Adult Acute Exam 3

Pre-Op

100

Focused questions to ask women prior to surgery include: 

Menstrual and obstetric history

Ex: Date of last menstrual period, number of pregnancies, any history of cesarean section

200

The most important nursing actions in pre-operative care is the _______ _______.

Preoperative interview

300

Common fears pts experience before surgery include:

1) Death

2) Pain and discomfort

3) Mutilation or altered body image

4) Anesthesia

5) Disruption of life functioning

400

Common preoperative medications include:

Benzodiazepines- for sedative and amnesic properties

Anticholinergics- to reduce secretions

Opioids- to decrease pain and anesthetic requirements during surgery

Antiemetics- to decrease nausea and vomiting

Other- antibiotics, eyedrops, routine prescription drugs

500

List what you expect to find in a preoperative checklist

Too big to put here

Reference Table 17.9 in Med Surg book

Intra-Op

100

The holding area is often called the:

Preoperative holding area

200

List a couple of roles you might find in the surgical team

1) Registered nurse

2) Licensed Practical/Vocational Nurse (LPN/VN) and Surgical Tech 

3) Surgeon and assistant

4) Registered Nurse First Assistant (RNFA)

5) Anesthesia Care Providers

300

Manifestations of anaphylactic reactions

1) Hypotension

2) Tachycardia

3) Bronchspasm

4) Pulmonary edema

400

Describe malignant hyperthermia 

A rare disorder characterized by hyperthermia with skeletal muscle rigidity. Succinylcholine is the primary trigger of MH. Reference pg 325

500

Openly describe and list the various anesthesia techniques and effects

Reference 18.4

Post-Op

100

How would you begin your initial assessment in the post-operative period?

Airway, breathing, circulation

200

List some potential respiratory problems you might find in the post-anesthesia period

Airway obstruction,  hypoxemia,  atelectasis, bronchospasm, bronchospasm, hypoventilation

300

List and described what would be included in the initial PACU assessment? 

REFERENCES

- Airway

-Breathing

-Circulation

-Neurologic

-Surgical site

-Genitourinary

-Gastrointestinal

-Pain

Reference 29.3

400

What do you know about a patient-controlled analgesia (PCA)?

Reference pg. 338-339

500

What are some special considerations for the older post-operative patient?

1) Decreased respiratory function

2) Decreased ability to cough

3) Decreased thoracic compliance

4) Altered vascular function

5) Drug toxicity

6) Changes in mental status

7) Pain control 

Type 1 Diabetes

100

Common signs of Type 1 Diabetes (hint: 3 P's)

Polydipsia, Polyuria, Polyphagia (also fatigue and unintentional weight loss)

200

Type 1 diabetes is more common in: 

Children and adolescents but can occur at any age

300

Most common complication of untreated type 1 diabetes:

Diabetic ketoacidosis

400

All persons with type 1 diabetes need: 

Insulin

500

Manifestations of type 1 diabetes develop when the person's ________ can no longer make enough _____ to maintain normal glucose.

pancreas; insulin

Type 2 Diabetes

100

Risk factors to type 2 diabetes:

1) Being overweight or obese 

2) Old age

3) Family history of type 2 diabetes

200

Type 2 diabetes is characterized by a combination of inadequate insulin secretion and insulin ________.

resistance

300

An appropriate meal plan for a pt with type 2 diabetes should have a low reduction in: 

1) Saturated fats

2) Trans fats

3) Carbohydrates

400

Monitoring of these labs help give feedback on how well the goals of nutrition therapy are being met for pts with type 2 diabetes

1) Blood glucose levels

2) A1C

3) Lipids

4) Blood pressure

500

Common manifestations of type 2 diabetes include:

1) Fatigue

2) Recurrent infections

3) Recurrent vaginal yeast or candida infections

4) Prolonged wound healing

5) Vision problems