Week 7:Resp/Pre/Post-op Flashcards
Pre-operative activity that is appropriate for all patients includes what instruction?
a. The importance of Intravenous(IV) fluid replacement after surgery
b. Specific description of planned surgical procedure
c. Physical procedures or preparation required before surgery
d. Withholding of all oral fluids or food after midnight on the day of surgery
B. Specific description of planned surgical procedure
NOT (d), b/c it says "all" which is not always true, not (c), b/c not as important as B And not (a), b/c not everyone will have Iv fluid after surgery.
During admission of the patient to the holding area or operating room before surgery, the preoperative nurse MUST perform what activity?
a. Verify the patients understand of the risks of surgery
b. Ensure the patients identity through a formal identification process
c. Prepare the skin by scrubbing the surgical site with an antimicrobial agent
d. Perform a preoperative assessment with a patient history and physical examination
B. Ensure the patients identity though a formal identification process - ESSENTIAL
Not A, b/c that is the optimally the surgeons responsibility
not C
not d (wouldn’t do that in holding area)
A patient becomes restless and agitated in the post-anaesthesia care unit (PACU) while regaining consciousness.. What is the FIRST action the nurse should take?
a. Turn the patient to a lateral position
b. Orient the patient, and tell him that the surgery is over
c. Administer the ordered post-op pain med
d. Check the patients O2 sat with pulse oximetry
think ACBS, or think of nursing health assess.
D. Check the patients 02 sat with pulse oximetry
(going to assess them, only answer here that involves assessment)
A patient is scheduled for a radical prostatectomy. Before signing the consent, the patient tells the nurse, “I am not sure if this surgery is safe”. Which response by the nurse is the most appropriate?
a. “You seem anxious; once you sign the consent, i can give you a sedative:
b. “Tell me what you know about your surgery and the risks involved.”
c. “Any surgery has risks, but we will be here to take good care of you.”
d. “You do not need to be concerned, your surgeon has not had any patient complaints”
B. “Tell me what you know about your surgery and the risks involved.”
The pre-operative order is lorazepam (Ativan) 1mg IV ‘on call to the OR’. Which of the following is the MOST appropriate action for the nurse to take before the administration of this medication?
a. Check the lab results for the most recent serum potassium level
b. Ask the patient about an allergy to iodine or shellfish.
c. Tell the patient the medication is used to prevent nausea.
d. Assist the patient to the bathroom to void.
D. Assist the patient to the bathroom to void.
(b/c the med is used to relax patient)
When assessing a patient’s surgical dressing on the first post-op day, the nurse observes new, bright red drainage about 5cm in diameter. In response to this finding, the nurse should do which of the following?
a. Recheck in one hour for increased drainage
B. Notify the surgeon of a potential hemorrhage.
c. Assess the patient’s blood pressure and heart rate.
d. Remove the dressing and assess the surgical incision.
C. Assess the patient’s blood pressure and heart rate.
always assess first
In planning post-op interventions to promote ambulation, cough, deep breathing, and turning. The nurse recognizes that which of the following actions will best enable the patient to achieve these desired outcomes?
a. Administer adequate analgesics to promote relief or control of pain
b. Ask the patient to demonstrate the post-op exercises every hour
c. Give the patient positive feedback when the activities are performed correctly
d. Warn the patient about possible complications if the activities are not performed.
A. Administer adequate analgesics to promote relief or control pain.
While caring for a patient who had abdominal surgery on the second post-op day, which information about the patient is MOST important to communicate to the health care provider?
a. The right calf if swollen, warm, and painful
b. The patients temp is 37.9
c. The 24-hour oral intake is 600ml greater than the total output
d. The patient complains of abd. pain at level 6(0-10 scale).
A. The right calf if swollen, warm, and painful
could indicate DVT
The nurse notes that the oxygen saturation is 88% in an unconscious patient who was transferred to the PACU 10 minutes previously. Which action should the nurse take FIRST?
a. Elevate the patients head.
B.Suction the patients mouth.
c. Increase the oxygen flow rate.
d. Perform the jaw-thrust maneuver.
D. Perform the jaw-thrust maneuver
(because, the pt. is unconscious,- think airway- what could be blocking the airway– the TONGUE– therefore, jaw-thrust.)
To promote airway clearance in a patient with pneumonia, the nurse instructs the patient to do which of the following? (Select all that apply.)
a. Maintain adequate fluid intake b. Splint the chest when coughing c. Maintain a high Fowler’s position d. Maintain a semi-Fowler’s position e. Instruct patient to cough at end of exhalation
A, B, C, & E
a. Maintain adequate fluid intake
b. Splint the chest when coughing
c. Maintain a high Fowler’s position
e. Instruct patient to cough at end of exhalation
The nurse should instruct the patient to splint the chest while coughing. This will reduce discomfort and allow for a more effective cough. Maintaining adequate fluid intake liquefies secretions, allowing easier expectoration. Coughing at the end of exhalation promotes a more effective cough. The patient should be positioned in an upright sitting position (high Fowler’s) with head slightly flexed.
When admitting a 45-year-old female with a diagnosis of pulmonary embolism, the nurse will assess the patient for which of the following risk factors? (Select all that apply.)
a. Obesity b. Pneumonia c. Hypertension d. Cigarette smoking e. Recent long distance travel
A, C, D, & E
Research has demonstrated an increased risk of pulmonary embolism in women associated with obesity, heavy cigarette smoking, and hypertension. Other risk factors include immobilization, surgery within the last 3 months, stroke, history of deep vein thrombosis (DVT), malignancy, and recent long-distance travel.
Which of the following elements should a plan of care for the patient with COPD include?
a. Chronic corticosteroid therapy
b. Reduction of risk factors for infection
c. High-flow oxygen administration
d. Lung exercises that involve inhaling longer than exhaling
b. Reduction of risk factors for infection
What are the common effects of cigarette smoking on the respiratory system?
a. Increased proliferation of ciliated cells
b. Hypertrophy of the alveolar membrane
c. Destruction of all alveolar macrophages
d. Hyperplasia of goblet cells and increased production of
mucus
d. Hyperplasia of goblet cells and increased production of
Which of the following is one of the most important things that a nurse can teach a patient with COPD?
a. Move to a hot, dry climate.
b. Perform chest physiotherapy.
c. Obtain adequate rest in the supine position.
d. Know the early signs of respiratory infection.
d. Know the early signs of respiratory infection.
What is the major advantage of a Venturi mask?
a. It can deliver up to 80% oxygen.
b. It can provide continuous 100% humidity.
c. It can deliver a precise concentration of oxygen.
d. It can be used while a patient eats and sleeps.
c. It can deliver a precise concentration of oxygen.
