Perioperative Nursing Overview
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Questions and Answers

Which of the following is a recommended nursing intervention to help reduce patient anxiety before surgery?

  • Providing psychosocial interventions (correct)
  • Transporting patient to presurgical area
  • Administering preanesthetic medication
  • Maintaining preoperative record

    • A nurse is preparing a patient for surgery. What is the primary rationale for having the patient void before administering premedication?

  • To ensure the patient is comfortable during the procedure
  • To reduce the risk of falls and injury (correct)
  • To facilitate easier placement of a urinary catheter
  • To prevent urinary retention during surgery

    • Which of the following is NOT a recommended preoperative nursing intervention?

  • Performing a thorough mouth inspection
  • Removing patient jewelry and valuables
  • Ensuring the patient has a full meal before surgery (correct)
  • Attending to family needs

    • What is the primary purpose of cognitive coping strategies in preoperative care?

    <p>To prevent postoperative delirium (D)</p> Signup and view all the answers

    Which of the following is a primary nursing responsibility that directly contributes to maintaining patient safety before surgery?

    <p>Managing the patient's nutrition and fluid intake (C)</p> Signup and view all the answers

    Which of the following is an expected outcome for a patient undergoing preoperative care?

    <p>Patient demonstrates understanding of the surgical process (A)</p> Signup and view all the answers

    What is the rationale for clipping hair instead of shaving the surgical site before surgery?

    <p>Shaving increases the risk of infection (A)</p> Signup and view all the answers

    What measures can be taken to minimize postoperative complications, such as pneumonia, after surgery?

    <p>Using deep breathing and coughing exercises (B)</p> Signup and view all the answers

    What phase of perioperative nursing begins with the decision to proceed with surgical intervention and ends with the transfer of the patient to the operating room?

    <p>Preoperative phase (D)</p> Signup and view all the answers

    Which surgical classification involves procedures aimed at facilitating a diagnosis or providing a cure?

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

    What is the primary purpose of preadmission testing in the surgical process?

    <p>To begin the nursing assessment process (C)</p> Signup and view all the answers

    Which aspect of preoperative assessment includes evaluating medications and allergies?

    <p>Health history and physical exam (B)</p> Signup and view all the answers

    Which medications should be carefully assessed due to their potential to affect surgical experience?

    <p>All of the above (D)</p> Signup and view all the answers

    What element of the preoperative assessment includes determining a patient's cultural beliefs?

    <p>Psychosocial factors (A)</p> Signup and view all the answers

    During which phase of perioperative nursing is the focus primarily on recovering from anesthesia?

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

    Which surgical classification would not typically involve immediate action?

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

    Which medication should be avoided during anesthesia due to the potential for excessive respiratory depression?

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

    Why must corticosteroids be discontinued gradually before surgery?

    <p>They may lead to cardiovascular collapse. (C)</p> Signup and view all the answers

    What is a crucial consideration for elderly patients during the preoperative period?

    <p>Lowered cardiac reserves (C)</p> Signup and view all the answers

    What type of patients may require special considerations during the preoperative period?

    <p>Patients undergoing emergency surgery (B)</p> Signup and view all the answers

    What must occur for an informed consent to be considered valid?

    <p>It should be written before nonemergent surgery. (A)</p> Signup and view all the answers

    What is the primary purpose of obtaining informed consent from a patient before surgery?

    <p>To prepare the patient psychologically. (A)</p> Signup and view all the answers

    Which of the following is NOT a reason for requiring written informed consent?

    <p>Ensure nurse accountability (D)</p> Signup and view all the answers

    During which situation is informed consent especially critical?

    <p>Before nonemergent surgery (B)</p> Signup and view all the answers

    Flashcards

    Corticosteroids

    Type of steroid hormone that can cause cardiovascular collapse if stopped suddenly.

    Diuretics

    Medications that promote the removal of excess fluids; may lead to electrolyte imbalance during anesthesia.

    Phenothiazines

    Class of drugs that may enhance the hypotensive effects of anesthetics.

    Insulin

    Hormone that regulates blood sugar levels; important consideration for diabetic patients under anesthesia.

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    Informed Consent

    Written approval from the patient prior to nonemergent surgery; protects both patient and surgeon.

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    Gerontologic Considerations

    Important factors to consider in elderly patients, including reduced cardiac reserves and renal function.

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    Legal Mandate

    A requirement enforced by law; for surgery, it involves obtaining consent.

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    Preoperative Period

    Time before surgery where special considerations apply, especially for certain patient groups.

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    Preoperative Phase

    Begins when the decision for surgery is made and ends with patient transfer to OR bed.

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    Intraoperative Phase

    Begins when the patient is on the OR bed and ends with admission to PACU.

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    Postoperative Phase

    Begins with admission to PACU and ends with follow-up evaluation.

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    Surgical Classification

    Categorizes surgeries by purpose: diagnostic, curative, reconstructive, etc.

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    Preadmission Testing

    Initiates nursing assessment, verifies diagnostic testing, starts discharge planning.

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    Preoperative Assessment

    Involves health history, medications, allergies, and physical exam before surgery.

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    Medications Affecting Surgery

    Includes corticosteroids, anticoagulants, insulin, opioids, etc. that may impact surgery outcomes.

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    Emergency Surgical Classifications

    Divided into emergent, urgent, required, elective, and optional based on timing.

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    Deep Breathing Techniques

    Methods to promote lung expansion and relaxation before surgery.

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    Mobility Importance

    Encouraging active movement to prevent complications post-surgery.

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    Premedication Patient Safety

    Ensuring patients void before administering preanesthetic medication.

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    Psychosocial Interventions

    Strategies to reduce patient anxiety and respect their beliefs.

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    Preoperative Record Maintenance

    Documenting all relevant patient information before surgery.

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    Family Presence During Surgery Prep

    Involving family members to support the patient emotionally.

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    Nutrition Management

    Monitoring food and fluid intake for patients pre-surgery.

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    Expected Postoperative Outcomes

    Goals such as relief from anxiety and no complications.

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    Study Notes

    Perioperative Nursing

    • Preoperative phase begins when the decision for surgery is made and ends with transfer to the operating room bed.
    • Intraoperative phase begins with transfer to the operating room bed and ends with admission to the PACU.
    • Postoperative phase begins with admission to the PACU and concludes with a follow-up evaluation at home or in a clinical setting.

    Surgical Classification

    • Purpose is to facilitate diagnosis, cure, or repair.
    • Types include reconstructive, cosmetic, palliative, and rehabilitative.
    • Categorized based on urgency (emergent, urgent, required, elective, optional).

    Preadmission Testing

    • Initiates nursing assessment.
    • Collects admission data (demographics, health history, surgical procedure-related information).
    • Confirms completion of preoperative diagnostic tests.
    • Plans discharge by assessing postoperative transportation and care needs.

    Preoperative Assessment #1

    • Involves health history and physical exam.
    • Records medications and allergies.
    • Evaluates nutritional and fluid status.
    • Examines dentition.
    • Assesses drug or alcohol use.
    • Monitors respiratory and cardiovascular status.
    • Assesses hepatic and renal function.

    Preoperative Assessment #2

    • Evaluates endocrine function.
    • Assesses immune function.
    • Records previous medication use.
    • Identifies psychosocial factors.
    • Considers spiritual and cultural beliefs.

    Medications That Affect Surgical Experience

    • Potential effects of specific medications: corticosteroids, diuretics, phenothiazines, tranquilizers, insulin, antibiotics, anticoagulants, anticonvulsant medications, thyroid hormone, opioids, over-the-counter and herbal medications.

    Question #1

    • Question: Which medication classification can cause electrolyte imbalance during surgery?
    • Answer: Diuretics.

    Answer to Question #1 (Rationale)

    • Diuretics during anesthesia can lead to excessive respiratory depression from electrolyte imbalance.
    • Discontinuing corticosteroids can cause cardiovascular collapse.
    • Phenothiazines can increase the hypotensive effects of anesthetics.
    • Interactions between anesthetics and insulin are important in patients with diabetes.

    Gerontologic Considerations

    • Lower cardiac reserves.
    • Impaired renal and hepatic function.
    • Reduced gastrointestinal activity.
    • Respiratory compromise.
    • Increased susceptibility to temperature changes due to decreased subcutaneous fat.
    • May require extended or multiple teaching methods for knowledge retention.

    Special Considerations During Preoperative Period

    • Patients with obesity.
    • Patients with disabilities.
    • Patients undergoing ambulatory surgery.
    • Patients undergoing emergency surgery.
    • Required in writing for nonemergent surgeries.
    • Surgeon must explain the procedure, benefits, risks, and complications.
    • Nurse clarifies information, witnesses signature, and ensures consent is obtained before administering psychoactive premedication.
    • Consent accompanies the patient to the operating room.

    Question #2

    • Question: Is voluntary and written informed consent necessary before nonemergent surgery solely to protect the surgeon from claims of unauthorized operation?
    • Answer: False.

    Answer to Question #2 (Rationale)

    • Voluntary and written informed consent is necessary to protect the patient from unauthorized surgery and the surgeon from claims of battery.
    • Consent is a legal requirement but also helps psychologically prepare patients for surgery by ensuring understanding.

    Patient Education

    • Includes techniques like deep breathing, coughing, incentive spirometry, mobility, active body movement, and pain management, and cognitive coping strategies.
    • Provides specific instruction for ambulatory surgery patients.

    Immediate Preoperative Nursing Interventions

    • Patient changes into gown, hair covered, mouth inspected, jewelry removed, and valuables secured.
    • Administering preanesthetic medication.
    • Maintaining preoperative records.
    • Transporting patient to presurgical area.
    • Attending to patient's and family's needs.

    General Preoperative Nursing Interventions

    • Providing psychosocial interventions, reducing anxiety and fear, respecting cultural, spiritual, and religious beliefs,
    • Maintaining patient safety.
    • Managing nutrition and fluids.
    • Preparing the bowel.
    • Preparing the skin.

    Question #3

    • Question: What's the first action a nurse should take when preparing to administer premedication?
    • Answer: Have the patient void.

    Answer to Question #3 (Rationale)

    • Having the patient void is crucial to prevent falls and injuries during premedication.
    • Clipping hair instead of shaving is now the recommended practice for many procedures.
    • While family presence is allowed, patient safety is paramount, especially after receiving sedatives.

    Expected Outcomes

    • Relief of anxiety.
    • Decreased fear.
    • Understanding of the surgical intervention.
    • Absence of preoperative complications.

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    Related Documents

    Chapter 14 Preoperative Nursing Management PDF

    Description

    This quiz covers the key phases of perioperative nursing, including preoperative, intraoperative, and postoperative stages. It also delves into surgical classifications by purpose and urgency, as well as the importance of preadmission testing and assessment. Test your understanding of these critical concepts in surgical care.

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