Surgical PTs and Pain

Question 1

all mes taken before surgery are automatically ________ after surgery unless a health care provider _______

Answer 1

discontinued, reorders the drugs

Question 2

care of the post-op PT centers on

Answer 2

the body systems that anesthesia, immobilization, and surgical trauma most likely affect

Question 3

Obesity places patients at an increased surgical risk because of which of the following factors? (Select all that apply.)
A. Risk for bleeding is increased.

B. Ventilatory capacity is reduced.

C. Fatty tissue has a poor blood supply.

D. Metabolic demands are increased.

Answer 3

B. Ventilatory capacity is reduced.

C. Fatty tissue has a poor blood supply.

A decreased blood supply in adipose tissue slows the delivery of essential nutrients, antibodies, and enzymes needed for wound healing. A decreased ventilatory capacity allows for alveolar collapse, which can lead to pneumonia.

Question 4

The primary reason that family members should be included when the nurse teaches the patient preoperative exercises is so they can:

Answer 4

Coach and encourage the patient after surgery.

(Patients may need support from family to be motivated to return to their previous state of health. The family may also have better retention of preoperative teaching and will be with the patient and able to help them in their recovery.)

Question 5

In the postanesthesia care unit (PACU) the nurse notes that the patient is having difficulty breathing and suspects an upper airway obstruction. The nurse would first:

Answer 5

Position the patient on one side with the face down and the neck slightly extended so the tongue falls forward.

(Positional change helps to move the tongue forward to open the airway. The immediate intervention should be to open the airway.)

Question 6

Because an older adult is at increased risk for respiratory complications after surgery, the nurse should:

Answer 6

Encourage the patient to turn, deep breathe, and cough frequently and ensure adequate pain control.

Question 7

a common early complication of surgery is

Answer 7

bleeding.

Question 8

Signs of bleeding post-op include:

Answer 8

hypotension; tachycardia; and cool, clammy, pale skin

Question 9

what is a life-threatening complication of general anesthesia?

Answer 9

malignant hyperthermia (a severe hypermetabolic condition that causes rigidity of skeletal muscles caused by an increase in intracellular Ca+ concentration-->hypercarbia, tachypnea, and tachycardia.
Elevated temp is actually a LATE sign

Question 10

After a surgical patient has been given preoperative sedatives, which safety precaution should a nurse take?

Answer 10

Reinforce to the patient to remain in bed or on the stretcher

Question 11

The operating room (OR) and postanesthesia care unit (PACU) are high-risk environments for patients with a latex allergy. Which safety measures to prevent a latex reaction should the nurse implement? (Select all that apply.)

Answer 11

A. Screening patients about food allergies known to have a cross-reactivity to latex such as kiwis and bananas
B. Having a latex allergy cart available at all times
C. Communicating with the operating room (OR) team as soon as 24 to 48 hours in advance of the surgery when a latex-sensitive patient is identified

Question 12

A nurse is recovering a patient who received conscious sedation for cosmetic surgery. Which of the following is an advantage that conscious sedation has over general anesthesia?

Answer 12

Amnesia and relief of pain

Question 13

PARSAP scale

Answer 13

The PARSAP is an important functional screen to assess the function of the ambulatory surgery patient. The total score must be at least 18 for a patient to be discharged to home, unless the patient is not walking or is unable to use extremities before surgery.

Question 14

pain is

Answer 14

a purely subjective physical and psychosocial experience

Question 15

the goal of pain mngt is

Answer 15

to anticipate and prevent pain rather than to treat it

Question 16

Which of the following signs or symptoms in an opioid-naïve patient is of greatest concern to the nurse when assessing the patient 1 hour after administering an opioid?

A. Oxygen saturation of 95%
B. Difficulty arousing the patient
C. Respiratory rate of 10 breaths/min

D. Pain intensity rating of 5 on a scale of 0 to 10

Answer 16

B. Difficulty arousing the patient

(Opioid-naive patients may develop a rare adverse effect of respiratory depression, and sedation always occurs before respiratory depression.)

Question 17

Patients usually become tolerant to the side effects of opioids, with the exception of

Answer 17

constipation.

Question 18

A patient is being discharged home on an around-the-clock (ATC) opioid for chronic back pain. Because of this order, the nurse anticipates an order for which class of medication?

Answer 18

Stimulant laxative

Question 19

The major adverse effect of acetaminophen is

Answer 19

hepatotoxicity.

Question 20

A patient with chronic low back pain who took an opioid around-the-clock (ATC) for the past year decided to abruptly stop the medication for fear of addiction. He is now experiencing shaking chills, abdominal cramps, and joint pain. The nurse recognizes that this patient is experiencing symptoms of:

Answer 20

Physical dependence.

Question 21

A patient returning to the nursing unit after knee surgery is verbalizing pain at the surgical site. The nurse’s first action is to:

Answer 21

Assess the characteristics of the pain.

(It is necessary to monitor pain on a regular basis along with other vital signs. It is important for the nurse to understand that pain assessment is not simply a number.)

Question 22

When using ice massage for pain relief, which of the following are correct? (Select all that apply.)

A. Apply ice using firm pressure over skin.

B. Apply ice until numbness occurs and remove the ice for 5 to 10 minutes.

C. Apply ice until numbness occurs and discontinue application.

D. Apply ice for no longer than 10 minutes.

Answer 22

A. Apply ice using firm pressure over skin.

B. Apply ice until numbness occurs and remove the ice for 5 to 10 minutes.

Question 23

When teaching a patient about transcutaneous electrical nerve stimulation (TENS), which information do you include?

Answer 23

TENS electrodes are applied near or directly on the site of pain.

Question 24

TENS pain therapy involves

Answer 24

stimulation of the skin with a mild electrical current passed through external electrodes. The therapy requires a health care provider order.

Question 25

While caring for a patient with cancer pain, the nurse knows that the World Health Organization (WHO) analgesic ladder recommends:

Answer 25

Transitioning use of adjuvants with nonsteroidal antiinfl ammatory drugs (NSAIDs) to opioids.

Question 26

A postoperative patient is currently asleep. Therefore the nurse knows that:

Answer 26

A. The sedative administered may have helped him sleep, but assessment of pain is still needed.