Podcast
Questions and Answers
Which of the following is the primary purpose of preoperative teaching?
Which of the following is the primary purpose of preoperative teaching?
- To inform the patient about hospital policies
- To explain the entire surgical procedure in detail
- To reduce anxiety and enhance recovery (correct)
- To ensure the patient signs the consent form
Which of the following are considered high-risk medications that may increase intraoperative and postoperative complications? (Select all that apply)
Which of the following are considered high-risk medications that may increase intraoperative and postoperative complications? (Select all that apply)
- Warfarin (correct)
- Lisinopril (correct)
- Herbal supplements (correct)
- Steroids (correct)
- Multivitamins
A patient scheduled for surgery states, “I'm not sure I want to go through with this.” What is the nurse's best action?
A patient scheduled for surgery states, “I'm not sure I want to go through with this.” What is the nurse's best action?
- Reassure the patient that everything will be fine
- Ask the patient to sign the consent quickly
- Notify the surgeon immediately (correct)
- Administer the preoperative sedative
The nurse notes a latex allergy in a patient's record. Which item should the nurse avoid bringing into the operating room?
The nurse notes a latex allergy in a patient's record. Which item should the nurse avoid bringing into the operating room?
Which are SCIP (Surgical Care Improvement Project) measures designed to prevent surgical complications? (Select all that apply)
Which are SCIP (Surgical Care Improvement Project) measures designed to prevent surgical complications? (Select all that apply)
During the "Time Out" in the OR, what is the nurse responsible for verifying?
During the "Time Out" in the OR, what is the nurse responsible for verifying?
A nurse in PACU notices a patient has shallow respirations and oxygen saturation of 88%. What is the nurse's first action?
A nurse in PACU notices a patient has shallow respirations and oxygen saturation of 88%. What is the nurse's first action?
Which assessment finding requires immediate intervention in the first hour after surgery?
Which assessment finding requires immediate intervention in the first hour after surgery?
Which findings would suggest postoperative hemorrhage? (Select all that apply)
Which findings would suggest postoperative hemorrhage? (Select all that apply)
You are developing a teaching plan for a post-op patient to prevent atelectasis. What will you include?
You are developing a teaching plan for a post-op patient to prevent atelectasis. What will you include?
Why is it important for a patient to be NPO prior to surgery?
Why is it important for a patient to be NPO prior to surgery?
The nurse is reviewing a patient's medications during pre-op. Which of these should be reported to the anesthesia provider? (Select all that apply)
The nurse is reviewing a patient's medications during pre-op. Which of these should be reported to the anesthesia provider? (Select all that apply)
During intraoperative positioning, which nursing action is most important?
During intraoperative positioning, which nursing action is most important?
A nurse in PACU is monitoring for signs of ineffective oxygenation. Which findings require immediate action? (Select all that apply)
A nurse in PACU is monitoring for signs of ineffective oxygenation. Which findings require immediate action? (Select all that apply)
What is the main purpose of the Aldrete Score in PACU?
What is the main purpose of the Aldrete Score in PACU?
Which statement indicates a patient understands teaching about incentive spirometry?
Which statement indicates a patient understands teaching about incentive spirometry?
You are designing a postoperative care plan for a patient. Which nursing interventions help reduce VTE risk? (Select all that apply)
You are designing a postoperative care plan for a patient. Which nursing interventions help reduce VTE risk? (Select all that apply)
A postoperative patient complains of nausea and is vomiting small amounts. Which intervention should the nurse perform first?
A postoperative patient complains of nausea and is vomiting small amounts. Which intervention should the nurse perform first?
The PACU nurse notes a patient is shivering and hypothermic. Which action is most appropriate?
The PACU nurse notes a patient is shivering and hypothermic. Which action is most appropriate?
The nurse observes that a patient has increasing drainage from a surgical wound. Which action is most appropriate?
The nurse observes that a patient has increasing drainage from a surgical wound. Which action is most appropriate?
What is the nurse's legal responsibility regarding informed consent before surgery?
What is the nurse's legal responsibility regarding informed consent before surgery?
Which of the following are common postoperative respiratory complications? (Select all that apply)
Which of the following are common postoperative respiratory complications? (Select all that apply)
Which assessment finding in a PACU patient would prompt the nurse to intervene immediately?
Which assessment finding in a PACU patient would prompt the nurse to intervene immediately?
Which actions should the nurse take to prevent postoperative infection? (Select all that apply)
Which actions should the nurse take to prevent postoperative infection? (Select all that apply)
A post-op patient becomes confused and restless. Oxygen saturation is 89%. What should the nurse do first?
A post-op patient becomes confused and restless. Oxygen saturation is 89%. What should the nurse do first?
What is the purpose of using a surgical checklist before transporting a patient to the OR?
What is the purpose of using a surgical checklist before transporting a patient to the OR?
A patient is receiving opioids for pain after surgery. What side effects should the nurse monitor for? (Select all that apply)
A patient is receiving opioids for pain after surgery. What side effects should the nurse monitor for? (Select all that apply)
A nurse receives a PACU report for a patient who had spinal anesthesia. What is a priority nursing assessment?
A nurse receives a PACU report for a patient who had spinal anesthesia. What is a priority nursing assessment?
Which intervention is part of standard VTE prophylaxis after surgery?
Which intervention is part of standard VTE prophylaxis after surgery?
A post-op patient has not voided 8 hours after surgery. What possible causes should the nurse consider? (Select all that apply)
A post-op patient has not voided 8 hours after surgery. What possible causes should the nurse consider? (Select all that apply)
The intraoperative nurse sees the patient's blood pressure rapidly declining. What is the nurse's priority action?
The intraoperative nurse sees the patient's blood pressure rapidly declining. What is the nurse's priority action?
What are the goals of general anesthesia? (Select all that apply)
What are the goals of general anesthesia? (Select all that apply)
Which intraoperative position carries the greatest risk for pressure injury to the ulnar nerve?
Which intraoperative position carries the greatest risk for pressure injury to the ulnar nerve?
A nurse is developing a care plan to support thermoregulation post-op. Which interventions should be included? (Select all that apply)
A nurse is developing a care plan to support thermoregulation post-op. Which interventions should be included? (Select all that apply)
The nurse notes redness and swelling around a surgical site 2 days post-op. What is the best action?
The nurse notes redness and swelling around a surgical site 2 days post-op. What is the best action?
Which is a priority assessment for a patient receiving regional anesthesia?
Which is a priority assessment for a patient receiving regional anesthesia?
Which assessments are part of the Aldrete Score used in PACU? (Select all that apply)
Which assessments are part of the Aldrete Score used in PACU? (Select all that apply)
A nurse is preparing to transport a patient to surgery. The patient says, “I don't remember signing the consent.” What should the nurse do?
A nurse is preparing to transport a patient to surgery. The patient says, “I don't remember signing the consent.” What should the nurse do?
Which patients are at higher risk for postoperative complications? (Select all that apply)
Which patients are at higher risk for postoperative complications? (Select all that apply)
Which postoperative finding is most concerning and requires immediate action?
Which postoperative finding is most concerning and requires immediate action?
The nurse is preparing to teach a post-op patient how to use an incentive spirometer. What should the nurse instruct the patient to do?
The nurse is preparing to teach a post-op patient how to use an incentive spirometer. What should the nurse instruct the patient to do?
Which factors increase a patient's risk for latex allergy? (Select all that apply)
Which factors increase a patient's risk for latex allergy? (Select all that apply)
Which finding in a post-op patient suggests a developing wound infection?
Which finding in a post-op patient suggests a developing wound infection?
A nurse in PACU notes a patient has a respiratory rate of 6 breaths/min, is difficult to arouse, and received morphine. What are the priority actions? (Select all that apply)
A nurse in PACU notes a patient has a respiratory rate of 6 breaths/min, is difficult to arouse, and received morphine. What are the priority actions? (Select all that apply)
You're preparing discharge instructions for a post-op patient. What should be included to prevent complications at home?
You're preparing discharge instructions for a post-op patient. What should be included to prevent complications at home?
What is a common complication of spinal anesthesia during recovery?
What is a common complication of spinal anesthesia during recovery?
Which interventions help prevent postoperative pneumonia? (Select all that apply)
Which interventions help prevent postoperative pneumonia? (Select all that apply)
A post-op patient with diabetes has a blood glucose of 65 mg/dL. Which symptom would you expect?
A post-op patient with diabetes has a blood glucose of 65 mg/dL. Which symptom would you expect?
Which patient behavior after receiving discharge teaching shows they need more instruction?
Which patient behavior after receiving discharge teaching shows they need more instruction?
A nurse is designing a teaching plan for a patient going home after abdominal surgery. What topics should be included? (Select all that apply)
A nurse is designing a teaching plan for a patient going home after abdominal surgery. What topics should be included? (Select all that apply)
Flashcards
Purpose of Preoperative Teaching
Purpose of Preoperative Teaching
Preoperative teaching reduces anxiety, improves cooperation, and leads to better postoperative outcomes.
High-Risk Pre-op Medications
High-Risk Pre-op Medications
ACE inhibitors, anticoagulants, steroids, and herbal supplements may increase bleeding risk or interfere with anesthesia.
Patient expresses doubt about surgery
Patient expresses doubt about surgery
If a patient expresses doubt about surgery, notify the surgeon and delay premedication.
Latex Allergy: What to Avoid
Latex Allergy: What to Avoid
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SCIP Measures
SCIP Measures
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"Time Out" in the OR
"Time Out" in the OR
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Shallow Respirations Post-Anesthesia
Shallow Respirations Post-Anesthesia
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Post-op Respiratory Rate of 8
Post-op Respiratory Rate of 8
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Postoperative Hemorrhage
Postoperative Hemorrhage
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Preventing Atelectasis Post-Op
Preventing Atelectasis Post-Op
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NPO before Surgery
NPO before Surgery
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Medications to Report Pre-op
Medications to Report Pre-op
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Intraoperative Positioning: Nursing Priority
Intraoperative Positioning: Nursing Priority
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Ineffective Oxygenation Signs
Ineffective Oxygenation Signs
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Aldrete Score Purpose
Aldrete Score Purpose
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Correct Incentive Spirometry Technique
Correct Incentive Spirometry Technique
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Nursing Interventions to Reduce VTE Risk
Nursing Interventions to Reduce VTE Risk
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Post-op Vomiting
Post-op Vomiting
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Shivering Post-Op
Shivering Post-Op
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Increasing Surgical Wound Drainage
Increasing Surgical Wound Drainage
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Study Notes
- Preoperative teaching reduces anxiety, improves cooperation, and leads to better postoperative outcomes.
- The nurse does not explain the full surgical procedure, as that is the surgeon's role.
- Consent is not the sole reason for preoperative teaching.
- High-risk medications that may increase intraoperative and postoperative complications include:
- Lisinopril
- Warfarin
- Steroids
- Herbal supplements
- These medications may increase bleeding risk or interfere with anesthesia.
- Multivitamins are not typically high-risk perioperatively.
- If a patient scheduled for surgery expresses doubt ("I'm not sure I want to go through with this"), notify the surgeon immediately.
- Informed consent must be voluntary.
- Proceeding without clarification violates ethical and legal standards.
- If a patient has a latex allergy, avoid bringing natural rubber gloves into the operating room.
- Silicone foley catheters, non-latex tourniquets, and polyvinyl oxygen masks are latex-free alternatives.
- Surgical Care Improvement Project (SCIP) measures designed to prevent surgical complications include:
- Maintaining normothermia
- Administering prophylactic antibiotics
- Preventing venous thromboembolism
- Straight razor use is discouraged due to skin microabrasions.
- During the "Time Out" in the OR, the nurse is responsible for verifying the surgical site, procedure, and patient identity.
- The "Time Out" is a critical safety step to verify correct patient identity, procedure, and site before surgery begins.
- If a nurse in PACU notices a patient has shallow respirations and oxygen saturation of 88%, stimulate the patient and apply oxygen.
- The most immediate concern is hypoxia.
- Supplemental oxygen and stimulation are first-line interventions.
- A respiratory rate of 8 breaths/min requires immediate intervention in the first hour after surgery.
- A respiratory rate of 8 indicates hypoventilation, possibly due to anesthetic or opioid effects, and poses a risk for respiratory depression.
- Findings that would suggest postoperative hemorrhage include:
- Increasing pulse rate
- Decreased blood pressure
- Increased drainage on dressing
- Sudden drowsiness
- Signs of hemorrhage include tachycardia, hypotension, excessive bleeding, and altered mental status.
- Pink, warm skin is not a sign of hemorrhage.
- A teaching plan for a post-op patient to prevent atelectasis should include encouraging deep breathing and the use of incentive spirometry.
- Deep breathing exercises and incentive spirometry are key in preventing atelectasis by promoting lung expansion.
- Early ambulation and adequate hydration are also essential.
- It is important for a patient to be NPO (nothing by mouth) prior to surgery to prevent aspiration during anesthesia induction.
- Being NPO minimizes the risk of aspiration, a potentially fatal complication during anesthesia induction.
- Medications that should be reported to the anesthesia provider during pre-op include:
- Warfarin
- Clopidogrel
- Herbal supplements
- Insulin
- Anticoagulants, antiplatelets, insulin, and herbals can affect bleeding and glucose levels or interact with anesthesia.
- Multivitamins are not typically a concern.
- During intraoperative positioning, the most important nursing action is preventing pressure on bony prominences.
- Preventing pressure ulcers and nerve damage is a critical intraoperative responsibility.
- Signs of ineffective oxygenation that require immediate action include:
- Restlessness
- SpO2 of 91%
- Use of accessory muscles
- Shallow respirations
- The main purpose of the Aldrete Score in PACU is to assess readiness for discharge from PACU.
- The Aldrete Score evaluates key recovery parameters (e.g., respiration, circulation, consciousness) to determine when a patient can leave PACU.
- The statement that indicates a patient understands teaching about incentive spirometry is: "I should take slow, deep breaths into it regularly."
- Incentive spirometry encourages deep inhalation to prevent atelectasis and must be used regularly, not just during coughing episodes.
- Nursing interventions that help reduce VTE risk include:
- Early ambulation
- Sequential compression devices (SCDs)
- Administration of low-dose heparin
- VTE prevention includes early mobilization, mechanical compression (SCDs), and pharmacologic anticoagulation. Spirometry helps lungs; protein aids healing.
- If a postoperative patient complains of nausea and is vomiting small amounts, the nurse should first position the patient in a side-lying position.
- Airway protection is the first priority.
- Positioning reduces aspiration risk.
- Medication and provider notification follow.
- If the PACU nurse notes a patient is shivering and hypothermic, the most appropriate action is to apply warm blankets or a Bair Hugger.
- Post-anesthesia hypothermia is common.
- If the nurse observes that a patient has increasing drainage from a surgical wound, the most appropriate action is to notify the provider and assess vitals.
- Increasing drainage may indicate hemorrhage or infection.
- The nurse's legal responsibility regarding informed consent before surgery is witnessing the patient's signature on the consent form.
- The nurse's legal responsibility is to witness the patient's signature and verify they are signing voluntarily.
- The surgeon explains risks and benefits.
- Common postoperative respiratory complications include:
- Atelectasis
- Pneumonia
- Pulmonary embolism
- Atelectasis, pneumonia, and pulmonary embolism are respiratory complications.
- Hypotension in PACU may indicate internal bleeding or shock and requires immediate evaluation.
- Other findings are expected post-op.
- Actions to prevent postoperative infection include:
- Perform hand hygiene before and after care
- Use sterile technique when changing dressings
- Encourage high-protein diet
- Educate patient on incision care
- Infection prevention involves hygiene, sterile technique, nutrition, and patient education.
- If a post-op patient becomes confused and restless and oxygen saturation is 89%, apply oxygen via nasal cannula.
- Restlessness and low SpO2 suggest hypoxia.
- Applying oxygen is the priority.
- The purpose of using a surgical checklist before transporting a patient to the OR is to improve communication and patient safety.
- Surgical checklists reduce errors and enhance team communication.
- If a patient is receiving opioids for pain after surgery, the nurse should monitor for:
- Respiratory depression
- Constipation
- Sedation
- Bradycardia
- Opioids commonly cause respiratory depression, constipation, sedation, and bradycardia.
- If a nurse receives a PACU report for a patient who had spinal anesthesia, the priority nursing assessment is the ability to move lower extremities.
- After spinal anesthesia, monitoring for motor function return is essential to identify prolonged blockade or complications like hematoma.
- An intervention that is part of standard VTE prophylaxis after surgery is applying sequential compression devices.
- SCDs help promote venous return and prevent clot formation.
- Possible causes for a post-op patient not voiding 8 hours after surgery include:
- Urinary retention from anesthesia
- Fluid volume deficit
- Urethral trauma
- Opioid side effects
- Anesthesia, low fluid volume, trauma, and opioids can cause urinary retention.
- If the intraoperative nurse sees the patient's blood pressure rapidly declining, the nurse's priority action is to notify the anesthesia provider immediately.
- A rapid drop in blood pressure during surgery requires immediate attention from the anesthesia provider.
- The goals of general anesthesia are to:
- Provide analgesia
- Cause temporary paralysis
- Induce amnesia
- General anesthesia aims to provide analgesia, amnesia, and muscle relaxation (paralysis).
- The intraoperative position that carries the greatest risk for pressure injury to the ulnar nerve is the lateral position.
- In the lateral position, improper arm placement can compress the ulnar nerve, leading to injury.
- Interventions to support thermoregulation post-op include:
- Use of Bair Hugger or warm blankets
- Avoiding prolonged OR exposure
- Monitoring core body temperature
- Prevention of hypothermia involves external warming devices, limiting exposure, and monitoring temperature.
- If the nurse notes redness and swelling around a surgical site 2 days post-op, the best action is to notify the healthcare provider.
- Redness and swelling may indicate infection.
- A priority assessment for a patient receiving regional anesthesia is the return of sensation and movement.
- After regional anesthesia, it's essential to monitor for the return of sensory and motor function to detect complications like nerve damage or prolonged block.
- Assessments that are part of the Aldrete Score used in PACU include:
- Respiratory effort
- Circulation (blood pressure)
- Consciousness level
- A nurse is preparing to transport a patient to surgery. The patient says, "I don't remember signing the consent." The nurse should notify the surgeon immediately.
- If a patient doesn't remember giving consent, it must be clarified before proceeding.
- Patients at higher risk for postoperative complications include:
- A 78-year-old with COPD
- A 45-year-old with BMI of 42
- A 65-year-old with diabetes and hypertension
- The postoperative finding that is most concerning and requires immediate action is a respiratory rate of 10 breaths/min.
- A respiratory rate of 10 may indicate opioid-induced respiratory depression and requires urgent intervention to maintain airway and oxygenation.
- When teaching a post-op patient how to use an incentive spirometer, the nurse should instruct the patient to inhale deeply into the device and hold for several seconds.
- The incentive spirometer promotes deep inhalation and expanding the lungs.
- Factors that increase a patient's risk for latex allergy include:
- History of hay fever
- Allergy to bananas and avocados
- Long-term exposure to medical gloves
- A finding in a post-op patient that suggests a developing wound infection is purulent drainage and fever.
- If a nurse in PACU notes a patient has a respiratory rate of 6 breaths/min, is difficult to arouse, and received morphine, the priority actions are:
- Stimulate the patient to breathe
- Call for rapid response or anesthesia
- Administer naloxone per standing order
- Respiratory depression likely requires stimulation and naloxone.
- Discharge instructions for a post-op patient should include: "Call if you experience shortness of breath or leg swelling."
- Shortness of breath and leg swelling may indicate VTE or pulmonary embolism.
- A common complication of spinal anesthesia during recovery is urinary retention.
- Interventions to help prevent postoperative pneumonia include:
- Early ambulation
- Deep breathing exercises
- Use of incentive spirometer
- A post-op patient with diabetes has a blood glucose of 65 mg/dL. The expected symptom is cool, clammy skin.
- Hypoglycemia causes adrenergic symptoms like sweating, clammy skin, and confusion.
- Patient behavior after receiving discharge teaching that shows they need more instruction: "I'll stop taking my blood thinner until I feel better."
- Patients should not discontinue anticoagulants without a provider's order due to increased VTE risk.
- A nurse is designing a teaching plan for a patient going home after abdominal surgery, the topics should include:
- Signs of wound infection
- How to prevent constipation
- Pain management plan
- Activity restrictions
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