Pre-Op Prep
Name three important nursing actions that must be completed before a patient proceeds to the operating room.
Verify informed consent is documented; complete the pre-op checklist and required assessments; confirm patient identity, procedure, and surgical site.
Your patient arrives in the PACU after general anesthesia, drowsy but arousable. What is the nurse’s FIRST assessment?
Assess airway patency and breathing, including respiratory rate, effort, and oxygenation.
Name THREE signs of a postoperative surgical wound infection.
Increasing redness/warmth; purulent drainage; fever (or increasing incisional pain/swelling).
A patient scheduled for surgery says, “I signed the consent, but I do not understand the risks.” What should the nurse do FIRST?
Pause preparations and notify the surgeon/proceduralist to explain the procedure and risks.
Name TWO nursing interventions to prevent postoperative deep vein thrombosis (DVT).
Early mobilization as appropriate; apply prescribed intermittent pneumatic compression devices.
On post-op day 2 after knee replacement, a patient has unilateral calf cramping, warmth, swelling, and a 3-cm size difference. What is the MOST appropriate action?
Stop ambulation, assess the extremity, and notify the provider promptly for suspected DVT.
A patient is scheduled for surgery this morning and reports taking warfarin last night. What is the priority nursing action?
Notify the surgical/anesthesia team and review the prescribed anticoagulation plan and coagulation results.
A patient returns from EGD with moderate sedation and topical throat anesthetic. The patient requests water. What should the nurse do FIRST?
Assess recovery of swallowing and protective airway reflexes before offering oral fluids.
On post-op day 5 after abdominal surgery, the patient coughs and bowel loops protrude through the incision. What is the FIRST action?
Cover the exposed organs with sterile gauze moistened with normal saline.
During the pre-op checklist, the patient reports a severe latex allergy. Name TWO nursing actions.
Notify the surgical/anesthesia team; institute latex-safe precautions and ensure appropriate equipment is available.
Name TWO priority nursing actions for a patient with a postoperative paralytic ileus.
Maintain NPO status as ordered and manage prescribed IV fluids/electrolytes; assess distention, bowel function, and nausea.
On post-op day 2 after total hip replacement, the patient suddenly develops chest pain, dyspnea, RR 32, HR 124, and SpO₂ 87%. What is the FIRST action?
Sit patient up and support airway and oxygenation.
A patient scheduled for surgery has a blood glucose of 54 mg/dL and is NPO. What is the priority nursing response?
Treat hypoglycemia immediately using the facility protocol (e.g., prescribed IV dextrose when unable to take oral glucose); notify anesthesia/provider and recheck glucose.
Six hours after bowel resection, a patient with a urinary catheter has output of 15 mL/hr for three hours. Why is this concerning, and what should the nurse do?
Report persistent low urine output promptly; assess catheter patency, hemodynamics, and fluid status.
After thyroidectomy, a patient develops noisy inspiratory breathing (stridor) and increasing restlessness. What is the PRIORITY action?
Maintain airway/oxygenation, and prepare for immediate airway intervention.