Hyperthyroid
The most common cause of hyperthyroidism, this is commonly associated with thyroid storm.
What is Grave's disease?
Thyroid stimulating hormone (TSH) is secreted by this gland.
What is the ANTERIOR pituitary?
VTE stand for what?
Venous Thromboembolism
The nurse is caring for a 78-year-old client who has had an outpatient cholecystectomy. The nurse is getting the client up for the first walk postoperatively. To decrease the potential for orthostatic hypotension and consequent falls, what should the nurse have the client do?
A. Sit in a chair for 10 minutes prior to ambulating.
B. Drink plenty of fluids to increase circulating blood volume.
C. Stand upright for 2 to 3 minutes prior to ambulating.
D. Perform range-of-motion exercises for each joint.
ANS: C
Rationale: Older adults are at an increased risk for orthostatic hypotension secondary to age-related changes in vascular tone. The client should sit up and then stand for 2 to 3 minutes before ambulating to alleviate orthostatic hypotension. The nurse should assess the client's ability to mobilize safely, but full assessment of range of motion in all joints is not normally necessary. Sitting in a chair and increasing fluid intake are insufficient to prevent orthostatic hypotension and consequent falls.
The number of hours to wait for a patient to void post-op?
EIGHT hours
Most common cause in thyroid storm.
What is untreated hyperthyroidism?
What are the labs for hyperthyroidism?
What is decreased TSH, increased T3, and increased T4
Endothelial Damage, Venous Statis, and Altered Coagulation are the three parts of what triad?
Virchow
The nurse is caring for a client on the medical–surgical unit postoperative day 5. During each client assessment, the nurse evaluates the client for infection. Which of the following would be most indicative of infection?
A. Presence of an indwelling urinary catheter
B. Oral temperature of 99.5°F (37.5°C)
C. Red, warm, tender incision
D. White blood cell (WBC) count of 8,000/mL
ANS: C
Rationale: Redness, warmth, and tenderness in the incision area should lead the nurse to suspect a postoperative infection. The presence of any invasive device predisposes a client to infection, but by itself does not indicate infection. An oral temperature of 99.5°F may not signal infection in a postoperative client because of the inflammatory process. A normal WBC count ranges from 4,000 to 10,000/mL.
A serious surgical complication where a there is a disruption of the surgical incision/wound.
What is wound dehiscence?
Name three main symptoms of hyperthyroidism.
What is high blood pressure, weight loss, heart palpitations. -- but i'll except others.
The main function of the thyroid is to control ________ ____________ activity.
What is Cellular Metabolic
Name three ways to prevent post-op DVT
Ambulation, hydration, no dangling, SCD's or compression hose.
The nurse is caring for a client who is postoperative day 2 following a colon resection. While turning the client, wound dehiscence with evisceration occurs. What should be the nurse's first response?
A. Return the client to the previous position and call the health care provider.
B. Place saline-soaked sterile dressings on the wound.
C. Assess the client's blood pressure and pulse.
D. Pull the dehiscence closed using gloved hands.
ANS: B
Rationale: The nurse should first place saline-soaked sterile dressings on the open wound to prevent tissue drying and possible infection. Then the nurse should call the health care provider and take the client's vital signs. The dehiscence needs to be surgically closed, so the nurse should never try to close it.
Use of this tool in the post-operative period can help prevent atelectesis.
What is Incintive Spirometer?
Some may call it hyperthyroidism, but this other "official bolded-in-the-textbook name seems to be more appropriate.
What is thyrotoxicosis?
Characterized by a swelling in the neck area associated with hyperthyroidism
What is Goiter
This test is performed to diagnose DVT
What is an ultrasound?
The nurse is admitting a 32-year-old woman to the presurgical unit. The nurse learns during the admission assessment that the client takes oral contraceptives. The nurse's postoperative plan of care should include what intervention?
A. Early ambulation and leg exercises
B. Cessation of the oral contraceptives until 3 weeks’ postoperative
C. Doppler ultrasound of peripheral circulation twice daily
D. Dependent positioning of the client's extremities when at rest
ANS: A
Rationale: Oral contraceptive use increases blood coagulability; with bed rest, the client may be at increased risk of developing deep vein thrombosis. Leg exercises and early ambulation are among the interventions that address this risk. Assessment of peripheral circulation is important, but Doppler ultrasound may not be necessary to obtain these data. Dependent positioning increases the risk of venous thromboembolism (VTE). Contraceptives are not normally discontinued to address the risk of VTE in the short term.
Name TWO reasons the geriatric population is more at risk for post operative complications
What is
recover more slowly
longer hospital stays
higher risk for post op delirium
more comorbidities
What was the name of our patient from lecture who went through a fierce "storm"? Were you paying attention?
Kenny
This is the the often forgotton THIRD hormone secreted by the thyroid.
What is calcitonin?
Pregnancy is included as a risk factor due to what "third" of Virchow Triad?
Altered Coagulation
A physician is explaining to a group of medical students the concept of Virchow's triad as it applies to venous thrombosis. Which clinical observation of a 50-year-old male client is most likely unrelated to a component of Virchow's triad?
A. The man has decreased cardiac output and an ejection fraction of 30%.
B. The man's prothrombin time and international normalized ratio (INR) are both low.
C. The man has a previous history of a dissecting aneurysm.
D. There is bilateral, brown pigmentation of his lower legs.
Answer: A
Rationale: Cardiac output is not a component of Virchow's triad. However, decreased INR and prothrombin time indicate hypercoagulability; a dissecting aneurysm is an example of vessel wall injury; and pigmentation in the lower legs indicates stasis of blood.
This is the type of bowel obstruction found in the post-operative period?
Functional or paralytic