TEST 1

Question 1

DEFINITION: art and science of treating diseases, injuries, and deformities by operation and instrumentation

Answer 1

SURGERY

Question 2

4 CATEGORIES OF Perioperative Nursing

Answer 2

1. preoperative care
2. intraoperative care
3. post-anesthetic care
4. post-operative care

Question 3

5 PARTS OF Preoperative Care

Answer 3

1) Client interview
2) Nursing assessment
3) Pre-op teaching
4) Legal preparation
5) Pre-op checklist

Question 4

THIS PART OF THE PREOPERATIVE NURSING ASSESSMENT INCLUDES:

• Previous experiences with Sx (surgery) and anesthesia
• Allergies, meds, age, nutrition
• Past medical history

Answer 4

Nursing history

Question 5

THIS PART OF THE PREOPERATIVE NURSING ASSESSMENT INCLUDES:

• Assessment of mobility (side weaknesses)
• Systems
• Head to Toe
• Lab work/test results

Answer 5

Physical examination

Question 6

LIST 7 PREOPERATIVE RISK FACTORS

Answer 6

1. Meds
2. Physical/mental impairments
3. Mobility limitations (side weaknesses)
4. Smoking, ETOH (ethanol/alcohol) use, street drugs (risk of withdrawal symptoms)
5. Occupation
6. Poor nutritional status (obesity-related healing complications such as dehiscence)
7. Infection, nausea, fever

Question 7

PRE-OP TEACHING: NUTRITION

3 items

Answer 7

1. NPO (Most surgeries require NPO after midnight)
2. POST-OP DIET (Increase diet slowly)
3. POST-OP NAUSEA (common—there are medications to help with this)

Question 8

PRE-OP TEACHING: AMBULATION

4 items

Answer 8

1. AMBULATE EARLY (important to prevent clots)
2. IMMOBILIZERS (May have immbolizers, have to use assistive devices)
3. LEG EXERCISES
4. TED SOCKS

Question 9

PRE-OP TEACHING: BREATHING

3 items

Answer 9

1. Perform deep breathing and coughing exercises
2. Splinting
3. Incentive spirometer
4. IMPORTANT TO PREVENT COLLAPSED LUNG & PNEUMONIA

Question 10

PRE-OP TEACHING: GROOMING

5 ITEMS

Answer 10

1. Take a bath or shower morning of surgery
2. Remove nail polish, artificial fingernails, hair clips, and jewellery before surgery
3. Dentures and eyeglasses will be removed and stored during surgery
4. Remove prosthetics
5. No contact lenses permitted

Question 11

PRE-OP TEACHING: MEDICATION

2 ITEMS

Answer 11

1. Take preoperative medication as ordered
2. Stop taking prescribed medications, OTC medications, and herbal remedies as suggested by the physician, anaesthesiologist, or surgeon

Question 12

PRE-OP TEACHING: PAIN CONTROL

2 ITEMS

Answer 12

1. Ask for pain medication as needed

2. Types of pain control (epidural, PCA)

Question 13

9 IMPORTANT THINGS ON AN INFORMED CONSENT

Answer 13

1. Name of procedure/surgery
2. Description of procedure/surgery
3. Person performing the procedure/surgery
4. Benefits of procedure/surgery
5. Potential risks and adverse effects of procedure/surgery
6. Approximate length of time for procedure/surgery
7. Approximate length of time needed for recovery
8. Alternative treatments
9. Consequences of refusing treatment

Question 14

INFORMED CONSENT - LEGAL OR ETHICAL NURSING ROLE?

act as a witness to verify that the person who signed the consent is the client so named or the client’s legal guardian

Answer 14

LEGAL

Question 15

INFORMED CONSENT - LEGAL OR ETHICAL NURSING ROLE?

act as the client’s advocate, ensures that the client understands the information and that the form has been signed and witnessed before the client receives preoperative medication

Answer 15

ETHICAL

Question 16

Post-operative Care (after surgery) begins ________________ after surgery and continues until the client is discharged

Answer 16

immediately

Question 17

PACU

Answer 17

post anesthesia care unit

Question 18

RR

Answer 18

recovery room

Question 19

patient stays in PACU until ________________

Answer 19

stable

Question 20

From PACU – client can be discharged to ______, _____________ _________, or ___________________ _________ _________.

Answer 20

ICU
IN-PATIENT UNIT
AMBULATORY CARE UNIT

Question 21

7 CRITERIA FOR PACU discharge:

Answer 21

1. Client awake (or baseline)
2. Vital signs stable
3. No excess bleeding or drainage
4. No respiratory depression
5. Oxygen saturation > above 90%
6. Pain controlled
7. Report given to receiving recipient (nurse from other units)

Question 22

FIRST STEP IN POST-OPERATIVE CARE

Answer 22

Get report (how much blood was lost, fluids received, pain meds, etc.)

Question 23

5th vital sign?

Answer 23

pain

Question 24

5 post-op exercises

Answer 24

1. deep breathing
2. controlled coughing
3. incentive spirometer
4. leg rom
5. repositioning

Question 25

8 Ambulatory surgery discharge criteria

Answer 25

1. All PACU discharge criteria met 2. No IV narcotics for last 30 minutes 3. Minimal nausea and vomiting 4. Pain controlled 5. Voided (if appropriate to surgical procedure/orders) 6. Able to ambulate if age-appropriate and not contraindicated 7. Responsible adult present to accompany client (not to drive home - sedatives can be in the body for up to 24 hours post-op) 8. Discharge instructions given and understood

Question 26

WHICH POST-OP EXERCISE? | prevents respiratory complications (collapsed lung/atelectasis & pneumonia)

Answer 26

DB&C

Question 27

WHICH POST-OP EXERCISE? | option for deep breathing, provides measurable visual feedback

Answer 27

INCENTIVE SPIROMETER

Question 28

WHICH POST-OP EXERCISE? removes secretions from lungs

Answer 28

CONTROLLED COUGHING

Question 29

IMPORTANT CONSIDERATION FOR CONTROLLED COUGHING?

Answer 29

SPLINT ABDOMINAL INCISIONS

Question 30

WHICH POST-OP EXERCISE? important for patient comfort and reduce risks related to immobility

Answer 30

REPOSITIONING/TURNING

Question 31

WHICH POST-OP EXERCISE? reduce risk of clots

Answer 31

LEG EXERCISES