NURS 310: Management of Surgical Client

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Questions and Answers

What are the three phases of perioperative patient care?

Preassessment, intraoperative, immediate postoperative

Preoperative, intraoperative, preassessment

Preoperative, intraoperative, postoperative (correct)

Preoperative, surgical, postoperative

Which of the following best describes informed consent in the surgical context?

A form that is signed post-operatively

An informal discussion that suffices without signatures

A verbal agreement without documentation

A legal and ethical requirement that ensures patient understanding (correct)

Which of the following is NOT a part of the preoperative nursing measures?

Assessing the patient's medical history

Establishing baseline vitals

Preparation of the surgical instruments (correct)

Patient education on postoperative care

What type of anesthesia would most likely allow a patient to remain awake but pain-free during a surgical procedure?

Regional anesthesia Signup and view all the answers

Which role is primarily focused on patient safety during the intraoperative period?

Circulating nurse Signup and view all the answers

What is the primary focus of the post anesthesia care unit nurse?

Management of immediate postoperative complications Signup and view all the answers

Which of the following is a principle of surgical asepsis?

Using sterile instruments for every surgery Signup and view all the answers

Which of these is considered a common postoperative problem?

Hemorrhage Signup and view all the answers

What is an important element of developing a preoperative teaching plan?

Discussing potential postoperative risks Signup and view all the answers

Which phase of surgery begins with the patient's transfer to the operating room?

Intraoperative Phase Signup and view all the answers

What is the primary focus of the perioperative phase?

Patient transfer and preparation for surgery Signup and view all the answers

Which type of surgical procedure is aimed primarily to relieve pain rather than curing a condition?

Palliative procedure Signup and view all the answers

Which of the following is an example of a reconstructive surgical procedure?

Mammoplasty Signup and view all the answers

What characterizes robotic surgeries in comparison to traditional surgical methods?

Enhanced precision and better range of motion Signup and view all the answers

Which procedure is a non-reparative surgical approach?

Exploratory laparoscopy Signup and view all the answers

Informed consent is essential for which reason regarding surgical procedures?

To respect patient autonomy in decision-making Signup and view all the answers

The decision to perform surgery based on a patient's chronic pain management represents which surgical classification?

Palliative surgery Signup and view all the answers

What distinguishes the postoperative phase from the other surgical phases?

Begins with the patient's admission to recovery and includes follow-up evaluations Signup and view all the answers

Which of the following accurately describes the preoperative phase?

Covers the time from decision for surgery to transfer to the operating room Signup and view all the answers

What is the primary indication that evisceration has occurred?

Protrusion of wound contents Signup and view all the answers

Which position is recommended for a patient experiencing wound disruption to minimize further protrusion?

Low Fowler's position Signup and view all the answers

What immediate action is taken when evisceration is recognized in a patient?

Cover the protruding contents with sterile dressings Signup and view all the answers

Which symptom might a patient report if they are experiencing evisceration?

A 'giving way' sensation Signup and view all the answers

What is the initial sign that may indicate the onset of evisceration?

Gush of peritoneal fluid Signup and view all the answers

Which of the following is NOT associated with evisceration?

Gradual wound edge separation Signup and view all the answers

What must be assessed regarding a patient's respiratory status before surgery?

Assessment of incentive spirometer use Signup and view all the answers

Which allergy may indicate a heightened risk for latex allergy?

Allergy to kiwi, avocado, or banana Signup and view all the answers

Why is it important to address nutritional status in preoperative assessments?

To determine the patient's likelihood of anesthesia complications Signup and view all the answers

What is a contraindication for surgery regarding renal function?

Presence of acute nephritis Signup and view all the answers

How should drug or alcohol use be approached during the preoperative assessment?

With frank questions delivered sensitively and nonjudgmentally Signup and view all the answers

Which test is crucial for monitoring endocrine function in diabetic patients before surgery?

Blood glucose levels Signup and view all the answers

What preoperative factor could lead to postponement of elective surgery?

Uncontrolled hypertension Signup and view all the answers

What does an elevated white blood cell count indicate in a preoperative assessment?

An active infection that must be treated Signup and view all the answers

What nutritional assessment is specifically important in monitoring metabolic abnormalities?

Measurement of body mass index (BMI) Signup and view all the answers

What health history detail is crucial for understanding risks regarding anesthesia?

Current medications including OTC and herbal supplements Signup and view all the answers

What is a common method to alleviate swelling after surgery?

Elevating the affected part to the level of the heart Signup and view all the answers

Which is a potential sign of an infection at a surgical site?

Increased pulse rate and temperature Signup and view all the answers

What is instructed to be avoided to prevent venous thromboembolism?

Sitting with legs crossed for prolonged periods Signup and view all the answers

What is a recommended action if a wound continues to appear red and painful after 8 weeks?

Consult a health care provider Signup and view all the answers

What should be done if a small hematoma occurs at the surgical site?

It usually doesn't require treatment Signup and view all the answers

When is wound sepsis most evident after surgery?

At least after postoperative day 5 Signup and view all the answers

Why is adequate hydration important after surgery?

It aids in preventing venous thromboembolism Signup and view all the answers

What should be done with the suture line after removal?

Keeping it clean and patting dry gently Signup and view all the answers

If excessive collagen formation occurs at a surgical site, what is likely needed?

Consultation with a specialist Signup and view all the answers

What condition may be indicated by calf pain and leg swelling post surgery?

Venous thromboembolism Signup and view all the answers

Study Notes

Objectives of Perioperative Nursing

Define three phases of perioperative patient care: preoperative, intraoperative, and postoperative.
Conduct comprehensive preoperative assessments, including health history, physical exams, and understanding of patient medications and allergies.
Understand legal and ethical considerations regarding informed consent.
Implement preoperative nursing measures and develop teaching plans for patients.
Emphasize an interdisciplinary approach to patient care during surgery and the principles of surgical asepsis.
Recognize roles of surgical team members and various types of anesthesia.
Apply the nursing process to enhance patient outcomes during the intraoperative phase.
Highlight the nurse's role in ensuring patient safety and responsibilities in the post-anesthesia care unit.

Perioperative Phase

Comprises the entire surgical experience: preoperative, intraoperative, and postoperative phases.
Begins with patient admission to the operating area and ends upon transfer to the post-anesthesia care unit.

Advances in Surgery

Minimally invasive surgeries and robotic surgeries are on the rise, improving accuracy and patient comfort.
Shorter hospital stays are facilitated by new techniques.

Surgical Classifications

Diagnostic procedures include biopsies or exploratory surgeries.
Curative procedures aim to remove or fix problems, e.g., tumor excision.
Reparative surgeries involve repairing existing damage.
Reconstructive or cosmetic surgeries enhance appearance, e.g., facelifts.
Palliative surgeries relieve symptoms without curing the condition, e.g., tumor debulking.
Rehabilitative surgeries, such as joint replacements, improve function and alleviate pain.

Defined as the patient’s autonomous choice to undergo surgery, ensuring full understanding of risks and benefits.
Alternative communication methods should be used for patients with disabilities.

Preoperative Assessment

Assess risk factors including allergies, comorbid conditions, and health history.
Physical exam includes vital signs and joint mobility.
Review nutritional and fluid status; monitor for obesity and metabolic issues.
Evaluate respiratory, cardiovascular, hepatic, renal, endocrine, and immune functions.
Encourage smoking cessation at least 30 days prior to surgery.
Monitor blood glucose for diabetic patients, and assess for adrenal insufficiency in corticosteroid users.

Patient Education: Wound Care Instructions

Instruct patients that wounds need time to heal after suture removal.
Recommendations include keeping the wound clean and following activity guidelines.
Monitor for signs of infection like pain, swelling, and color changes post-surgery.

Managing Potential Complications

Venous Thromboembolism (VTE): Use anticoagulants, anti-embolism stockings, and promote early ambulation.
Hematoma: Occurs from concealed bleeding; treat large clots as needed.
Wound Infection: Look for increased vital signs and local signs of infection; treat aggressively with medications and drainage.
Wound Dehiscence and Evisceration: Disruption of wound integrity; manage by maintaining wound cleanliness and notifying the surgeon immediately if evisceration occurs.

Postoperative Nursing

Monitor patients for immediate postoperative complications and educate on home care strategies.
Emphasize the importance of follow-up evaluations in the clinical setting or home.

Surgical Team Roles

Collaborative roles contribute to effective surgery and patient safety, emphasizing communication and defined responsibilities.

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Description

This quiz covers key aspects of the management of surgical clients in the NURS 310 course. Topics include perioperative patient care, preoperative assessment, legal and ethical considerations for informed consent, and preoperative nursing measures. Additionally, it addresses the interdisciplinary approach to patient care and principles of surgical asepsis.