Nursing Care in Surgical Settings Quiz

Preoperative Assessment

• Communication and documentation of important preoperative assessment findings are essential to the continuity of care.

Malignant Hyperthermia Treatment

• Stop triggering agents
• Hyperventilate with 100% oxygen
• Administer dantrolene (2.5 mg/kg)
• Provide bicarbonate
• Give glucose and insulin
• Use iced IV fluids and cooling blanket
• Monitor fluid output and administer furosemide if necessary

Informed Consent

• Include the patient's name
• Specify the type and reason for surgery
• Identify the surgeon performing the surgery
• Explain how the surgery will benefit the patient
• Discuss anesthesia options
• Obtain consent for anesthesia
• A legally appointed representative may consent for minors, unconscious, or mentally incompetent patients

Supplements and Bleeding Risk

• Gingko biloba, garlic, ginseng, fish oil, and dong quai may increase bleeding risk

Nursing Assessment

Allergies

• Assess for drug and non-drug allergies
• Screen for latex allergy, which may be indicated by banana or kiwi allergy

Cardiovascular Assessment

• Report any cardiac problems to the operative team
• Note the use of cardiac drugs
• Perform a 12-lead EKG and coagulation studies
• Consider prophylactic antibiotics

Respiratory System

• Inquire about recent airway infections, which may lead to procedure cancellation
• Report dyspnea, coughing, or hemoptysis to the operative team
• Note COPD, asthma, or high risk for atelectasis and hypoxemia
• Smokers should quit 6 weeks before the procedure to decrease complications
• Consider sleep apnea, obesity, and airway deformities affecting respiratory function

Genitourinary System

• Perform renal function tests
• Note problems voiding and inform the operative team
• Assess women for the possibility of pregnancy

Hepatic System

• The liver detoxifies many anesthetics and adjunctive drugs
• Hepatic dysfunction may increase the risk of postoperative complications

Integumentary System

• Assess for skin and musculoskeletal problems
• Consider a history of pressure ulcers and provide extra padding during the procedure
• Note body art, tattoos, and piercings
• Assess mobility restrictions that may affect positioning and ambulation

Musculoskeletal System

• Identify joints affected by arthritis
• Note mobility restrictions that may affect positioning and ambulation
• Consider hip replacement, neck injuries, and report problems affecting the neck or lumbar spine to the ACP

Endocrine System

• Patients with diabetes mellitus are at risk for hypo/hyperglycemia
• Cardiovascular alterations, delayed wound healing, and infection may occur
• Fluid and electrolyte status may require additional fluids and electrolytes before surgery if dehydration occurs

Test your knowledge on nursing care in various surgical settings such as the operating room (OR), postanesthesia care unit (PACU), and surgical intensive care unit (SICU). Focus on communication, documentation, preoperative assessments, and important treatments like malignant hyperthermia protocol.