Pre-Op Nursing Care
Post-Op Nursing Care
Complications
Age-Related & Diabetes
Pain
100
You assess your patient's age to be 85 years old, does not look well nourished and has several co-morbities and is going for urgent bowel surgery this afternoon.
What are the risk factors when going undergoing surgery? P&P page 1330 Daily Double: Name two more risk factors of individuals you need to plan for pre and post operative care?
100
You assess that your patient immediately post-operatively has a weak pharyngeal muscle tone from the anaesthetics.
What is airway obstruction? PP 1360 What are the other risk factors for atelectasis, pneumonia complications?
100
The OR staff have a pause just before the incision and verbally confirm: patient identity, site, side, level of surgery, procedure to be performed, positioning of patient and clarify any further questions.
What is the Safe Surgery Checklist? Which national organization developed and promoted the implementation
100
Your clinical judgment is based on the following assessment: the skin elasticity is decreased and there is a loss of collagen in your older adult.
What is the nursing diagnosis: risk for injury from tape, electrodes, warming and cooling blankets, .... page PP 453
100
A state of severe distress associated with events that threaten the integrity of the person.
What is suffering?
200
You assess that a Middle aged gentleman has reduced respiratory capacity and decreased cardiac function.
What is obesity? Daily Double: What is the name of a partial collapse of the alveoli?
200
You closely assess and record the fluids from IV line, oral intake, drainage from foley catheter and wound drainage on the fluid balance sheet.
What is the functioning of the renal and circulatory function. PP 1360 Why would a patient exhibit signs of fluid retention - pedal edema or abnormal breath sounds within the first 48 hours after surgery?
200
Your knowledge as a nurse recognizes that this medication is excellent for anxiety BUT it is not for patients with hepatic or renal disease or pediatric and geriatric patients.
What is Lorazepam (Ativan)? What is the half-life of Lorazepam?
200
You assess a decrease ability to cough and decrease ability to move the chest walls.
What are the respiratory assessments needed for the older adult?
200
A dose of one analgesic whose pain-relieving effect is equivalent to that of another analgesic.
What is equianalgesic?
300
You assess that your patient pre-operatively will have a poor tolerance of anaethesia, has a negaive nitrogen balance, and a prolonged blood clotting factor.
What are the factors to poor nutrition? P & P page 1330. Daily Double: What other factors are included with poor nutrition?
300
Your patient has had regional spinal anaesthesia. You assess segmental skin areas innervated by specific spinal nerves from the spinal column.
What are dermatomes. PP 1361 DD: What does your assessment include?
300
You recognize this patient risk factor for prodecural sedation, so you do not use long-lasting opioids and you administer small incremental doses of sedatives.
What is chronic renal failure?
300
You assess that the patient's blood glucose falls from 16 mmol/L to 8 mmol/L within 3 hours, skin is cool and clammy, patient is irritable.
What is hypoglycemia? How could this happen when a patient is receiving insulin by IV?
300
A phenonmenon in which increasing dosage of a given medication produces progressively smaller effects.
What is a ceiling effect?
400
You are preparing a woman who is 70 years old for a hysterectomy today. You review her fluid balance record and note that she has voided small amounts of urine every hour or so for the last 24 hours.
What is reduced bladder capacity? pp 1331, P&P What lab values assess kidney function?
400
Your patient has had a resection of his bowels. You assess and confirm by xray nasogastric tube is in the right place. You assess his abdomen is distended and ask your patient if he has passed gas and he says no.
What is paralytic ileus?
400
Your patient after surgery is very restless, thrashing around, agitated and disorientated.
What is emergence delirium? What is the first risk factor a nurse needs to rule out with an emergence delirium?
400
As a nurse you know that a reduction in beta-cell function, decreased insulin sensitivity and altered carbohydrate metabolism affects people as they age.
What is the prevalence of diabetes melitius with age? DD: What are two disadvantages of a clinical pathway?
400
Pain caused by damage to somatic or visceral tissue
What is nocieptive pain?
500
You have explained to your patient how you are going to assist them to manage their post operative pain, how to cough to prevent pneumonia, how to mobilize after surgery and how hopeful you are their surgery will go well (promoting hope).
What are the patient expectations that are influenced by the nurse? PP 1336 What is the test that measures cardiac rhythm?
500
Your post-operative care includes getting the patient to mobilize early and regularly, checking effectiveness of sequential stockings and promotion of leg exercises every hour while awake (think system).
What nursing actions that prevent circulatory system complications? DD: What are two advantages of clinical pathways?
500
As surgery nurse, you know that a urinary infection or a respiratory infection may manifest post-operatively.... (how & when)
What are possible causes of an elevated temperature on the third day or later of the post operative day? DD: What are the other possible reasons for an elevated temperature after 3 days post op?
500
You read in your patient chart that she has microvascular damage to the small blood vessels of the kidneys and has been a diabetic for 30 years.
What is diabetic nephropathy? Lewis pp 1463 What are risk factors increase diabetic nephropathy?
500
An expected physiological response to ongoing exposure to pharmacological agents.
What is physical dependence? DD: What is a clinical pathway?
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