Medications
Perioperative Nursing
Perioperative Nursing
Perioperative Nursing
Perioperative Nursing
100

what is the concern when adding opiates with general anesthesia? 

Synergistic effect:

Placing patient at risk for respiratory depression 

100

what is the drug class for (Atropine, Glycopyrolate, Scopolamine)?

what is it used for?

what is the mechanism of action? 

Side effect?


1- Anticholinergics

2- Decrease salivation, Prevents bradycardia

3- Inhibit smooth muscle contraction in the GI tract

4- 

Related to decreased parasympathetic stimulation

Decreased peristalsis

Dry mouth

Urinary retention

CNS disturbances – dizziness

Dysrhythmias

100

A client is preparing for a surgical procedure is taking corticosteroids for Crohn’s disease. What is most important for the nurse to monitor during the operative experience with the client?

  •  hypoglycemia
  •  surgical site infection
  •  adrenal insufficiency
  •  obstruction

adrenal insufficiency

100

The nurse is preparing the medical record for a client scheduled for surgery. Which item(s) will the nurse ensure are in the history and physical? Select all that apply.

  • Home care needs

  • Current medications

  • Surgical history

  • Medical history

  • History of present illness

  • Allergies

  • Allergies

  •  Surgical history

  • Medical history

  • Current medications
  • History of present illness
100

What action by the nurse best encompasses the preoperative phase?

  •  Educating clients on signs and symptoms of infection
  •  Documenting the application of sequential compression devices (SCDs)
  •  Monitoring vital signs every 15 minutes
  •  Shaving the client using a straight razor


  •  Educating clients on signs and symptoms of infection




200

what is the drug class for Midazolam? 

what is the band name? 

what is the anidote for Midazolam? 

Does it produce Amnesia? 

Does it have analgesic properties?

where is Metabolized by?


1- Benzodiazepines

2- Versed 

3- Romazicon: brand name (Flumazenil)  

4- Produces amnesia

5-Does not have analgesic properties

6- the liver

200

what are the 5 rights of delegation?

1- Right task

2- Right person

3- Right communication

4- Right feedback

5- Right time

200

An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?

  •  Neurologic and musculoskeletal complications are the leading cause of postoperative morbidity and mortality for older adults.
  •  All older people face similar risks when undergoing surgeries.
  •  Aging processes reduce the chances that surgery will be successful for these clients.
  •  Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients.

 Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients.

200

Which nursing statement would best ease a client’s anxiety before an emergency operative procedure?

  •  "It is best to take deep breaths and relax before the procedure."
  •  "Let me explain to you what will happen next."
  •  "You will be just fine; the operating room nurses will take good care of you."
  •  "We will keep your family informed of your progress."


  •  "Let me explain to you what will happen next."




200

Nursing assessment findings reveal that the client is afraid of dying during the surgical procedure. Which surgical team member would be most helpful in addressing the client's concern?

  •  Registered nurse first assistant
  •  Anesthesiologist
  •  Circulating nurse
  •  Surgeon

Surgeon

300

what is the drug class for (morphine, meperidine, fentanyl)? 

what is the antidote for these opioids? 

Does it produce analgesia (pain relieve)? 

what is the biggest concern about opioids? 

when would you give the antidote? 

1- Opioids analgesics  

2- Naloxone (Narcan)  

3- yes 

4- Falls 

5- When you want to wake the patient up, and Respiratory depressed

300

to whom do you report elder abuse? 

If it is:

a)City of san Diego = SDPD

b)County of san Diego = sheriff department

300

How does the nurse determine that the patient may have hidden fears about the impending surgical procedure? (Select all that apply.)

  •  The patient informs the nurse of problems with postoperative nausea in the past and that it was a bad experience.
  •  The patient tells the nurse of concerns with the outcome of the procedure.
  •  The patient avoids communication with the nurse.
  •  The patient talks incessantly.
  •  The patient repeatedly asks questions that have previously been answered.


  •   The patient avoids communication with the nurse.


  •   The patient repeatedly asks questions that have previously been answered.


  •   The patient talks incessantly.
300

When is the ideal time to discuss preoperative teaching

  •  Day of surgery
  •  When the patient is comfortable and sedated
  •  Preadmission visit
  •  Prior to entering the pre-op area
  •  Preadmission visit
300

When a client with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the client may show signs of alcohol withdrawal delirium during which time period?

  •  Upon awakening in the postanesthesia care unit
  •  Up to 24 hours after alcohol withdrawal
  •  Up to 72 hours after alcohol withdrawal
  •  Immediately upon admission

 Up to 72 hours after alcohol withdrawal

400

what is the drug class for (cimetidine, famotidine, nizatidine, Axid, and ranitidine)

how do they work?

Indication?

nursing consideration?

Why would you care what is in the stomach when we are operating on the foot?

1- Histamine (H2) receptor antagonists

2- Inhibit gastric acid secretion

3- Heart burn

4- Do not administer at same time as antacids.

5- Due to risk of aspiration (because peristalsis is decreased due to the stress responses) You make more acid when you are stressed

400

A client is having surgery through an ambulatory surgical center. Which information will the nurse provide to the client’s family?

  • “You can go home and I will call you in a day or two when the client can be discharged.”

  • “The client will go to the postanesthesia care unit after the surgery.”

  • “I will give you the name of the hospital that the client will be transferred to after the surgery.”

  • “Be prepared to take the client home as soon as the surgery is over.”

“The client will go to the postanesthesia care unit after the surgery.”




400

A nurse evaluates the potential effects of a client's medication therapies before surgery. Which drug classification may cause respiratory depression from an associated electrolyte imbalance during anesthesia?

  •  diuretics
  •  insulin
  •  corticosteroids
  •  anticoagulants

 diuretics



Diuretics during anesthesia may cause excessive respiratory depression resulting from an associated electrolyte imbalance. Corticosteroids, insulin, and anticoagulants are not known to cause respiratory depression during anesthesia.



400

The nurse is doing a preoperative assessment of an 87-year-old man who is slated to have a right lung lobe resection to treat lung cancer. What underlying principle should guide the nurse's preoperative assessment of an elderly client?

  •  Elderly clients have a smaller lung capacity than younger clients.
  •  Elderly clients have less physiologic reserve than younger clients.
  •  Elderly clients have more sophisticated coping skills than younger clients.
  •  Elderly clients require higher medication doses than younger clients.


  •  Elderly clients have less physiologic reserve than younger clients.




400

A nurse is teaching a client about diaphragmatic breathing. What client action indicates that further teaching is needed?

  •  The client breathes in deeply through the nose and mouth.
  •  The client places the hands on the lower chest to feel the rise and fall with breathing.
  •  The client exhales forcefully with a short expiration.
  •  The client performs diaphragmatic breathing in a semi-Fowler's position.


  •  The client exhales forcefully with a short expiration.




500

what is the drug class for (Metoclopramide, Droperidol, ondansetron, promethazine)?

what is it used for?

Side effects?

1- Antiemetics

2- Alleviate nausea and vomiting

3- side effect include:

Drowsiness (CNS depression)

Hypotension Dry mouth (anticholinergic effect)

Blurred vision (dilation from anticholinergic)

Uncoordination

500

A client has been transported to the operating room for emergent surgery. Which statement by the nurse best supports the need for emergent surgery?

  •  “The client had severe pain and a laceration to the face with minimal bleeding after being attacked by a dog 1 hour ago.”
  •  “The client was tachycardic, had progressive weight loss, and experienced bouts of insomnia as a result of hyperthyroidism.”
  •  "The client was unresponsive, had a distended abdomen, and had unstable vital signs after a motor vehicle accident."
  •  “The client had epigastric abdominal pain, an elevated white blood count, and vomiting for 1 day.”

"The client was unresponsive, had a distended abdomen, and had unstable vital signs after a motor vehicle accident."

500

A client is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications?

  •  Deep breathing and coughing exercises should be completed every 8 hours.
  •  Pain medication should be taken before completing deep breathing and coughing exercises.
  •  Deep breathing and coughing exercises may be used as relaxation techniques.
  •  Splint the incision site using a pillow during deep breathing and coughing exercises.


  •  Splint the incision site using a pillow during deep breathing and coughing exercises.




500

A client refuses to remove her wedding band when preparing for surgery. What is the best action for the nurse to take?

  •  Remove the ring once the client is sedated.
  •  Discuss the risk for infection caused by wearing the ring.
  •  Notify the surgeon to cancel surgery.
  •  Allow the client to wear the ring and cover it with tape.


  •  Allow the client to wear the ring and cover it with tape.




500

A client with osteoarthritis receives a recommendation to have joint replacement surgery. For which type of surgery will the nurse plan teaching for this client?

  • Urgent

  • Required

  • Elective

  • Emergent

Elective

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