Medical Surgical Nursing Concepts
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Questions and Answers

What is the first step in managing a chemical burn?

  • Transport victim to a hospital
  • Cover the burn with a dry sterile cover
  • Irrigate the wound with water (correct)
  • Assess for inhalation injury

Which of the following injuries requires hospital care regardless of burn degree?

  • Electrical burns (correct)
  • Superficial burns
  • Burns greater than 10% of body surface area
  • Second-degree burns under 5% surface area

What is a critical assessment after an electrical burn?

  • Establish airway and give oxygen
  • Assess for chemical exposure
  • Check the victim's peripheral pulse (correct)
  • Cover the victim with warm sheets

What is the primary purpose of muscle spasms that accompany fractures?

<p>To minimize further movement of the fracture fragments (A)</p> Signup and view all the answers

Which diagnostic test is NOT commonly performed for systemic reactions in burn patients?

<p>Magnetic resonance imaging (C)</p> Signup and view all the answers

Which condition describes the abnormal movement seen in fractures?

<p>False motion (C)</p> Signup and view all the answers

What causes the deformity associated with a fracture?

<p>Displacement, angulation, or rotation of bone fragments (D)</p> Signup and view all the answers

What should be done to prevent heat loss in a burn victim?

<p>Cover the victim with a warm, dry cover (A)</p> Signup and view all the answers

What is the primary objective of burn management?

<p>Prevent infection and promote healing (B)</p> Signup and view all the answers

What is the primary concern when moving a patient with a suspected fracture?

<p>To immobilize the body part before movement (B)</p> Signup and view all the answers

Which of the following signs is NOT typically associated with a fracture?

<p>Increased muscle strength (B)</p> Signup and view all the answers

What type of burn needs to be assessed for inhalation injury?

<p>Major burns (D)</p> Signup and view all the answers

What action should be avoided if the victim of an electrical burn is still in contact with the source?

<p>Touch the victim directly (A)</p> Signup and view all the answers

How much actual shortening may occur in long bone fractures due to muscle contraction?

<p>Approximately 2.5 to 5 cm (A)</p> Signup and view all the answers

What is a temporary method to immobilize a fracture in the lower extremities?

<p>Bandaging the legs together (A)</p> Signup and view all the answers

What should be assessed to determine the adequacy of tissue perfusion after a fracture?

<p>Neurovascular status distal to the injury (A)</p> Signup and view all the answers

What is the primary role of an anesthesiologist regarding anesthesia?

<p>Supervise the anesthetist and explain anesthesia risks. (B)</p> Signup and view all the answers

Which of the following best describes a Certified Registered Nurse Anesthetist (CRNA)?

<p>A nurse who has completed an accredited anesthesia program. (D)</p> Signup and view all the answers

What is the primary purpose of adequate preoperative teaching?

<p>To ensure a shorter and uncomplicated recovery period (B)</p> Signup and view all the answers

During which phase does the client get transferred to the operating room?

<p>Intraoperative phase (B)</p> Signup and view all the answers

Who is responsible for ensuring that the surgical consent form is signed and available in the client's chart?

<p>The nurse (B)</p> Signup and view all the answers

What is NOT a responsibility of the circulating nurse?

<p>Administering anesthesia to the patient. (A)</p> Signup and view all the answers

Which of the following is NOT a criterion for valid informed consent?

<p>Witness must be a family member (D)</p> Signup and view all the answers

How do anesthesiologists and anesthetists classify clients?

<p>According to their general physical status and risk potential. (D)</p> Signup and view all the answers

In what situation can a surgeon operate without consent?

<p>In an emergency situation (B)</p> Signup and view all the answers

What is a key component of preoperative nursing care?

<p>Conducting a complete assessment of the client. (B)</p> Signup and view all the answers

What information must be included in the informed consent document?

<p>Explanation of the procedure and its risks (B)</p> Signup and view all the answers

What attire do anesthesiologists and anesthetists wear during surgery?

<p>Theatre attire but not sterile gowns. (C)</p> Signup and view all the answers

Who must sign the surgical consent form if the patient is cognitively impaired?

<p>A family member or guardian (C)</p> Signup and view all the answers

Which of the following phases of perioperative care follows admission to the post anesthesia care unit?

<p>Postoperative phase (A)</p> Signup and view all the answers

What should a nurse offer to the client as part of the informed consent process?

<p>The opportunity to ask questions about the procedure (C)</p> Signup and view all the answers

What defines a 'voluntary consent' in the context of informed consent?

<p>Consent given without any coercion (D)</p> Signup and view all the answers

What is the primary reason chromic sutures have a longer absorption time compared to plain sutures?

<p>They are chemically structured to delay hydrolysis. (A)</p> Signup and view all the answers

Which of the following synthetic absorbable sutures is known for its fast absorption rate?

<p>Polyglycolic Acid (Surucryl suture) (C)</p> Signup and view all the answers

What key feature differentiates synthetic absorbable sutures from naturally absorbable sutures?

<p>Synthetic absorbable sutures undergo hydrolysis. (B)</p> Signup and view all the answers

What is the typical tensile strength duration for plain absorbable sutures?

<p>7-10 days (A)</p> Signup and view all the answers

What is a characteristic of non-absorbable sutures?

<p>They can be encapsulated within body tissue. (A)</p> Signup and view all the answers

Which sutures are known to have strong tissue reactions and encourage infections?

<p>Silk sutures (D)</p> Signup and view all the answers

Which natural suture material can be found in both absorbable and non-absorbable forms?

<p>Catgut (B)</p> Signup and view all the answers

What is the absorption time range for synthetic absorbable sutures?

<p>60-90 days (C)</p> Signup and view all the answers

What is the primary purpose of a split-thickness skin graft (STSG)?

<p>To provide coverage and promote healing for wounds (B)</p> Signup and view all the answers

How does a meshed graft differ from a sheet graft?

<p>A meshed graft can cover a larger area than a sheet graft. (A)</p> Signup and view all the answers

What type of skin graft is primarily used when both the donor and recipient are the same person?

<p>Autograft (B)</p> Signup and view all the answers

What is a common donor site for split-thickness skin grafts?

<p>Thigh (B)</p> Signup and view all the answers

When is a split-thickness skin graft (STSG) indicated?

<p>For wounds larger than 5–6 cm in diameter that cannot be closed primarily (A)</p> Signup and view all the answers

What happens to the donor site after a split-thickness skin graft is taken?

<p>It heals on its own because some dermal elements remain. (D)</p> Signup and view all the answers

What is typically the texture of a donor site after harvesting a split-thickness skin graft?

<p>It is similar to a second-degree burn. (B)</p> Signup and view all the answers

How long does graft ‘take’ or vascularization typically take after applying an STSG?

<p>3 to 5 days (D)</p> Signup and view all the answers

Flashcards

Anesthetist

A medical professional who administers anesthesia, but may not have completed a residency in anesthesia.

Certified Registered Nurse Anesthetist (CRNA)

A registered nurse who has specialized training in administering anesthesia.

Intraoperative Phase

The stage of perioperative care that begins when the patient is transferred to the operating room and ends when they are admitted to the post-anesthesia care unit (PACU).

Postoperative Phase

The stage of perioperative care that starts when the patient is admitted to the post-anesthesia care unit (PACU) and continues until they are discharged.

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Preoperative Phase

The stage of perioperative care that starts when the decision for surgery is made and ends when the patient is transferred to the operating room.

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Circulating Nurse

A nurse who assists in the operating room by handling equipment, supplies, and monitoring the patient's vitals.

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Preoperative Assessment

The assessment of the patient's physical condition before surgery, which helps determine the appropriate level of care and anesthesia.

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Surgical Nursing

The process of caring for a surgical patient, which involves meeting their physical and psychological needs.

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Absorbable Sutures

Sutures that are broken down by the body's enzymes or hydrolyzed in the body tissue.

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Non-Absorbable Sutures

Sutures that are not broken down by the body's enzymes or hydrolyzed in the body tissue. They remain in the body permanently.

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Catgut

A type of absorbable suture made from the submucosa of sheep gastrointestinal tract. It is absorbed within about one week.

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Chromic Catgut

A type of catgut suture treated with chromium solution to slow down absorption.

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Synthetic Absorbable Sutures

Sutures made from synthetic materials like polymers. They are absorbed by a process called hydrolysis.

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Fast Absorbing Sutures

A type of absorbable suture that is absorbed at a faster rate compared to other absorbable sutures.

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Silk Sutures

Strong suture material that often causes inflammation and infection, but replaced by synthetic options.

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Hydrolysis

The process by which water breaks down the polymer chains of synthetic absorbable sutures.

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Pre-operative Teaching

The patient's understanding of their surgery and recovery process, involving information about the procedure, pre-operative preparation, post-operative care, and more. It also includes their emotional preparedness for the operation.

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Surgical Consent

A legal document that authorizes a medical procedure to be performed on a patient. It ensures the patient is aware of the risks, benefits, and alternatives to the surgery.

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Incompetent Client

A person who can't make their own decisions due to mental or cognitive impairments. They need a legal representative to consent to medical procedures.

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Informed Consent

The process of explaining a procedure to a patient, including risks, benefits, and alternatives, and ensuring they understand the information before giving consent.

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Explanation of Procedure

A formal explanation of the planned medical procedure that includes potential risks, benefits, and alternative treatments.

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Descriptions of Benefits

Describing the potential positive outcomes of the procedure, including improved health or quality of life.

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Descriptions of Alternatives

Outlining other possible treatment choices besides the proposed surgery.

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Withdrawal of Consent

A provision for the patient to withdraw consent to the surgery, even after signing the consent form.

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Stopping the Burning Process

The process of stopping the burning process immediately by removing clothing and cooling the wound with tepid water.

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Electrical Burn

A type of burn caused by electricity, where the victim is still in contact with the electrical source. Do not touch victim.

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Chemical Burn

A burn caused by chemicals. Carefully remove clothing and irrigate the wound with water.

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First-Degree Burn

A burn that affects the top layer of skin, characterized by redness, pain, and swelling.

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Second-Degree Burn

A burn that damages the top two layers of skin, characterized by blisters, pain, and swelling.

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Third-Degree Burn

A burn that destroys all layers of skin and may affect underlying tissues, characterized by charring, numbness, and potential loss of function.

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Hospital Treatment for Burns

Any second-degree burn greater than 5 to 10 percent of surface area and all third-degree burns should be managed in a hospital.

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Diagnostic Investigations for Burns

Medical procedures performed to assess systemic reactions, infection, and complications.

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Muscle Spasms with Fracture

A natural defense mechanism where muscles contract around a fracture to minimize movement and prevent further damage.

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Crepitus

A common sign of a fracture, where a broken bone rubs against another, causing a rough feeling.

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Loss of Function in Fractures

The inability to use the injured limb due to pain, swelling, and instability.

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Deformity in Fractures

A noticeable shift, bend, or rotation in the bone after a fracture.

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Shortening in Fractures

The shortening of a limb caused by the overlapping of fractured bone ends.

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Swelling and Discoloration in Fractures

Swelling and bruising that happens after a fracture, indicating bleeding and trauma in the area.

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Immediate Immobilization in Fractures

The initial step in treating a suspected fracture, which involves keeping the injured body part still before moving the person.

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Splinting for Fractures

Temporarily immobilizing the fractured area with a padded splint, covering it with bandages, and addressing adjacent joints.

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Autograft

A skin graft where the donor and recipient are the same person, e.g., skin taken from the thigh and applied to a leg wound.

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Split-thickness Skin Graft (STSG)

A skin graft that includes only the top layers of skin, leaving the deeper layers intact.

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Meshed Graft

A type of STSG where the graft is stretched to cover a larger area.

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Sheet Graft

A type of STSG where the graft is applied as a single sheet.

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Graft Take

The process of a skin graft becoming integrated with the recipient's tissue.

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Donor Site

The area where skin is taken for a graft.

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Indications for Skin Graft

Wounds that are too large or complex to close directly.

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Secondary Intention Healing

Healing of a wound where the edges are not closed directly.

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Study Notes

Medical Surgical Nursing Concepts

  • Surgical team members are categorized into sterile and unsterile groups.
  • Sterile members perform surgical hand scrubs, wear sterile gowns and gloves, and work within a sterile field.
  • The surgical team includes the surgeon, surgical assistants, and the scrub nurse.
  • The surgeon is responsible for determining the surgical procedure, obtaining consent, performing the surgery, and post-operative care.
  • Surgical assistants may be physicians, surgical residents, RNs, Practical nurses or surgical technologists.
  • The scrub nurse performs surgical hand scrubs, wears sterile gowns and gloves, sets up sterile tables (with necessary supplies), and assists the surgeon.

Perioperative Nursing Care

  • The surgical process occurs in three phases: preoperative, intraoperative, and postoperative.
  • Preoperative phase begins with the decision for surgery and ends with transfer to the operating room.
  • Intraoperative phase begins with transfer to the operating room and ends with admission to the post anaesthesia care unit (PACU).
  • Postoperative phase begins with admission to the PACU (recovery room) and continues until patient discharge.

Preoperative Nursing Care

  • A comprehensive preoperative assessment of the patient is critical.
  • This assessment considers factors like the urgency of the surgery, planned admission date, and any other relevant information.
  • The nurse reviews preoperative instructions regarding diet and skin preparation with the patient.
  • The nurse ensures the client has adhered to the instructions given.
  • The nurse assesses the client's nutritional status, physical condition, surgical procedure, and ability to participate in recovery.
  • The nurse accommodates and understands the client's cultural needs regarding the surgical procedure, personal privacy preferences and family member involvement during the preoperative and postoperative periods.

Perioperative Medications

  • The anesthesiologist frequently orders preoperative medications.
  • Anticholinergics decrease respiratory tract secretions and dry mucous membranes.
  • Histamine2-receptor antagonists decrease gastric acidity and volume.
  • Opioids decrease the amount of anesthesia needed, help reduce anxiety and pain and promote sleep.
  • Sedatives promote sleep, decrease anxiety and reduce anesthesia needs.
  • Tranquilizers decrease nausea, prevent emesis, enhance preoperative sedation, preoperative anxiety, slow motor activity, and promote induction of anesthesia.
  • The nurse should check the client's identification, obtain allergies, check the client's BP, pulse and respiratory rates, and confirm the surgical consent form has been signed before administering medications.

Suture Materials

  • Sutures are surgical materials used in operative procedures to tie off blood vessels and hold wounds together.
  • The ideal suture material should have good handling characteristics, adequate tensile strength, not cut through tissue, be non-electrolytic, be non-allergenic, be cheap and sterile.

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Description

This quiz covers the essential concepts of medical surgical nursing, focusing on the roles of surgical team members and the phases of perioperative nursing care. Learn about the responsibilities of sterile and unsterile team members, and the critical functions during preoperative, intraoperative, and postoperative phases. Test your understanding of surgical procedures and nursing care.

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