Ready Set Surgery
Your client is scheduled for surgery and tells you they had a rash from penicillin years ago. Which action should you take first?
Notify the surgeon/anesthesia team before any antibiotic is administered.
During the time-out, the nurse notices the consent says 'left knee,' but the surgeon marked the right knee. What should the nurse do?
Stop the procedure until the discrepancy is resolved.
Two hours after surgery, your client is restless, BP 90/60, HR 128, and the dressing is saturated with blood. What complication do you suspect?
Hemmorrhage
A patient receives an antacid pre-op. How does this medication contribute to perioperative safety?
Antacids reduce gastric acidity to prevent aspiration
An older adult client is scheduled for abdominal surgery. Their skin is dry and fragile. What preoperative teaching should you prioritize to reduce postoperative complications?
Teach about wound care and the importance of repositioning to prevent skin breakdown and delayed healing.
A client is under general anesthesia. What is the most important priority for the anesthesia provider to monitor?
Airway and/or Oxygenation
Your postoperative client is drowsy but arousable, with O₂ sat 89% on room air. What is a priority intervention?
Apply oxygen and/or assess airway patency.
A patient in the PACU (post-anesthesia care unit) suddenly becomes unresponsive with no detectable pulse. What priority actions should the nurse take?
Immediately call a code and begin high-quality CPR.
Assess for airway patency.
Continue compressions while another team member prepares the AED.
A client states, 'I don’t really understand what the surgeon will do.' What is the nurse’s best next step?
Contact the surgeon to return and clarify the procedure before consent is valid.
Sequential compression devices (SCDs) are applied intraoperatively. Which complications are they specifically intended to prevent?
Deep venous thromboembolism (leading to pulmonary embolism)
Mrs. Miller reports pain 8/10 despite IV acetaminophen. What order should the nurse anticipate?
Administer an opioid or multimodal pain management strategy
A patient who received general anesthesia reports severe nausea in the PACU. Which medication class is indicated, and what is the nurse’s role in administration and monitoring?
Antiemetics
Which preoperative assessment finding requires the most urgent follow-up: BP 150/88, HR 92, or history of malignant hyperthermia?
History of malignant hyperthermia (life-threatening anesthetic reaction risk).
This practice involves using techniques and barriers to prevent the introduction of pathogens during invasive procedures and is fundamental to patient safety in the perioperative setting.
surgical asepsis or sterile technique
Write an SBAR report to communicate that a patient has a new fever and worsening pain to the provider. Add content to the message as appropriate.
S – Situation:
Dr. [Name], this is [Your Name] on [Unit]. Mr./Ms. [Patient Name] has a new fever of 101.8°F and reports worsening abdominal pain.
B – Background:
Admitted 3 days ago for [reason]. Pain was previously controlled. Vitals stable until today. No new symptoms previously.
A – Assessment:
Patient appears uncomfortable and tender in the lower right quadrant. HR 102, BP 128/76, RR 20, SpO₂ 97%. Pain is more severe than prior episodes.
R – Recommendation:
Request provider evaluation for possible infection, consider labs or imaging, and advise on pain management.
A post-operative patient requires CPR with compressions and ventilations, but no advanced airway is in place. What is the recommended rate for chest compressions?
100–120 compressions per minute
A patient scheduled for surgery has the following lab results: potassium 3.5 mEq/L, WBC 15,000/mm³, and INR 3.2. What finding(s) require immediate follow-up?
WBC 15,000/mm³: Elevated WBC may indicate infection; assess for infection source and delay elective surgery if necessary.
INR 3.2: High INR increases bleeding risk; notify provider and manage per protocol before surgery.
This type of sedation depresses the patient’s consciousness but allows them to maintain their own airway and respond to verbal commands, commonly used for endoscopy.
Moderate (conscious) sedation
Your client has diminished breath sounds after abdominal surgery. What should the nurse educate the patient on?
Encourage use of the incentive spirometer and ambulation to prevent atelectasis.
A patient is recovering from laparoscopic abdominal surgery and reports abdominal distention, nausea, and absent bowel sounds. What order should the nurse anticipate to address the concern?
Insertion and management of a nasogastric (NG) tube to decompress the stomach and relieve pressure.