Intraoperative Nursing
During surgery, which role is primarily responsible for maintaining a sterile field and assisting the surgeon with instruments?
What is the scrub nurse?
Rationale: The scrub nurse maintains the sterile field, manages instruments, and assists the surgeon, ensuring that all aspects of the surgical environment remain sterile and organized
A nurse has made an error in a patient's medication dosage. What is the most professional course of action?
A) Cover up the mistake and hope it is not noticed
B) Immediately inform the patient’s physician and document the error
C) Blame the error on a faulty medication system
D) Wait until the end of the shift to report the error
B) What is immediately inform the patient’s physician and document the error?
Rationale: Reporting and documenting medication errors promptly is essential for patient safety and professional integrity. This approach allows for timely intervention and prevention of potential harm.
Before a surgical procedure, obtaining informed consent is primarily the responsibility of:
What is the surgeon?
Rationale: The surgeon is responsible for explaining the procedure, risks, and benefits to the patient and obtaining informed consent, ensuring the patient is fully aware and agrees to the procedure.
A pH of 7.48, PaCO2 of 28 mmHg, and HCO3- of 24 mEq/L indicate this type of acid-base imbalance.
What is respiratory alkalosis?
Respiratory alkalosis is characterized by an elevated pH and low PaCO2, indicating that the patient is hyperventilating. This condition can be caused by anxiety, fever, or other respiratory issues. Treatment focuses on addressing the underlying cause.
Which postoperative assessment finding requires immediate intervention?
A) Serous drainage from the surgical site
B) Mild swelling at the incision site
C) Sudden drop in blood pressure and rapid pulse
D) Slight increase in body temperature
C) What is sudden drop in blood pressure and rapid pulse?
Rationale: A sudden drop in blood pressure and rapid pulse can indicate shock or significant internal bleeding, which requires immediate medical intervention to prevent serious complications.
This condition is characterized by a serum sodium level below 135 mEq/L.
What is hyponatremia?
Hyponatremia occurs when there is an imbalance in sodium levels, often due to excessive fluid intake or loss of sodium. Symptoms may include confusion, headache, and nausea. Monitoring and managing sodium levels are crucial to prevent complications.
Which type of anesthesia involves blocking nerve pathways to provide pain relief in a specific area of the body without affecting consciousness?
A) General anesthesia
B) Local anesthesia
C) Regional anesthesia
D) Conscious sedation
C. What is regional anesthesia?
Rationale: Regional anesthesia blocks pain in a specific area of the body while allowing the patient to remain conscious. It is often used for procedures involving larger body parts.
In the context of nursing professionalism, what does the term "advocacy" refer to?
A) Protecting the nurse’s own rights in the workplace
B) Supporting patients’ rights and interests within the healthcare system
C) Promoting the nurse’s personal views and preferences
D) Ensuring the nurse's schedule and preferences are met
B) What is supporting patients’ rights and interests within the healthcare system?
Rationale: Advocacy involves representing and protecting patients’ rights and interests, ensuring they receive appropriate care and support within the healthcare system.
Which of the following preoperative assessments is critical for determining the patient’s risk of complications during surgery?
A) Patient’s socioeconomic status
B) History of allergic reactions and current medications
C) The patient's family history of chronic diseases
D) The patient’s level of physical activity
B) What is history of allergic reactions and current medications?
Rationale: Knowing the patient's allergies and current medications is crucial for preventing allergic reactions and interactions during surgery, ensuring safe anesthetic and medication management.
The ABG value that indicates the amount of carbon dioxide dissolved in the blood is known as this.
What is PaCO2?
Rationale: PaCO2 reflects the respiratory component of acid-base balance. Elevated levels suggest hypoventilation and respiratory acidosis, while low levels indicate hyperventilation and respiratory alkalosis.
This classification of medication is commonly administered postoperatively to manage pain and ensure patient comfort.
What are analgesics?
Rationale: Analgesics, including opioids and non-opioid pain relievers, are used to manage postoperative pain, helping patients recover more comfortably and facilitating early mobilization.
Elevated levels of this electrolyte can cause cardiac arrhythmias and muscle weakness.
What is potassium?
Hyperkalemia, or elevated potassium levels, can disrupt cardiac function and lead to arrhythmias. Monitoring potassium levels and administering treatments like diuretics or potassium binders are essential for patient safety.
The primary purpose of the "surgical timeout" procedure is to:
What is verify the patient’s identity and correct surgical site?
If a nurse discovers that a colleague is not following proper hand hygiene practices, the best course of action is to:
A) Ignore the issue if it does not seem to affect patient outcomes
B) Inform the colleague about the importance of hand hygiene privately
C) Report the issue immediately to the infection control department
D) Discuss the issue openly with the entire team during a meeting
B) What is inform the colleague about the importance of hand hygiene privately?
Rationale: Addressing hand hygiene issues through private, respectful communication promotes a culture of safety and professionalism while avoiding public shaming and fostering a supportive work environment.
This preoperative intervention involves ensuring that the patient has not eaten or drunk anything for a specified period before surgery to reduce the risk of aspiration.
What is fasting and NPO (nil per os) orders?
Rationale: Fasting and NPO orders are essential to minimize the risk of aspiration during surgery by ensuring that the stomach is empty, which is crucial for patient safety, especially when under anesthesia.
This compensatory mechanism is observed in response to metabolic acidosis and involves an increase in respiratory rate.
What is hyperventilation?
Rationale: Hyperventilation helps to expel excess CO2 from the blood, thus compensating for the low pH seen in metabolic acidosis. It helps normalize blood pH by reducing CO2 levels.
This common postoperative complication is characterized by the accumulation of fluid in the lungs, leading to difficulty breathing.
What is atelectasis?
Rationale: Atelectasis occurs when alveoli in the lungs collapse or fill with fluid, often due to shallow breathing post-surgery. Incentive spirometry and deep breathing exercises are used to prevent and treat this condition.
The primary treatment for severe hypomagnesemia often involves this type of medication.
What is magnesium sulfate?
Magnesium sulfate is commonly used to correct severe hypomagnesemia, which can lead to neuromuscular and cardiovascular problems. Administering magnesium sulfate helps restore normal magnesium levels and stabilize the patient.
Which of the following is an essential practice for maintaining aseptic technique during surgery?
A) Wearing sterile gloves and gown
B) Using non-sterile instruments to handle sterile supplies
C) Talking freely with the surgical team without a mask
D) Touching non-sterile areas before touching sterile instruments
A) What is wearing sterile gloves and gown?
Rationale: Maintaining aseptic technique involves wearing sterile gloves and gowns to prevent contamination of the sterile field and reduce the risk of infection.
This ethical principle involves being honest and truthful with patients and colleagues.
What is veracity?
Veracity requires nurses to be truthful and transparent, ensuring that patients are fully informed and able to make decisions based on accurate information.
This document is required for the patient to legally agree to undergo a surgical procedure after being informed of the risks and benefits.
What is the informed consent form?
Rationale: The informed consent form ensures that the patient understands the procedure, its risks, and benefits, and provides legal authorization for the surgery.
This ABG component measures the partial pressure of oxygen in the blood and is crucial for assessing oxygenation status.
What is PaO2?
Rationale: PaO2 measures the amount of oxygen dissolved in the blood. Low levels indicate poor oxygenation, which can be due to respiratory or cardiovascular issues. It is essential for determining the need for supplemental oxygen.
This intervention helps prevent postoperative deep vein thrombosis (DVT) by promoting circulation and reducing blood stasis in the legs.
What are sequential compression devices (SCDs)?
Rationale: Sequential compression devices (SCDs) apply intermittent pressure to the legs to enhance venous return and reduce the risk of DVT, a common complication following surgery.
This electrolyte imbalance is commonly seen in patients with kidney failure and is characterized by high serum calcium levels.
What is hypercalcemia?
Hypercalcemia is often caused by hyperparathyroidism or malignancy. It can lead to symptoms such as confusion, bone pain, and kidney stones. Treatment may include hydration, diuretics, and medications to lower calcium levels.
This intraoperative role includes coordinating the surgical team, ensuring all equipment is functioning, and managing communication between the operating room and other departments.
What is the circulating nurse?
Rationale: The circulating nurse oversees the operating room environment, ensures sterile technique is maintained, and facilitates communication among team members, helping to manage the flow and safety of the procedure.
The practice of continuously updating knowledge and skills in nursing through various educational opportunities is known as this.
What is continuing education?
Rationale: Continuing education is essential for maintaining competency and staying current with advances in nursing practice. It ensures that nurses provide safe and effective care.
This preoperative intervention helps to enhance lung function and reduce the risk of postoperative complications by encouraging deep breathing and coughing.
What is incentive spirometry?
Rationale: Incentive spirometry promotes lung expansion and helps prevent postoperative complications such as atelectasis and pneumonia by encouraging the patient to take deep breaths.
The combination of a low pH, elevated PaCO2, and normal bicarbonate levels suggests this type of acid-base imbalance.
What is respiratory acidosis?
Rationale: Respiratory acidosis occurs when CO2 is retained due to hypoventilation, leading to a low pH. It is important to address the underlying cause, such as impaired lung function or obstructive diseases.
This term describes the sudden onset of severe chest pain, shortness of breath, and hypotension, which may indicate a serious complication such as pulmonary embolism.
What is a pulmonary embolism?
A pulmonary embolism is a blockage in the pulmonary artery usually caused by blood clots. It is a serious postoperative complication that requires immediate medical intervention to prevent severe outcomes.
This condition involves an excess of fluid in the interstitial spaces, often resulting from heart failure or renal issues.
What is edema?
Edema is the accumulation of fluid in the interstitial spaces and can be caused by various conditions, including heart failure and kidney disease. Managing fluid intake and using diuretics can help reduce edema and improve patient comfort.