Scalpels & Safety
What are two fundamental principles of maintaining surgical asepsis?
Only sterile surfaces may touch sterile surfaces.
Edges of packages are contaminated
Gowns are sterile only from chest to waist and 2 inches above elbows.
Identify two diagnostic tests for brain and CNS tumors?
•CT
•MRI
•PET
•Biopsy
•Lumbar puncture
Identify two meds used to manage SLE (lupus)?
NSAIDs, corticosteroids, antimalarial
A client in shock has a blood pressure of 78/40 mm Hg and is anxious, with difficulty breathing and wheezing. What physiological response is occurring?
Increased vascular permeability. Histamine release causes vasodilation and permeability, leading to hypotension and fluid shift.
What is the priority nursing action for a patient presenting with snoring and cyanosis?
Perform the Head tilt–chin lift to restore airway patency.
Identify two physiological impacts of cancer on overall health for individuals who experience cancer.
Pain
Infections
Gastrointestinal changes
Anemia
Lymphedema
Peripheral neuropathy
Fertility
What is the difference between natural and acquired immunity?
Natural: Nonspecific response to any foreign invader
Acquired: Specific against foreign antigens. Result of prior exposure to an antigen
This is the first-line medication for treating anaphylactic shock due to its ability to reverse airway constriction and hypotension.
Epinephrine rapidly reverses life-threatening symptoms by stimulating alpha and beta receptors.
Identify three priority assessments during the postoperative phase.
Airway and Breathing
Anesthesia can depress respiratory drive and compromise airway patency. Monitoring for airway obstruction (e.g., due to the tongue falling back), respiratory rate, and oxygen saturation ensures adequate ventilation and prevents hypoxia.
Circulation
Postoperative patients are at risk for hemorrhage, hypovolemia, and shock. Monitoring blood pressure, heart rate, skin color, and capillary refill helps detect early signs of circulatory compromise and ensures tissue perfusion.
Neurological Status
Assessing level of consciousness and orientation helps determine the patient’s recovery from anesthesia and detect potential complications such as stroke, delayed emergence, or over-sedation.
Urinary Output
Urinary retention is a common postoperative issue due to anesthesia, immobility, or pain. Monitoring for spontaneous voiding and measuring urine output helps assess renal perfusion, fluid balance, and detect complications like retention or acute kidney injury.
Differentiate the diagnostic indications for ERCP and MRCP in evaluating the bile and pancreatic ducts.
ERCP (Endoscopic Retrograde Cholangiopancreatography):
A diagnostic and therapeutic procedure that uses endoscopy and fluoroscopy to visualize the bile and pancreatic ducts. It allows for biopsy, stone removal, and stent placement, making it useful in pancreatic cancer, biliary obstruction, and chronic pancreatitis.
MRCP (Magnetic Resonance Cholangiopancreatography):
A non-invasive imaging technique using MRI to visualize the biliary and pancreatic ducts. It is primarily used for diagnosis, not treatment, and is preferred when intervention is not immediately required.
This immunosuppressive medication is used to treat autoimmune conditions such as rheumatoid arthritis and systemic lupus erythematosus.
Methotrexate suppresses the immune response by inhibiting folate-dependent cell replication
What finding requires immediate intervention in a client with suspected septic shock?
A. WBC count of 15,000/mm³
B. Serum lactate level of 5.0 mmol/L
C. Platelet count of 180,000/mm³
D. Hemoglobin level of 6.8 g/dL
Serum lactate level of 5.0 mmol/L
Elevated lactate indicates tissue hypoperfusion and is a key marker of septic shock severity.
This lab relates to clotting and indicates a bleeding risk in all perioperative phases.
PTT and INR
This type of skin cancer is often asymmetrical, irregularly shaped, and may ulcerate or bleed
Asymmetry, irregular borders, varied pigmentation, and potential ulceration or bleeding characterize melanoma.
This lab value is preferred over the neutrophil percentage when assessing a patient’s immune function, especially during chemotherapy, because it reflects the actual number of infection-fighting cells in circulation.
Absolute Neutrophil Count (ANC) is used because it quantifies neutrophils and bands to assess infection risk
Convert 0.35 grams to mg.
350 mg
In a client with an advanced airway in place during CPR, what is the correct compression-to-ventilation ratio?
Continuous compressions with 1 breath every 6 seconds. With an advanced airway, compressions should be uninterrupted while ventilations are delivered every 6 seconds.
This type of cancer presents as red, elevated lesions that heal slowly.
Basal and squamous cell carcinomas typically appear as red, elevated lesions and are more localized with slower progression.
This type of shock occurs when blood volume is significantly reduced, leading to decreased perfusion and oxygenation. It often presents with tachycardia, hypotension, and warm, flushed skin in early stages. What is it?
Hypovolemic Shock: Early signs include compensatory mechanisms like increased heart rate and vasodilation to maintain perfusion.
Infuse 500 mL of NS over 4 hours using tubing with a drop factor of 15 gtts/mL. How many gtts/min? Round to whole number.
31 gtts/min