Bariatric Patients
Chest Tubes
Pedi Surgery
Nursing Interventions
Miscellaneous
100
True/False: Surgery is the only treatment with proven, significant long-term weight loss
True
100
Where should your chest tube chamber be secured at the bedside?
On the floor, with the kickstand out.
100
NG output should be measured at least _______.
Q12 hours/ Q shift
100
It is appropriate to wean MIVF when a patient is....
tolerating a diet
100
Scoring used to determine a patient's readiness to leave PACU phase 1 to move to phase 2 recovery or transfer to the inpatient floor. Assesses patients recovery from anesthesia.
Aldrete Score
200
______ affects our understanding, actions, and decisions in an unconscious manner and encompasses both favorable and unfavorable assessments and are involuntarily activated
Implicit bias
200
Upon assessment, you notice that there is occasional bubbles in the water seal chamber of your patient's chest tube. Is this abnormal?
No
200
Common general pedi surgery procedures include appendectomies, gastrostomy tube placements, pyloromyotomies, cholecystectomies, chest tube placement, abscess I&Ds, and small bowel resections. Name 2 signs of post-op infections.
fever greater that 100.4, increased pain, redness/swelling of the surgical sites, pus like drainage from the surgical sites.
200
Studies show that this intervention for post-operative patients can decrease length of stay and is associated with fewer complications
early ambulation
200
Your patient received Exparel (Liposomal Bupivacaine). The patient should have a TEAL armband in place with the administration date/time as well as EPIC banners to flag administration. How many hours after Exparel administration should similar medications be avoided for the patient?
96 hours
300
Name 2 short-term post-op complications for sleeve gastrectomy
DVT, PE, pneumonia, bleeding, gastric leak
300
Your patient's chest tube is ordered to be set to suction at -20mmHg. What should your wall suction be set to?
Your chest tube should be set to -20mmHg. Your wall suction should be high enough to overcome the pressure and make the bellows come out to arrow, indicating appropriate suction.
300
Your patient has pyloric stenosis and is scheduled for surgery at 7AM tomorrow. It is currently 5PM. Their parents want to know if they can order a dinner tray. What is your answer?
NO
300
Name 2 interventions to avoid post-op complications in bariatric surgery patients
elevate HOB 30 degrees, monitor with CAM & Cont. Pulse Ox, have regular IV assessments, ambulate Q2 hours from 0600-2200
300
This medication for pain management will NOT be ordered for patients with concern for post-op bleeding
toradol/ketorlac
400
Name 2 long-term complications for a sleeve gastrectomy
Dehydration, PE, DVT, pancreatitis, gastric leak
400
Your patient's chest tube was accidentally dislodged. What emergency supplies should be available?
vaseline gauze or xeroform, 4x4 gauze, occlusive dressing, 2 blue chest tube clamps, suture removal kit
400
This is the number of weeks after initial balloon G-button placement during which only the surgeon should replace a button that has come out
8 weeks
400
Your patient has the following orders:
"Clear liquid diet" and "Advance diet as tolerated, target diet: regular diet"
How would you proceed?
After the patient tolerates clear liquids without nausea and/or vomiting, you may change the order to a regular diet and progress the patient as appropriate.
400
Your patient received Exparel (Liposomal Bupivacaine). Name 5 signs/symptoms of local anesthesia systemic toxicity (LAST).
restlessness, anxiety, incoherent speech, lightheadedness, numbness and tingling, metallic taste, tinnitus, dizziness, blurred vision, tremors, twitching, depression, drowsiness, depressed cardiac conductivity and excitability, depressed myocardial contractility and peripheral vasodilation.
500
A gastric sleeve removes ___ % of the stomach. It results in rapid weight loss with an average of ____% reduction in BMI over the first year.
70, 30
500
You receive in report that your patient's chest tube is ordered to have suction to -20mmHg. Upon assessment, this is what you find. What is wrong with this picture?
The bellows is not out to the arrow, so the chest tube is not actually on suction
500
What are two procedures where you should avoid placing a NG tube post-op?
Sleeve Gastrectomy & Pyloromyotomy
500
This simple intervention post-op can provide valuable data for guiding clinical decisions based on hydration status and effectiveness of treatments
Strict I & O
500
What drug class is avoided in bariatric patients to try and prevent post-op nausea/vomiting?
opioids