Questions and Answers
What is the primary focus of the preoperative phase in nursing?
Which type of surgery is performed to relieve pain or alleviate distressing symptoms?
What distinguishes major surgery from minor surgery?
What type of surgery is an exploratory laparotomy classified as?
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In which category of surgical procedures is appendectomy classified?
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Which statement best describes the characteristic of minor surgery?
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What defines urgent surgery in terms of timing?
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Which type of surgery is intended to estimate the extent of a disease?
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What is the primary purpose of incentive spirometry before surgery?
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Which of the following exercises is NOT recommended for patients after certain surgeries?
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Why is splinting necessary when coughing postoperatively?
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What should be provided to the patient before surgery to help ensure rest?
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When should a patient be NPO (nothing by mouth) before surgery?
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What is one method to minimize postoperative gas pains?
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Following which type of surgery are coughing exercises contraindicated?
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What specific skin preparation is recommended on the night before surgery?
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What is the main purpose of preadmission testing?
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Which phase includes the time from patient transfer to the operating room until admission to postanesthesia care unit (PACU)?
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Which of the following assessments is NOT typically included in a preoperative assessment?
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What type of surgery would be classified as optional?
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What is a potential effect of taking anticoagulants before surgery?
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Which of the following is a gerontologic consideration during the preoperative period?
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Which medication type is known to potentiate the effects of narcotics?
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Which option is an example of elective surgery?
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What factor is considered when assessing a patient's fluid status preoperatively?
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Which of the following is NOT a focus of the preoperative assessment?
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What must be included in informed consent documentation?
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Which of the following individuals is considered incompetent to give consent?
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Which of the following is an appropriate preoperative nursing intervention?
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What is NOT a requirement for valid voluntary consent?
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What is a primary goal in withholding food before surgery?
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Which procedure should be a part of patient teaching before surgery?
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Which intervention is NOT typically included in immediate preoperative nursing care?
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Which statement about consent is accurate?
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What is the primary purpose of administering pre-operative medications?
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Which type of medication is administered to lower the patient's anxiety level prior to surgery?
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What is the recommended time frame for administering pre-operative sedatives before anesthesia induction?
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What should be checked regarding food intake before surgery?
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What is a potential risk of an overdose of sedative medication?
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Which of the following actions should be completed during early morning care before surgery?
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What type of medication is Atropine sulfate classified as?
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What is an important task that should be performed just before the patient goes to the operating room?
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Study Notes
Perioperative Nursing Phases
- Preoperative Phase: Timeframe from surgery decision to patient transfer into the operating room.
- Intraoperative Phase: Span from patient transfer into the operating room to admission in the postanesthesia care unit (PACU).
- Postoperative Phase: Period from PACU admission to follow-up evaluation either in clinical settings or at home.
Classifications of Surgery
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Categories of Surgical Procedures:
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According to Purpose:
- Diagnostic: Confirm suspected diagnosis (e.g., biopsy).
- Exploratory: Assess disease extent (e.g., exploratory laparotomy).
- Curative: Remove or repair damaged organs or tissues.
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According to Purpose:
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Types of Curative Surgery:
- Ablative: Removal of diseased organs (e.g., appendectomy, hysterectomy).
- Reconstructive: Restoration of damaged organs (e.g., plastic surgery).
- Constructive: Repair congenital defects.
- Palliative: Alleviate pain and distressing symptoms.
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According to Degree of Risk:
- Major Surgery: High risk, prolonged operation, potential extensive blood loss, vital organs involved.
- Minor Surgery: Lower risk, typically outpatient with fewer complications.
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According to Urgency:
- Emergency: Immediate surgery required.
- Urgent: Needs to be done within 24–48 hours.
- Required: Necessary within weeks to months for patient health.
- Elective: Not immediately necessary, but beneficial to patient.
- Optional: Patient-requested, e.g., plastic surgery.
Preoperative Assessment
- Involves assessing:
- Nutritional and fluid status
- Dentition
- Substance use (drugs/alcohol)
- Respiratory, cardiovascular, hepatic, and renal function.
- Endocrine and immune function
- Previous medication use
- Psychosocial, spiritual, and cultural factors.
Special Considerations
- Demographics: Tailor care for elderly, obese, disabled, ambulatory, and emergency surgery patients.
Medications Affecting Surgery
- Corticosteroids, Anticoagulants, Diuretics, Antiseizure medications, Phenothiazines, Tranquilizers, Thyroid Hormone, Insulin, and Opioids may influence surgical outcomes.
- Regular medications can impact the surgical experience regarding anesthesia reaction and bleeding risks.
Informed Consent
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Requires:
- Written explanation of procedure, risks, benefits, alternatives.
- Opportunity for questions.
- Instructions on withdrawal of consent.
- Awareness of variations from customary procedures.
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Voluntary Consent: Must be freely given, by individuals 18+ years old, witnessed by a professional.
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Incompetent Patients: Those unable to consent due to cognitive, mental, or neurological impairments.
Patient Teaching
- Important topics include:
- Deep breathing, coughing techniques, incentive spirometry
- Mobility and movement strategies
- Pain management techniques
- Cognitive coping strategies.
General Preoperative Nursing Interventions
- Focus on:
- Psychological support to reduce anxiety and fear.
- Safety protocols.
- Nutritional management and bowel/skin preparation.
Immediate Preoperative Nursing Interventions
- Administer preanesthetic medications and maintain surgical records while addressing family needs.
Postoperative Complications Prevention Instructions
- Diaphragmatic breathing, coughing, leg exercises, turning positions, and ambulation.
Physiological Preparation
- Respiratory Preparation: Use incentive spirometry to prevent atelectasis and improve lung function.
Night Before Surgery Preparation
- Ensure skin is shaved, NPO status, possible enemas or tube insertion.
- Promote rest through a comfortable environment and possible sleep aids.
Day of Operation Protocol
- Preoperative care includes recording vital signs, gowning, personal items removal, and confirming NPO status.
Pre-Operative Medications
- Administered 60-90 min before anesthesia induction to reduce anxiety, secretions, and anesthesia dosage.
- Types include sedatives (e.g., Phenobarbital), tranquilizers (e.g., Thorazine), narcotics (e.g., Morphine), and vagolytics (e.g., Atropine).
Recording and Checklist
- Final preparations and patient emotional responses should be noted before surgery to ensure comprehensive care.
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Description
Test your knowledge on the three critical phases of perioperative nursing: preoperative, intraoperative, and postoperative. This quiz will help you understand the key responsibilities and processes involved in each phase, enhancing your nursing skills and patient care. Prepare to deepen your understanding of the surgical patient journey.
