Nursing Delegation
Perioperative Care

A UAP goes into a patient's room to get vitals. The patient's temperature is slightly elevated. The UAP explains to the patient that they may have an infection due to the elevated temperature. The UAP finishes changing the bed sheets and leaves the room. What is wrong with this scenario?

UAPs are not allowed to assess, interpret, or educate.


What is the definition of cholecystitis?

Bonus: What can cause cholecystitis?

It is the inflammation of the gallbladder.

Bonus: cholelithiasis -When stones obstruct the cystic duct or the common bile duct


Pancreatic cancer can often obstruct the bile duct or the duodenum, leading to symptoms such as jaundice, severe pain, and difficulty eating. Inserting a stent into the bile duct or duodenum relieves the obstruction and alleviate symptoms, thereby improving the patient's quality of life. What type of surgery is this?

Palliative surgery.


What is the definition of cystitis?

Inflammation/Infection of the bladder


What type of medication is used for nausea and vomiting prevention?



What is the definition of "assignment"?

The transfer of responsibility & accountability. 

Bonus: does not require transfer of authority

What is the most common complication of peptic ulcer disease?



Which patients are high risk diagnoses?

Patients with extremes of age, chronic diseases, and obesity.


What is the most common sign for UTI in elderly patients?

altered level of consciousness


What medication mechanism does Ursodiol have?

It breaks up cholesterol stones. This is believed to reduce cholesterol saturation of bile, thereby allowing solubilization of cholesterol-containing gallstones.


A nurse threatens to strap the patient down and force an IV into them if they do not cooperate. The patient continues to refuse the administration of the IV. The nurse then proceeds to hold the patient down and forcefully start an IV line. What is this scenario an example of?

Bonus: what is the difference between assault and battery?

Intentional tort": assault and battery


assault: verbal offensive insults/threats

battery: physical touching that is unwanted, embarrassing, or unwarranted


True or False: Ulcerative colitis is an inflammatory process that affects segmental areas along the entire wall of the GI tract usually depicted with cobblestone granulomas.

False: Cobblestone granulomas are commonly seen in Chron's disease not UC.


It is the responsibility of the surgeon to get the patient's informed consent. What are the responsibilities of the nurse?

The nurse's responsibilities are to be a witness and to check the patient's informed consent on the chart prior to pre-medication.


True or False: These are prevention tactics for UTI:

 Limit length of time of indwelling catheter

 Sterile technique on insertion

 Prevent backflow/reflux from system

 Limit opening drainage system

 Good catheter/perineal care



True or False: All Volatile Liquids exhibit respiratory depression, hypotension, and myocardial depression



Which nursing task could be appropriately delegated to a certified nursing assistant (CNA) caring for an unstable patient with diabetes?

Nothing. The nurse has to see the patient first.

Which complication of peptic ulcer disease is the most lethal? What are the clinical manifestations?

Perforation; Peritoneal signs: rebound tenderness, guarding, abdominal rigidity


Which phase in general anesthesia do the initiation of medications cause unconsciousness?

Induction phase.


What are 5 risk factors for UTI?



Improper cleaning

Incomplete emptying of bladder

**Indwelling catheters


Which medications are used Pre-Op and Intra-Op as part of balanced anesthesia?


Midazolam (Versed) Diazepam (Valium)


What are the six elements of delegation?

-nursing task requires no nursing judgment

-results are reasonably predictable

-can be safely performed w/ no need to alter the standard procedure

-doesn't require complex observations or critical decisions

-doesn't require repeated performance of nursing assessments

-consequences of performing task improperly are minimal & not life-threatening


What is the pathophysiology of bowel necrosis?

—Intestinal contents, fluid, and gas collect proximal to the obstruction causing increased distension and pressure

—Increased pressure obstructs arterial blood flow

—Fluids leak into peritoneal cavity further decreasing the circulating blood volume, which can result in hypovolemic shock and bowel necrosis


What are the clinical manifestations of malignant hyperthermia? 

Bonus: What is a common cause of malignant hyperthermia?

Progressive increase in body temperature with skeletal muscle rigidity.

Bonus: Certain people when exposed to certain anesthetic agents (Succinylcholine)


A client is admitted to the hospital and has a diagnosis of early-stage chronic renal failure. Which of the following would the nurse expect to note on assessment of the client?

  •  A. Polyuria
  •  B. Polydipsia
  •  C. Oliguria
  •  D. Anuria



What medications have these characteristics:

 Minimal post-op effects

 May have post-op nausea

 Produces sedation and hypnosis

 Does not produce analgesia

 Duration of action is less than 5 minutes