Preoperative and Postoperative Care Quiz

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Questions and Answers

What is a common clinical manifestation of diverticulitis?

Acute pain in the left lower quadrant (correct)

Smooth, sore red tongue

Urinary frequency

Iron deficiency

Which of the following is true regarding pernicious anemia?

It can be treated with oral vitamin B12 supplements.

It has lower incidence in individuals with a family history.

It occurs due to an absence of intrinsic factor. (correct)

It is caused by a deficiency of vitamin B6.

What are symptoms associated with a hemolytic blood transfusion reaction?

Fever and dizziness

Hives and pruritus

Flushing and tachycardia

Low back pain and chest pain (correct)

What is one effect of benign prostatic hyperplasia (BPH) on the urinary system?

Incomplete emptying of the bladder Signup and view all the answers

What is a common early symptom of rheumatoid arthritis?

Morning joint stiffness lasting longer than 1 hour Signup and view all the answers

Which procedure should be prioritized when initiating a blood transfusion?

Confirm the blood type match Signup and view all the answers

Which symptom is commonly associated with systemic lupus erythematosus (SLE) exacerbations?

Oral ulcers Signup and view all the answers

Which of the following is NOT a sign of urinary retention in males due to BPH?

Complete urinary incontinence Signup and view all the answers

What can result from untreated obstruction due to benign prostatic hyperplasia?

Urinary tract infection (UTI) Signup and view all the answers

What should be done postoperatively to prevent complications?

Early and frequent ambulation as tolerated Signup and view all the answers

Which of the following is an important nutrient deficiency identified in pernicious anemia?

Vitamin B12 Signup and view all the answers

Which of the following is an indication of malignant hyperthermia during surgery?

Heart rate greater than 150 bpm Signup and view all the answers

What is a classic symptom of rheumatoid arthritis when palpating the joints?

Spongy or boggy tissue Signup and view all the answers

What can exacerbate the lesions associated with systemic lupus erythematosus?

Exposure to sunlight or ultraviolet light Signup and view all the answers

Which laboratory tests are routinely used to detect infection before surgery?

White blood count and urinalysis Signup and view all the answers

Which of the following is not a symptom of malignant hyperthermia?

Low blood sugar Signup and view all the answers

What is one of the earliest signs associated with abnormal calcium transport?

Generalized muscle rigidity Signup and view all the answers

What should a nurse assess to evaluate bowel function postoperatively?

Frequency and presence of bowel sounds Signup and view all the answers

What body temperature change can occur every 5 minutes as a late sign of a serious condition?

Increase of 1°C to 2°C Signup and view all the answers

Which condition is characterized by the protrusion of wound contents?

Wound evisceration Signup and view all the answers

Which of the following is NOT a common adverse effect of Galantamine hydrobromide?

Nausea Signup and view all the answers

What type of patients may benefit from the use of an abdominal binder?

Patients with weak abdominal walls Signup and view all the answers

Which of the following contraindications relates to Galantamine hydrobromide?

Severe hepatic or renal impairment Signup and view all the answers

Which drug is similar to Galantamine hydrobromide in its mechanism of action?

Donepezil Signup and view all the answers

What is the primary benefit of pursed-lip breathing?

It helps control the rate and depth of respiration. Signup and view all the answers

Which of the following is NOT a common symptom of COPD?

Pursed-lip breathing Signup and view all the answers

What types of asthma develop due to environmental factors and usually manifest in childhood?

Allergic asthma Signup and view all the answers

What is a recommended strategy when using inhaled corticosteroids to prevent thrush?

Use a spacer and rinse mouth after use. Signup and view all the answers

Which symptom is characteristic of severe, persistent asthma?

Nocturnal dyspnea Signup and view all the answers

What triggers non-allergic asthma in individuals over 40 years old?

Cold air and exercise Signup and view all the answers

What is recommended to alleviate gastric reflux in individuals with GERD?

Eat small, frequent feedings throughout the day. Signup and view all the answers

What is a systemic preparation of glucocorticoids used for?

To manage severe, persistent asthma symptoms. Signup and view all the answers

What is the primary goal of promoting independence in self-care activities for individuals with Alzheimer's disease?

To enhance quality of life Signup and view all the answers

Which of the following medications is indicated for the cognitive enhancement in early Alzheimer's disease?

Rivastigmine Signup and view all the answers

What posture is commonly observed in patients with Parkinson's disease?

Bent forward with a propulsive gait Signup and view all the answers

Which statement best describes the role of nightlights for dementia patients?

They assist in decreasing confusion at night. Signup and view all the answers

What is a common risk associated with long-term use of Dilantin?

Development of gingival hyperplasia Signup and view all the answers

What is the primary post-operative concern following a total thyroidectomy?

Hypocalcemia Signup and view all the answers

In managing diabetes during illness, what is an important point to remember?

Usual insulin doses should be maintained. Signup and view all the answers

What is a classic symptom associated with hypothyroidism as indicated by lab results?

Increased TSH levels Signup and view all the answers

What does an aura in seizure patients signify?

The seizure is about to occur. Signup and view all the answers

Which of the following is NOT a contributing factor to foot complications in patients with diabetes?

Regular foot examinations Signup and view all the answers

What type of lifestyle change is recommended for managing ulcerative colitis?

Maintaining a low-stress environment Signup and view all the answers

What is the primary focus in the treatment of rheumatoid arthritis?

Symptom management through medications Signup and view all the answers

What is a known effect of levothyroxine treatment in hypothyroid patients?

Increased energy levels Signup and view all the answers

What condition can result from consuming excessive water without adequate electrolytes?

Dilutional Hyponatremia Signup and view all the answers

Which diuretics are least likely to cause hypokalemia?

Potassium-sparing diuretics Signup and view all the answers

What is the expected peak time for regular insulin after administration?

2-3 hours Signup and view all the answers

What is the most common risk factor for developing Type Two Diabetes?

Obesity Signup and view all the answers

Which medication is a key component of the rheumatoid arthritis treatment plan?

Methotrexate Signup and view all the answers

What symptom is associated with extreme hyperglycemia in Type One Diabetes?

Ketoacidosis Signup and view all the answers

What can potentially lead to hyperkalemia?

Adrenal insufficiency Signup and view all the answers

What dietary component is essential to avoid for preventing calcium phosphate renal calculi?

Milk and dairy products Signup and view all the answers

Study Notes

Preoperative Assessment Checklist

Consent is obtained, the surgeon ensures the patient understands the procedure
Patient history, including allergies and previous surgeries, is reviewed
Expectations for pre- and post-operative care are discussed
Baseline vital signs are documented

Postoperative Priorities

Pain management is a top priority
Frequent monitoring of vital signs and the surgical site
Assess for signs of infection or decline in baseline vitals
Monitor IV fluid rate and patency
Assess patient's level of sensation and circulation

Pain Management

Preventive approach (rather than PRN) is more effective for pain relief
Opioid analgesics are commonly prescribed for immediate postoperative pain relief and restlessness.
Patient-controlled analgesia (PCA) allows patients to self-administer pain medication when needed
Epidural infusions and intrapleural anesthesia can improve coughing and deep breathing in specific surgical cases

Malignant Hyperthermia

The patient remains at risk in the postoperative period for malignant hyperthermia
Characterized by severe muscle rigidity, rapid breathing, and problems with low oxygen and high carbon dioxide levels.

Pain Assessment and Outcomes

The nurse assesses pain using a verbal or visual analog scale.
The goal of pain management is prevention rather than sporadic control.
Adequate pain relief promotes faster recovery.
PCA is a useful method for pain management.

Pneumonia

Prevention is through vaccination (23)
Occurs in patients not hospitalized or in long-term care within 14 days of onset
Can be treated at home or in hospital

COPD and Oxygen Levels

Patients will have lower baseline oxygen levels (88%)
Pulse oximetry is used to assess the need for supplemental oxygen.

Heart Failure and COPD

Pulmonary vascular changes can result in pulmonary hypertension and chronic hypoxemia
COPD and infections-report any signs of change in sputum, fever, increased dyspnea, or fatigue.

Crohn's Disease

Chronic inflammation of the GI tract.
Bowel wall thickens and becomes fibrotic, narrowing the intestinal lumen (cobblestone).
Symptoms may include diarrhea, crampy abdominal pain (especially after meals), malnourishment, and secondary anemia.

Bariatric Surgery - Postoperative Checklist

Watch for dumping syndrome and vitamin/mineral imbalances.
Monitor for ulcers and bleeding.

Medical Management and Dietary Supplements

Medical management includes dietary supplements
Follow-up appointments are essential

Constipation

Defined as less than 3 bowel movements per week
Establish healthy bowel habits
Digital dislodgement or enema administration may be needed
Consider bulk-forming OTCs (like Docusate) if needed

Bowel Obstruction

Decompression with an NG tube may be necessary.

Appendicitis - Preoperative Preparation

Correct or prevent fluid and electrolyte imbalance; dehydration, and sepsis
Antibiotics and IV fluids may be administered

Septic Shock/Peritonitis

Signs may include increased pulse rate, fever (100-101), progressive hypotension, absent bowel sounds, and abdominal rigidity due to leakage of contents

Diverticulosis

Diverticulum inflammation, leading to possible obstruction, abscess, fistula formation, peritonitis, or hemorrhage.
Symptoms include frequent bowel irregularity, constipation, diarrhea, nausea, anorexia, and abdominal bloating.

Colitis

Symptoms typically start in the rectum and spread inward.
May present with bloody diarrhea, mucus or pus in stool, and left-lower quadrant abdominal pain.

Hypertension- High Blood Pressure

Hemorrhages, exudate (fluid buildup), narrowed arterioles, and cotton-wool spots (small infarcts).
Symptoms to watch for include blurred vision.

Heart Disease, Diuretics, and Potassium

Patients receiving potassium-sparing diuretics must be carefully monitored.
Monitor for hyperkalemia
Monitor for orthostatic hypotension and kidney injury.

Iron supplementation

Iron supplementation may be needed, or given intravenously.
Can stain teeth

Anemia

Deficiency of vitamin B12, absence of intrinsic factor
Common symptoms include run in families, history of gastric cancer, red tongue, and mild diarrhea. A replacement is needed in the form of monthly B12 injections.

Blood Administration Reactions

Febrile, chills, fever, headache, flushing.
Allergic reactions (hives, pruritus, shortness of breath), hemolytic reactions (low blood pressure, tachycardia, fever, chills, chest pain, and blood in the urine)
History of pregnancy, blood transfusions, or incorrect blood typing may increase the risk of reaction.

SBAR - Situation, Background, Assessment, Recommendation

Process to communicate essential information for patient care
Confirm order, documents, blood type, vitals, signs of reaction, and proper tubing.

Chronic Ulcerative Colitis and Crohns Disease

Inflammatory diseases of the bowel
Symptoms can include bloody diarrhea, mucus or pus in stool and left-lower quadrant abdominal pain.

Bariatric Surgery

Increased risk for osteoporosis
Increased risk of malabsorption disorders

Gallbladder Diseases

Presence of gallstones, risk factors involving cirrhosis, hemolysis, infection of the biliary tract.
Symptoms-jaundice(yellowing of skin), with pruritus (itching) of the skin.

Peptic Ulcer Disease

Gastric, and duodenal ulcers.
Symptoms may include abdominal pain, often after eating.

Glaucoma

Increased intraocular pressure.
Symptoms include blurred vision, headaches, and eye pain.
Can lead to sudden permanent vision loss.

Diabetes

Patient's blood glucose level (with A1C above 6.5).
Symptoms-polyuria (increased urination), polydipsia (extreme thirst), and polyphagia (increased hunger), and osmotic diuresis.

Hypothyroidism and Hyperthyroidism (Thyroid Storm)

High fever, extreme tachycardia (high heart rate), exaggerated symptoms of hyperthyroidism.
Systems involved-gastrointestinal (weight loss, diarrhea, abdominal pain), cardiovascular (edema, chest pain, dyspnea, palpitations), and neurologic/mental status (delirium psychosis, somnolence, or coma).

Insulin

Regular, short-acting, and long-acting insulins.
Important for those who need multiple types or are adjusting to a specific treatment.
Safety precautions are critical when dealing with insulin.

Wound Dehiscence and Evisceration

Disruption of surgical incision or wound. Severe injuries are especially serious.
Factors that increase risk may include increasing age; anemia; poor nutrition; obesity; and malignancy,
Abdominal binder may provide support and guard against dehiscence, especially for patients with weak abdominal walls, or when a previously closed wound has opened.

Galantamine

Medication approved for mild to moderate dementia
Can have side effects like insomnia, tremor, dizziness, and headache.
Should be taken with food to decrease upset stomach.

Sinemet

Medication combination of levodopa and carbidopa, used to treat Parkinson's.
Should not be taken with a high-protein meal.
Adequate fluid intake is essential

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Description

Test your knowledge on key components of preoperative assessment, postoperative priorities, and effective pain management strategies. This quiz covers essential practices that ensure patient safety before and after surgery.