Pre/Peri-op surgery
Surgery procedure that can be done on an outpatient basis.
Minimally invasive surgery
A client has been on Warfarin (coumadin) for six months and is in the process of completing preop Preparation. What would the nurse do?
a. Nothing, the patient needs the warfarin to prevent blood clots.
b. Notify the provider who should stop the warfarin 5 days before surgery.
c. Stop the Warfarin immediately.
d. The MD will cut the dose in half and request and INR and PT to be completed before surgery.
Discontinue warfarin at least 5 days prior to surgery.
Within the first 24 hours after surgery the nurse carefully assesses for which of the following:
a. Hemorrhage
b. DVT
c. Infection
d. Patient ability to ambulate to the bathroom
a. Hemorrhage
Total joint replacement is considered what type of surgery?
a. Rehabilitative
b. Curative
c. Reconstructive
d. Emergent
a. Rehabilitative: For patients with DJD, arthritis, correct crippling pain.
curative is removal of an inflamed organ gallbladder or appendix.
reconstructive (facelift)
emergent degree of urgency (urgent, required, elective, optional).
Epidural and Spinal anesthesia are considered what type of anesthesia?
a. Local
b. Moderate
c. Regional
d. General
Correct: Regional
Local: injection directly tissues of planned incision site.
Moderate: Conscious sedation (for minor procedures)
General: for major surgery are NOT arousable.
The nurse arrives in the room of a patient who just arrived from the PACU. After performing proper hand hygiene and completing a twostep ID of the patient. What is the next step?
a. Head to toe assessment
b. Focused assessment
c. Complete set of vital signs
d. Hook the patient up to the cardiac monitor
Focused assessment
Surgery that does not require an overnight stay.
Ambulatory surgery
Malignant Hyperthermia, is a rare muscle disorder which is a reaction to anesthesia. True or False?
True
The patient is one day post op and is asking for his morphine every 3-4 hours. The nurse understands the following regarding opioids and the surgical patient:
a. post op surgical patients can become addicted quickly to narcotic opioids therefore every 6-8 hours is best.
b. post op narcotics are usually discontinued on the day of surgery.
c. The risk for addiction in the post-op patient is negligible therefore ensure the patient is getting adequate pain control with the ordered narcotic opioid.
C.
Surgical problems that are common with the bariatric patient. Select all that apply:
a. Dehiscence
b. Infection of fatty tissue
c. Rapid respirations when supine.
d. Wound infections
e. Inability to void
Correct: Dehiscence, infection of fatty tissue, wound infections.
The following are PACU nursing management objectives in the postoperative period:
a. Assessment of patient
b. Maintenace of fluids
c. Starting the patient on a liquid diet
d: Applying appropriate dressings to the surgical area
e. Remove the endotracheal tube if the patient is stable
Assessment, fluids only.
Which wound healing mechanism is used in infected wounds?
a. First
b. Second
c. Third.
Correct; Secondary
First is generally performed post operatively and is closed with sutures or staples. (Clean Incision)
Third used for deep wounds
The nurse is responsible to provide extensive instructions about the upcoming surgery including benefits and possible risks of surgery. True or False?
False, the nurse can have the patient sign the consent and the nurse can be the witness as well as clarifying the information but not extensive instructions.
To maintain cardiovascular stability, the nurse assesses which of the following. Select all that apply.
a. Patients LOC
b. IV line patency
c. skin color and temperature
d. bowel sounds
e. cardiac rate and rhythm
a, b, c, e
Which medication affects healing? Select all that apply
a. Some Antibiotics
b. Narcotic Opioids
c. Corticosteroids
d. Anticoagulants
e. Vitamin C
A, C, D