Chapter 42: Surgical Patient Care Quiz

Questions and Answers

Which factors are affected by a patient's age and health?

Age, health, nutritional status, mental state (correct)

Financial income, occupation, age, health (correct)

Occupation, age, nutritional status, health (correct)

Occupation, health, mental state, financial income

Which information should a postoperative patient receive before discharge? (Select all that apply)

Signs and symptoms to report to the physician (correct)

Report bowel movements to the physician

Care of the wound site and any dressings (correct)

Call the physician's office once he arrives home

When he may operate a motor vehicle (correct)

Actions and side effects of any medications (correct)

What are two considerations for the older adult surgical patient? (Select the two that apply)

Lower morbidity and mortality

Quick assessment skills

Pre- and postoperative teaching (correct)

Surgery causes much physiological stress (correct)

Which interventions can the Assistive Personnel (AP) perform in preparing a patient for abdominal surgery? (Select all that apply)

Height and weight Signup and view all the answers

What type of therapy is aimed at alleviating uncomfortable symptoms without curing the problem?

Palliative Signup and view all the answers

Discharge planning for a surgical procedure begins in the and continues through the .

preoperative, recuperative Signup and view all the answers

Place the interventions in the correct order for immediate assessment once the patient enters the PACU:

D = Airway B = Breathing E = Level of consciousness C = Circulation A = System review Signup and view all the answers

The inappropriate intervention related to caring for a patient with a PCA is:

Administering the analgesia to the patient Signup and view all the answers

Removal of a right leg in a 73-year-old patient with diabetes is an example of which type of surgery?

Ablative Signup and view all the answers

What is the legal term for the permission that a patient must give for any specific test or procedure?

Informed consent Signup and view all the answers

Which circumstance could prevent a patient from signing his informed consent?

An injection of Demerol, 75 mg IM, 1 hour ago Signup and view all the answers

The anesthesiologist provides anesthesia by inhalation and IV administration routes. This is called:

General Signup and view all the answers

A type of anesthesia that requires a depressed level of consciousness is:

Conscious sedation Signup and view all the answers

The older adult patient may not respond to surgical treatment as well as a younger adult because of:

His or her body's response to physiological changes Signup and view all the answers

Which postoperative nursing interventions would be contraindicated for a patient presenting signs of increased intracranial pressure (ICP)?

Coughing every 2 hours Signup and view all the answers

Anxiety, hypotension, and jarring during transfer can cause a postoperative increase in which vital sign?

Pulse rate Signup and view all the answers

On postoperative day 4, the surgical wound dehisced. This means that:

There is partial or complete wound separation Signup and view all the answers

The most effective way to increase her peristalsis on postoperative day 2 is:

Ambulation Signup and view all the answers

Which is the first assessment to make when a patient is transferred from the operating room to the recovery room after surgery?

Check airway for patency Signup and view all the answers

One of the first signs and symptoms of hemorrhage may be:

Restlessness Signup and view all the answers

Frequent monitoring of the postoperative patient's vital signs assesses which body system?

Cardiovascular Signup and view all the answers

Decreased activity in an obese surgical patient predisposes the patient to which complication?

Hypoventilation Signup and view all the answers

The nurse acknowledges that all preoperative nursing interventions have been performed by signing which document?

Preoperative checklist Signup and view all the answers

Which nursing interventions would be appropriate after a wound evisceration?

Apply a warm, moist normal saline sterile dressing Signup and view all the answers

When should the nurse offer prescribed analgesics to a patient who is 24 hours postoperative?

Regularly every three to four hours before pain gets severe Signup and view all the answers

What nursing interventions will minimize the effects of venous stasis?

Early ambulation Signup and view all the answers

Serum potassium levels are usually determined before surgery to:

Prevent dysrhythmias related to anesthesia Signup and view all the answers

The nurse is assisting with the sponge and instrument count in the operating room. The operative phase in which the nurse is assisting is called the:

Intraoperative phase Signup and view all the answers

Which early postoperative observation is abnormal and should be reported immediately?

Emesis that is red Signup and view all the answers

Sudden chest pain combined with dyspnea, cyanosis, and tachycardia is an indication of:

Pulmonary embolus Signup and view all the answers

An appendectomy during a hysterectomy would be classified as:

Minor, elective, ablative Signup and view all the answers

Which patients would be at greatest risk during surgery?

27-year-old taking an anticoagulant agent Signup and view all the answers

A patient will have an incision in the lower left abdomen. Which intervention by the nurse will help decrease discomfort in the incisional area when she coughs postoperatively?

Apply a splint directly over the lower abdomen Signup and view all the answers

Although informed about the proposed surgical procedure, the patient has only vague responses about the postoperative period. A nursing diagnosis at this time would be:

Deficient knowledge, postoperative Signup and view all the answers

In preparing for the return of the surgical patient, the patient's bed should be in what position?

Highest position with the side rails down on receiving side and up on opposite side Signup and view all the answers

Southeast Asian and Native American patients often do not make eye contact during preoperative teaching because:

They believe eye contact is disrespectful Signup and view all the answers

What are the high-risk conditions that may affect perioperative procedures? (Select all that apply):

Age, health, occupation, mental status Signup and view all the answers

Study Notes

Postoperative Care Overview

Patient-controlled analgesia (PCA) allows patients to self-administer pain relief; nurses should not administer doses.
A below-the-knee amputation is classified as an ablative surgery, involving removal of body parts.

Informed consent is necessary for procedures; it confirms that the patient understands the procedure.
Patients under sedation should not be asked to sign consent due to disorientation.

Anesthesia and Its Types

General anesthesia is provided via IV and inhalation, influencing patient awareness during surgery.
Conscious sedation results in a depressed level of consciousness, suitable for minor procedures.

Response to Surgical Treatment

Older adults exhibit varied responses to surgery due to physiological changes, affecting recovery.
Postoperative complications can include increased intracranial pressure, which should be monitored closely.

Vital Signs and Complications

Frequent vital sign monitoring is essential to detect cardiovascular complications.
Early signs of hemorrhage include restlessness and increased pulse rate, indicating potential hypovolemic shock.

Postoperative Interventions

Early ambulation post-surgery facilitates recovery and reduces complications like venous stasis.
Wound evisceration requires immediate sterile dressing application and patient positioning to prevent further injury.

Education and Preoperative Considerations

Preoperative teaching should occur a day or two before surgery to ease anxiety and enhance understanding.
Special cultural considerations may affect communication and preoperative teaching.

High-Risk Patients

Patients on anticoagulants face increased surgery risks due to potential bleeding; these medications should be paused before surgery.
Risk factors for surgical complications include age, mental state, and nutritional status.

Discharge Instructions

Essential discharge information includes wound care, signs to report, and medication side effects.
Compliance with discharge instructions is critical for a successful recovery.

Role of Nursing Staff

Nurses are responsible for ensuring informed consent is properly obtained and documented.
Assistive Personnel can conduct basic assessments like vital signs and height/weight but cannot perform invasive procedures.

Cultural Sensitivity in Care

Awareness of cultural differences regarding eye contact and communication styles can improve patient-nurse interactions.

Postoperative Assessment Techniques

Bowel sounds assessment requires auscultation for one minute to determine the functionality of the digestive system post-surgery.
Changes in bowel movements and pain levels should be monitored and reported as necessary.### Palliative Therapy
Designed to alleviate or decrease uncomfortable symptoms.
Focuses on symptom relief rather than curing the underlying issue.
Important in providing comfort for patients with serious or terminal illnesses.

Discharge Planning

Initiated in the preoperative period before surgery.
Continues throughout the recuperative period post-surgery.
Ensures a smooth transition for patients from hospital to home or next care facility.

Post-Anesthesia Care Unit (PACU) Assessment

Immediate assessment protocol after surgery involves a specific sequence of checks for a patient's safe recovery.
Assessments should be conducted in the following order:
- Airway (D)
- Breathing (B)
- Level of consciousness (E)
- Circulation (C)
- System review (A)
Follows a systematic approach to monitor vital functions and overall patient status after anesthesia.

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Test your knowledge on the care of surgical patients with this quiz focused on postoperative care and analgesia management. Review the critical concepts surrounding patient-controlled analgesia (PCA) and identify inappropriate interventions. Ideal for nursing students or healthcare professionals!