Post-Op Priorities
In the PACU, you noticed your patient's urinary catheter is patent, however, over the last hour, they have produced 15mL of urine. What's your next move?
Call the provider!
Key note here- the question already addressed the fact that the catheter is patent meaning you, the RN, has already assessed it. No need to do anything else futher like irregate, change position, etc, you have done this already. Call the DOC!
After a head injury, a patient is disoriented and restless. What might be happening inside the skull?
Increased ICP
Your patient has scheduled a total open hysterectomy. When should the education happen?
As soon as the surgery is scheduled and before sedation!
A left-brain stroke patient has trouble moving their right side. What helps prevent complications?
Passive ROM to the affected side
Your patient is scheduled for surgery in 2 hours but just finished eating a sausage biscuit and OJ in the lobby. What now?
Call the provider and delay the procedure
A patient in the PACU following major surgery received IV push narcotics for severe pain. Minutes later, they developed respiratory depression. What quick action can you take to manage their airway?
Head tilt-Jaw trust
Which part of the brain is responsible when a stroke patient can’t understand speech?
Wernicke’s area
A tumor removal is planned just to reduce pain, not cure it. What kind of surgery is this?
Palliative
Patient with MCA (middle cerebral artery) stroke keeps bumping into things. What’s your best safety move?
Coach them to scan their environment
How would you describe a generalized seizure?
A patient who is twitching and then goes stiff and jerky.
Your post-op patient has a large abdominal incision. What action helps keep it intact?
Avoid extra strain
WHY?
THis cold cause dehiscence, or worse, eviceration.
A patient holds their arms out, but one drops slightly. What could that mean?
THere is a cerebral lesion on the opposite side of the brain.
Your spinal anesthesia patient complains of a headache. What should they avoid doing?
Getting up too soon
What’s a priority action if your stroke patient suddenly shows new symptoms?
Call the provider
What do you do if your patient has limited english and needs to sign consent? What is your best move?
You must have a hospital provided interpreter- or at least try to
You just gave a med that can trigger malignant hyperthermia. What are you watching for?
Muscle rigidity, fever, tachycardia
What is this med called?
succ...sin..o..col..late
What’s the red flag sign in a patient with a known subdural hematoma?
Sudden change in LOC with new deficits
Before brain surgery, the provider orders a med to help prevent seizures. Which one?
Phenytoin
Your patient has increasing intracranial pressure after their hemorrhagic stroke. What med will help them the most?
mannitol
Like, what must be done or confirmed before any surgery can happen?
Informed consent
Patient had a pituitary tumor removed. What med helps if they develop DI?
Vasopressin
Patient drank coffee before an EEG. Now what?
Tell the provider and reschedule if needed
Which test can help monitor vasospasms in a patient with an AVM?
Transcranial Doppler
When assessing your patient's arms, one has a pronator drift down, what does this suggest about their type of stroke?
It means that the stroke lesion happened on the opposite side of the brain from the arm that is drifting.
Your patient had a blow to the front of the head and now has visual issues. Which lobe is likely involved?
Occipital