Questions and Answers
What is a crucial criterion for safely discharging a postoperative patient from recovery?
Which of the following statements about dormant tuberculosis (TB) is true?
What is the initial phase of treatment for active tuberculosis (TB)?
During active tuberculosis treatment, which precaution must be taken for the patient?
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What nursing management aspect is important when caring for a patient with active TB?
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What is the importance of two consecutive negative cultures in the diagnosis of TB?
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In terms of patient teaching, which of the following is most crucial for someone diagnosed with active TB?
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Which of the following is a characteristic of a patient with dormant TB?
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What is a primary benefit of effective preoperative teaching?
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Which patient information is essential to gather about medications preoperatively?
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What does the surgical 'time-out' process ensure?
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What should a preoperative nurse ensure about the informed consent?
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Which comorbidity is NOT typically associated with increased surgical risk?
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Why is it important to document allergy findings for a surgical patient?
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What is a significant sign of malignant hyperthermia to monitor for in patients?
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What is the role of the circulator nurse in the operating room?
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What is the recommended action for a patient with a known history of substance abuse undergoing surgery?
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How should a nurse respond to a patient expressing fear about anesthesia?
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What should be accomplished prior to transporting a patient to the OR?
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For the prevention of surgical site infections, when should prophylactic antibiotics be administered?
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Which type of anesthesia is associated with total loss of sensation and consciousness?
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Which intervention is NOT appropriate for preventing hypoxemia in postoperative patients?
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What is a common cause of hypotension in postoperative patients?
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Which of the following symptoms is associated with hypoventilation?
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What is an important nursing action to manage emergence delirium?
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What type of medication management is recommended for effective postoperative pain control?
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Which statement about postoperative nausea and vomiting (PONV) is true?
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What is the priority nursing action for managing postoperative urinary retention?
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What is the expected nursing practice for temperature management in postoperative patients?
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Which complication is the most common cause of postoperative fever?
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What should be assessed first in patients exhibiting postoperative cognitive dysfunction?
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What factor primarily contributes to the risk of developing SSI?
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Which is NOT a cause of post-operative ileus?
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What is an important assessment related to skin integrity in postoperative patients?
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What should be done if a patient has a decreased urine output postoperatively?
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What is the primary goal of treating patients with pulmonary fungal infections?
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Which medication may cause hepatotoxicity and requires monitoring of liver function tests?
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Which of the following symptoms is NOT a cardinal sign of acute exacerbation of COPD?
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What is a potential complication associated with prolonged ischemia in PAD patients?
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What diagnostic test is commonly used to confirm the diagnosis of bronchiectasis?
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Which condition is most likely to cause orthopnea and requires the use of accessory muscles for breathing?
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How should nutritional therapy be adapted for patients with COPD?
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What is the primary treatment focus for patients with venous insufficiency?
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Which type of therapy is essential for patients with a multi-drug resistant strain of tuberculosis?
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Which technique is NOT considered an airway clearance technique for patients with COPD?
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What vital sign change is significant in the assessment of someone with COPD?
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What is the purpose of using antiplatelet therapy in patients with PAD?
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Which of the following is a contraindication for using rifampin?
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What is the primary goal for clients with progressive neurological diseases?
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Which medication is primarily used for managing seizures in epilepsy?
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Which dietary factors can trigger headaches?
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What is the recommended first course of action for managing a tonic-clonic seizure?
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In patients with Huntington's disease, what calorie intake is often required to maintain weight?
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What is a common characteristic of multiple sclerosis (MS) in terms of disease management?
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Which of the following is NOT a common precipitating factor for restless leg syndrome?
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What is the first-line treatment for managing acute myasthenic crisis symptoms?
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In patients with Parkinson's disease, what is the primary medication used for treatment?
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What is an important safety advice for individuals with epilepsy?
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Which of the following treatments is recommended for chronic headaches?
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Which medication is commonly used as a preventative treatment for migraines?
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Which condition is characterized by the presence of generalized seizures that may involve only tonic or clonic movements?
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Study Notes
Preoperative Nursing Care
- Educating and preparing patients reduces postoperative anxiety, leading to improved outcomes.
- Effective teaching boosts patient satisfaction and diminishes complications, length of stay (LOS), and recovery time.
- Initiation of patient education occurs in the surgeon's office and is reinforced on the day of surgery.
- Prioritize information based on individual patient needs and document teaching efforts to streamline admissions.
- Essential information categories:
- Sensory: patient experiences before/after anesthesia.
- Procedural: details on timing, restrictions, comfort measures, anesthesia, and site markings.
- Process: information on the admissions, preoperative area, OR, PACU, and family updates.
- Preoperative nurses clarify testing results, associated risks, and implement coping strategies while maintaining effective communication and documentation.
Health History and Assessment
- Collect comprehensive health history to mitigate surgical risks, including past surgeries, menstrual and obstetric history, and family medical history.
- Medication assessment: obtain all prescription and over-the-counter medications, including herbs that may affect surgery; review timing for administration or withholding doses.
- Allergies must be documented accurately, with specific attention to severity and possible reactions; include environmental and food allergies.
- Review of Systems (ROS) includes cardiovascular, respiratory, neurological, gastrointestinal, hepatic, integumentary, musculoskeletal, endocrine, immune system, fluid and electrolyte status, and nutritional concerns.
- Identify and address potential complications from comorbidities such as obesity, diabetes, and respiratory issues.
Communication and Consent
- Effective communication during the perioperative phase is crucial to prevent errors.
- Nurses advocate for the patient by ensuring they have all necessary information regarding their surgery.
- Surgical consent must include complete diagnosis disclosure, risks, benefits, and must be voluntarily signed without coercion.
- Special provisions apply for minors and individuals deemed unable to give consent.
Preoperative Checklist and Transport
- Preoperative nurses validate that all orders are followed and checklists are completed before OR transport.
- Checklist items include verifying consent, ensuring the patient is NPO, confirming presence of test results, skin preparation, and removal of personal items (dentures, jewelry).
- Administer preoperative medications like benzodiazepines and ensure IV antibiotics are ready.
Intraoperative and Postoperative Nursing Care
- Different zones in the surgical environment: unrestricted (public access), semi-restricted (authorized staff), and restricted (sterile area).
- Emphasis on safety and teamwork through clear communication and structured protocols (e.g., SBAR).
- Surgical checklists ensure compliance with procedures and protocols (e.g., Universal Protocol).
- Monitor anesthesia type and patient assessment to communicate potential concerns effectively.
Complications and Monitoring
- Postoperative complications include respiratory issues, cardiovascular problems, neurologic changes, and pain management.
- Key respiratory complications:
- Airway obstruction or hypoxemia requires patient repositioning and oxygen administration.
- Hypoventilation may need assessment of the level of sedation before opioid administration.
- Cardiovascular complications like hypotension and dysrhythmias must be monitored for perfusion adequacy and electrolyte balance.
- Neurological issues include emergence delirium and postoperative cognitive dysfunction, necessitating thorough neuro assessments.
Pain and Temperature Management
- Postoperative pain needs effective assessment and management to prevent complications like atelectasis.
- Multimodal analgesia should be used for optimal pain control; monitor regularly.
- Temperature management involves frequent monitoring; hypothermia can arise from exposure or anesthesia, while fever may indicate infection.
Gastrointestinal and Urinary Concerns
- Significant postoperative nausea/vomiting rates; management includes hydration and medications.
- Constipation and postoperative ileus are common, requiring hydration and ambulation to resolve.
- Urinary retention is commonly seen post-surgery, necessitating prompt assessment and interventions.
Surgical Site Infection (SSI) Prevention
- SSIs significantly prolong recovery and increase costs; adherence to safety protocols is essential.
- Nursing care should incorporate hand hygiene, proper antibiotic administration, and maintaining normothermia for prevention.
Discharge Criteria
- Patients must meet specific criteria before being released from the PACU or discharged home; monitoring for stability and recovery is crucial.### Postoperative Patient Discharge
- Safe discharge criteria: easily arousable, stable vital signs, O2 saturation > 90%, controlled pain and nausea/vomiting.
- Important assessments include vital signs, sedation scale, presence of drains, pain, and general focused assessment.
- Communication between nursing units facilitated via SBAR (Situation, Background, Assessment, Recommendation).
Tuberculosis (TB) Management
- TB can remain dormant for years, progressing to active disease, characterized by a positive TB test, normal chest X-ray initially, and no symptoms.
- Active TB is contagious and requires aggressive treatment with a combination of 1st and 2nd line agents over 6-9 months.
- Nursing care includes risk assessment, planning for adherence to medication, patient education, and airborne precautions.
Active TB Treatment
- Multi-drug resistant TB necessitates directly observed therapy (DOT) to ensure compliance.
- Medications like isoniazid should be monitored for hepatotoxicity, rifampin can stain secretions and interfere with contraception, pyrazinamide may raise uric acid levels, and ethambutol poses eye health risks.
Pulmonary Fungal Infections
- Histoplasmosis is caused by inhaling spores and presents like bacterial pneumonia; diagnosed with specific blood tests and chest CT.
- Treatment involves oxygen, IV amphotericin B, and prolonged oral antifungal therapy.
Bronchiectasis Diagnosis and Treatment
- Protocols for diagnosis include CT chest scans, sputum cultures, and pulmonary function tests.
- Treatment focuses on preventing infections and flare-ups through antibiotics, airway clearance techniques, and vaccinations.
Dyspnea Management
- Early assessment of respiratory acidosis and hypoxemia is essential; non-invasive mechanical ventilation may be necessary.
- Pharmacological options include bronchodilators and corticosteroids, with additional antibiotics if indicated.
Chronic Obstructive Pulmonary Disease (COPD)
- Symptoms include progressive dyspnea, chronic cough, and chest heaviness; exacerbations often show increased dyspnea and sputum changes.
- Management includes oxygen therapy, breathing retraining, and nutritional support to prevent weight loss; pulmonary rehabilitation is beneficial.
Peripheral Artery Disease (PAD)
- Symptoms include claudication pain, pallor, diminished pulses, and ulceration; treatment focuses on restoring blood flow.
- Surgical options include revascularization or conservative management through angioplasty or lifestyle changes.
Venous Insufficiency
- Characterized by edema, pain, and skin changes; treatment aims to improve venous return through compression and skin care.
- Complications can include venous stasis ulcers which require specific wound care and lifestyle adaptations.
Myasthenia Gravis (MG) and Amyotrophic Lateral Sclerosis (ALS)
- MG management focuses on ventilation and adjusting medications for peak effectiveness; corticosteroids may be utilized.
- ALS care emphasizes infection risk reduction and supportive respiratory strategies.
Seizure Management
- Tonic-clonic seizures require vigilance for patient safety; caregivers should monitor and document seizure activity.
- Headache and epilepsy triggers include diet, stress, and structural brain issues; treatment incorporates various medications, including NSAIDs and anticonvulsants.
Neurological Disorders Management
- Goals for progressive neurological diseases include safety, function maintenance, and quality of life improvement.
- Conditions like MS and Parkinson’s require tailored medication strategies to mitigate symptoms and prevent complications; patient and caregiver education is crucial for effective management.
Restless Leg Syndrome (RLS) and Multiple Sclerosis (MS)
- RLS is treated by addressing underlying causes and using medications that enhance comfort.
- MS treatment involves immunomodulators and education on mobility limitations, self-care, and maximizing independence.
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Description
This quiz focuses on the essential aspects of preoperative nursing care, emphasizing education and preparation to alleviate client anxiety and improve postoperative outcomes. Learn about the benefits of effective teaching and how information provided before surgery can enhance patient satisfaction and recovery.
