Perioperative Nursing Care
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Questions and Answers

What is one of Jeff's primary responsibilities when preparing Mr. Cooper for surgery?

  • Administering anesthesia
  • Explaining preoperative procedures (correct)
  • Supervising other nurses
  • Performing the surgery

Which element is essential for maintaining patient safety in the perioperative nursing process?

  • Scheduling surgeries without preparation
  • Relying solely on nurses' instincts
  • Providing high-quality care (correct)
  • Ignoring the patient's medical history

What should Mr. Cooper expect as part of his preoperative preparation?

  • No dietary restrictions before surgery
  • Immediate discharge after consultation
  • Surgery without any prior assessment
  • Details about bowel preparation (correct)

How does Jeff's experience benefit Mr. Cooper during his preoperative assessment?

<p>He has two years of experience in the center (C)</p> Signup and view all the answers

What principle should drive the nursing goals in the preoperative area?

<p>Quality improvement and evidence-based practices (D)</p> Signup and view all the answers

In what settings can surgery take place according to the perioperative nursing framework?

<p>Ambulatory surgery centers and mobile units (D)</p> Signup and view all the answers

What is a common risk factor for urinary retention after anesthesia?

<p>Neurological disease (D)</p> Signup and view all the answers

Which factor is important for effective communication in the perioperative setting?

<p>Collaborating with surgical teams (C)</p> Signup and view all the answers

Which surgical procedure is specifically associated with an increased risk of urinary retention?

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

What is one of the key aspects of the nursing process in the context of perioperative care?

<p>Applying sound clinical judgment (C)</p> Signup and view all the answers

What is recommended if a bladder scan measures 600 mL of urine postoperatively?

<p>Perform a single-time catheterization (B)</p> Signup and view all the answers

Which medication category is associated with an increased risk of urinary retention?

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

What should ambulatory surgery patients be instructed to do if they cannot void 8 hours after discharge?

<p>Seek medical assistance (B)</p> Signup and view all the answers

Which factor does NOT commonly contribute to urinary retention after anesthesia?

<p>Lack of preoperative counseling (B)</p> Signup and view all the answers

How is bladder scanning typically utilized in patients at risk for urinary retention?

<p>To confirm an overdistended bladder (A)</p> Signup and view all the answers

Which group of healthcare providers is involved in the continuity of care during the perioperative setting?

<p>Nurses, respiratory therapists, and physical therapists (A)</p> Signup and view all the answers

What should patients be instructed to do when they feel bladder fullness?

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

What is a potential consequence of decreased tactile sensation in patients?

<p>Decreased ability to respond to early warning signs of complications (A)</p> Signup and view all the answers

What is a recommended practice to maintain normothermia during surgery?

<p>Provide warm blankets and monitor heart function (A)</p> Signup and view all the answers

What should be done to help prevent confusion and delirium after anesthesia?

<p>Allow adequate time to respond and process information (B)</p> Signup and view all the answers

What should be monitored to avoid postoperative complications related to urinary output?

<p>Frequency of sensation of bladder fullness (B)</p> Signup and view all the answers

What is a common outcome of increased pain tolerance in patients?

<p>Decreased likelihood of seeking medical help (C)</p> Signup and view all the answers

What should be done to assess the risk of falls in patients after surgery?

<p>Perform fall-risk screening (B)</p> Signup and view all the answers

What is one way to ensure vigilance for signs of undiagnosed infection during surgery?

<p>Monitor patient temperature closely (B)</p> Signup and view all the answers

What is a primary focus of nursing interventions during the preoperative surgical phase?

<p>Communicating pertinent data and the plan of care (D)</p> Signup and view all the answers

Which of the following elements is typically included in an Enhanced Recovery After Surgery (ERAS) protocol?

<p>Minimally invasive surgical approaches (C)</p> Signup and view all the answers

What is a critical decision-making approach used in the nursing process?

<p>Applying critical thinking and clinical judgment (D)</p> Signup and view all the answers

Why is establishing rapport with patients and their families essential during the preoperative phase?

<p>To foster a trusting and supportive environment (A)</p> Signup and view all the answers

What is a benefit of early mobilization in the context of ERAS protocols?

<p>It supports quicker recovery and reduces complications (A)</p> Signup and view all the answers

Which statement best describes the purpose of ERAS protocols?

<p>They are interprofessional and based on scientific evidence (C)</p> Signup and view all the answers

In the context of surgery, what determines the level of health of patients entering a healthcare setting?

<p>The time they have to prepare for surgery (D)</p> Signup and view all the answers

What aspect of patient care should be established collaboratively with patients and their families?

<p>Nursing interventions and outcomes (B)</p> Signup and view all the answers

What is defined as a 'never event' according to the Centers for Medicare and Medicaid Services?

<p>Hospital-acquired deep vein thrombosis (DVT) (A)</p> Signup and view all the answers

Which of the following is a key component of the WHO Surgical Safety Checklist?

<p>Communication prior to skin incision (B)</p> Signup and view all the answers

Why are transitions between care providers considered risky for patients?

<p>They are at risk for injuries and missed care (C)</p> Signup and view all the answers

What method is considered more effective for preoperative education compared to videos?

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

What is one of the TJC National Patient Safety Goals regarding patient care?

<p>To promote accurate patient identification (B)</p> Signup and view all the answers

What aspect of patient care is crucial for perioperative nurses, especially for patients with diabetes?

<p>Monitoring blood glucose levels (D)</p> Signup and view all the answers

Which of the following is a characteristic of hospital-acquired DVT?

<p>It can develop post-surgery (C)</p> Signup and view all the answers

What does the CDC report regarding patients with a discharge diagnosis of VTE from 2007 to 2009?

<p>There were over 550,000 occurrences documented (D)</p> Signup and view all the answers

Which scale is specifically recommended to assess pressure injury risk in perioperative patients?

<p>Munro Pressure Ulcer Risk Assessment Scale (B)</p> Signup and view all the answers

What aspect does the intraoperative component of the Munro Scale assess?

<p>Moisture and surface motion (A)</p> Signup and view all the answers

What should be included in the patient's medical record concerning advance directives?

<p>The patient's durable power of attorney for health care (D)</p> Signup and view all the answers

Which of the following are included in the preoperative assessment using the Munro Scale?

<p>Co-morbidities and nutritional state (B)</p> Signup and view all the answers

What is a unique feature of electronic health records (EHRs) mentioned in the context of nursing assessments?

<p>They provide standardized documentation forms (C)</p> Signup and view all the answers

Which risk factors does the Munro Scale assess in its cumulative model?

<p>Mobility, BMI, and nutritional state (C)</p> Signup and view all the answers

Which scale was not specifically designed to target intraoperative risk factors for pressure injuries?

<p>Braden Scale (C)</p> Signup and view all the answers

Which postoperative factor is included in the Munro Risk Assessment Tool?

<p>Duration of surgery (D)</p> Signup and view all the answers

Flashcards

Perioperative nursing

A registered nurse's planned patient-centered approach to providing care before, during, and after surgery.

Patient safety

Ensuring high-quality care during all phases of surgical procedures.

Preoperative screening

Assessment and preparation of a patient before surgery.

Bowel resection

Surgical removal of a cancerous tumor in the bowel.

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Bowel prep

Preparing the bowel for surgery by cleansing it.

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Preoperative goals

Quality improvement and evidence-based standards for patient safety.

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Surgical settings

Variety of locations where surgical procedures occur, including hospitals, ambulatory centers, and more.

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Patient-centered approach

Providing care focused specifically on the patient's needs and preferences.

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Reduced bladder capacity

A decreased ability to hold urine in the bladder.

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Increased risk of UTI

Higher chance of urinary tract infections.

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Sensory loss & pain tolerance

Reduced ability to feel and higher tolerance for pain.

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Pressure sores

Skin damage from prolonged pressure.

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Febrile response

A fever or elevated body temperature.

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Hypothermia

Abnormally low body temperature.

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Decreased reaction time

Slower response to actions and stimuli.

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Confusion/Delirium

Mental cloudiness and disorientation.

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What is POUR?

Postoperative Urinary Retention, a common problem after anesthesia where patients can't urinate.

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Who is at risk for POUR?

Patients at risk include older adults, men, those with previous POUR, neurological issues, pelvic surgery history.

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What procedures increase POUR risk?

Surgeries like anorectal, joint replacement, hernia repair, and incontinence surgery.

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How can anesthesia cause POUR?

Excessive fluids, certain medications (opioids, anticholinergics, sympathomimetics), prolonged anesthesia, and the type of anesthesia used.

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How can POUR be detected?

Patients may not complain, physical assessment might miss it, but bladder scanning can confirm it.

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What are the guidelines for bladder scanning?

Use when patients have POUR risk factors or can't void 4 hours after surgery.

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When is catheterization used?

Recommended for patients with a bladder scan showing 600 mL or more of urine.

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What advice is given to ambulatory surgery patients?

Contact a doctor if unable to void 8 hours after discharge.

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VTE risk after surgery

Patients are at higher risk of blood clots (deep vein thrombosis, DVT) in the legs after certain surgeries like knee or hip replacement.

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Never events

Medical errors that should never happen, such as hospital-acquired DVT after knee/hip surgery.

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Surgical Safety Checklist

A standardized tool used during surgery to ensure communication and safety in three phases: before anesthesia, before incision, and before leaving the operating room.

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Glycemic control in surgery

Monitoring and managing blood sugar levels for patients with diabetes or prediabetes during surgery.

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Preoperative education

Preparing the patient before surgery with information about the procedure, risks, and recovery.

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Verbal vs. video education

Talking to patients about their surgery is more effective than showing them videos because it allows them to ask questions and clarify concerns.

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Perioperative nurse role

A registered nurse who provides care to patients before, during, and after surgery, monitoring their health and ensuring safety.

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TJC National Patient Safety Goals

Standards set by The Joint Commission to improve patient safety in healthcare, including accurate patient identification and communication.

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Nursing Process in Surgery

A systematic approach to patient care involving critical thinking and clinical judgment, used before, during, and after surgery.

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ERAS Protocol

A standardized approach to surgical care designed to shorten recovery time and improve outcomes through evidence-based interventions.

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Patient Preparation for Surgery

Assessing a patient's overall health, addressing concerns, and preparing them for surgery, considering their unique needs and preferences.

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Collaboration in Surgical Care

Working together as a team, including surgeons, nurses, and other healthcare professionals, to provide coordinated and safe surgical care.

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Patient Education in Surgery

Providing clear and concise information about the surgery, recovery process, and potential risks to patients and their families.

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Postoperative Urinary Retention (POUR)

A common condition where patients cannot urinate after surgery, often caused by anesthesia or surgery-related factors.

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Risk Factors for POUR

Factors increasing the likelihood of POUR, such as older age, male gender, previous POUR history, certain surgeries, and neurological conditions.

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Management of POUR

Monitoring for POUR, assessing bladder fullness with a scan, and using interventions like catheterization to relieve the condition.

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Intraoperative Pressure Injury Risk

The chance of developing pressure sores during surgery. Standard Braden Scale doesn't assess this risk, so specialized scales are needed.

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Munro Scale

A tool used to assess pressure injury risk specifically for surgery patients. It's divided into pre-, intra-, and postoperative sections.

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What does the Munro Scale assess preoperatively?

The Munro Scale looks at mobility limitations, nutrition status, weight loss, BMI, and existing health conditions.

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What does the Munro Scale assess intraoperatively?

The intraoperative components assess anesthesia type, physical status, moisture levels, positioning, blood pressure, and body temperature.

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What does the Munro Scale assess postoperatively?

The postoperative scale considers surgery length and bleeding.

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AORN's Recommendation

The Association of Operating Room Nurses recommends using either the Munro or Scott Triggers scale to assess intraoperative pressure injury risk.

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Benefits of the Munro Scale

The Munro Scale allows nurses to assess risk at each stage of surgery (pre, intra, and post), increasing the frequency of assessments.

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Electronic Health Records (EHRs)

Digital systems that standardize documentation forms for comprehensive and accurate nursing assessments.

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Study Notes

Perioperative Nursing Care Objectives

  • Discuss three phases of perioperative nursing
  • Explain rationale for nursing assessment of patient's surgical risk factors
  • Identify comorbid conditions increasing risks of postoperative complications
  • Explain approach for assessing patient's psychological response to surgery
  • Explain preoperative teaching plan's impact on surgical recovery
  • Explain rationale for postoperative exercises
  • Identify benefits of early ambulation for postoperative patients
  • Illustrate how nurses use clinical judgement in intraoperative assessments to promote patient safety
  • Explain differences between postoperative phases
  • Outline SBAR communication components for perioperative hand-off
  • Identify nursing care priorities for postoperative patients
  • List principles for providing patient education during recovery

Key Terms

  • Ambulatory surgery
  • American Society of Anesthesiologists (ASA)
  • American Society of PeriAnesthesia Nurses (ASPAN)
  • Association of periOperative Registered Nurses (AORN)
  • Atelectasis
  • Bariatric
  • Circulating nurse
  • Co-morbid
  • Conscious sedation
  • Enhanced Recovery After Surgery (ERAS)
  • General anesthesia
  • Informed consent
  • Intermittent pneumatic compression (IPC) stockings
  • Laparoscopy
  • Latex sensitivity
  • Local anesthesia
  • Malignant hyperthermia
  • Moribund
  • Never event
  • Obstructive sleep apnea (OSA)
  • Oxygen desaturation
  • Paralytic ileus
  • Perioperative nursing
  • Postoperative nausea and vomiting (PONV)
  • Postoperative urinary retention (POUR)
  • Preanesthesia care unit (PCU)
  • Preoperative teaching plan
  • Regional anesthesia
  • Scrub nurse

Media Resources

  • Evolve.elsevier.com/Potter/fundamentals/
  • Review Questions
  • Video Clips
  • Concept Map Creator
  • Case Study with Questions
  • Skills Performance Checklists
  • Audio Glossary
  • Content Updates
  • Answers to QSEN Activity and Review Questions

Mr. Cooper Case Study

  • Mr. Cooper (72 years old) scheduled for bowel resection
  • Alert and oriented; normal vision and hearing; no prior major surgery
  • Given preoperative instructions (bowel prep, diet, arrival time, surgery details)

Perioperative Nursing

  • Registered nurse's patient-centered approach before, during, and after surgery
  • Apply national practice standards to provide quality care in hospitals, surgical centers, and offices
  • Focus on: quality improvement, evidence-based practices, patient safety, and cost containment

Classification of Surgical Procedures

  • Procedures categorized by seriousness (major/minor), urgency (elective/urgent/emergency), and purpose (diagnostic/ablative/palliative/reconstructive...etc)
  • Urgent procedures are often major in seriousness

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Related Documents

Perioperative Nursing Care Chapter 50 PDF

Description

This quiz explores the essential responsibilities of nursing in the perioperative setting, focusing on patient safety, preoperative preparations, and effective communication. It addresses the risks and nursing goals associated with surgery and anesthesia. Test your knowledge on these critical aspects of perioperative care.

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