enhance gastric emptying.
Tranquilizing effect.
Prevent postoperative nausea and vomiting.

Nursing interventions
Monitor for sedation and extrapramidal reaction (involuntary movement, muscle tone changes, and abnormal posture). Instruct patient to report any difficulty in breathing.

Answer 4

metoclopramide (Reglan)
droperidol (Inapsine)
ondanstron HCI (Zofran)—> 5 HT3 receptor antagonist)

(Antiemetics)

Question 5

Action
Reduce oral and respiratory secretions to decrease risk of aspiration.
Decrease vomiting and laryngospasm.

Nursing implications
Monitor for confusion, restlessness, and tachycardia.
Prepare patient to expect dry mouth.

Answer 5

atropine sulfate
glycopyrrolate (Robinul)

(Anticholinergics)

Question 6

Action

1. Bactericidal, minimizes risk of wound infection
2. Bactericidal, used for perioperative prophylaxis
3. Bactericidal, used for perioperative prophylaxis

Nursing implications
If large doses are given, therapy is prolonged, or patient is at high risk, monitor for signs and symptoms of superinfection, including abdominal pain, moderate to severe diarrhea, severe anal or genital pruritus, and severe mouth soreness.
Determine patient’s history of allergies.
If dosing continues, space drug evenly around the clock.
Advise patient to complete therapy.

Answer 6

1. cefazolin sodium (Ancef)
2. cefotaxime sodium (Clarforan)
3. ceftriaxone

(Antibiotics)

Question 7

Action
Decrease inflammation

Nursing implications
Determine whether patient has hypersensitivity to drug.
Determine whether patient has diabetes mellitus, and anticipate an increase in antidiabetic drug regimen because of raised blood glucose level

Answer 7

methylprednisolone (Depo-Medrol, Solu-Medrol)

Adrenocortical Steroid

Question 8

Action
Reduces intensity of pain
Reduces inflammation

Nursing implications
Assess the duration, location, onset, and type of pain the patient is having.
Evaluate patient for therapeutic response.

Answer 8

ketorolac

NSAID

Question 9

Action
Produces anticoagulation
Prevents new clot formation or secondary embolic complications

Nursing Implications
Do not give IM, but give subQ.
Tell the patient not to take aspirin or similar over-the-counter drugs.

Answer 9

enoxaparin sodium (Lovenox)

Anticoagulants

Question 10

Nursing implications
Cross-check dose with another nurse before administering.
Use constant rate IV infusion pump.
Monitor the patient’s partial thrompopastin time diigently.
Assess patient’s gums for erythema and gingival bleeding; skin for bruises or petechiae; and urine for hematuria.

Answer 10

heparin sodium (Heparin)

Anticoagulants

Question 11

Nursing implications
Observe patient for evidence of hemorrhage such as abdominal or back pain, decreased blood pressure, increased pulse rate, and severe headache.
Urge patient not to ingest alcohol or make drastic dietary changes.
If administration continues, urge patient to notify the physcian if he or she experiences black stools; bleeding; brown, dark, or red urine; coffee-ground vomitus; or red-speckled mucus from a cough.

Answer 11

warfarin sodium (Coumadin)

Anticoagulants