Podcast
Questions and Answers
Which of the following best describes the nurse's role in obtaining informed consent?
Which of the following best describes the nurse's role in obtaining informed consent?
- The nurse obtains verbal consent from the patient before surgery.
- The nurse independently assesses the patient's understanding of the procedure.
- The nurse is responsible for explaining the risks and benefits of the procedure.
- The nurse ensures the consent form is signed before administering preoperative medication. (correct)
Which of the following medications would require close monitoring due to increased intraoperative and postoperative risk?
Which of the following medications would require close monitoring due to increased intraoperative and postoperative risk?
- Lisinopril
- Warfarin
- Metformin
- All of the above (correct)
Which patient is at highest risk for complications during surgery?
Which patient is at highest risk for complications during surgery?
- A 68-year-old diabetic patient with chronic kidney disease (correct)
- A 40-year-old smoker with controlled hypertension
- A 25-year-old athlete with no medical history
- A 50-year-old patient with seasonal allergies
A patient with a latex allergy is scheduled for surgery. What should the nurse do first?
A patient with a latex allergy is scheduled for surgery. What should the nurse do first?
Which assessment finding in the preoperative patient should be reported to the surgeon immediately?
Which assessment finding in the preoperative patient should be reported to the surgeon immediately?
Which of the following actions would best reduce the risk of postoperative pneumonia? (SATA)
Which of the following actions would best reduce the risk of postoperative pneumonia? (SATA)
A patient on warfarin is scheduled for surgery in 48 hours. What is the nurse's priority action?
A patient on warfarin is scheduled for surgery in 48 hours. What is the nurse's priority action?
Which patient statement requires further teaching regarding preoperative care?
Which patient statement requires further teaching regarding preoperative care?
Which intervention best prevents venous thromboembolism (VTE) postoperatively? (SATA)
Which intervention best prevents venous thromboembolism (VTE) postoperatively? (SATA)
A 74-year-old patient with a history of COPD is scheduled for elective colon surgery. What should the nurse prioritize in preoperative teaching?
A 74-year-old patient with a history of COPD is scheduled for elective colon surgery. What should the nurse prioritize in preoperative teaching?
A patient is anxious about surgery and asks, “What if I don't wake up?” Which is the best nursing response?
A patient is anxious about surgery and asks, “What if I don't wake up?” Which is the best nursing response?
Which of the following factors places a patient at high risk for poor wound healing postoperatively? (SATA)
Which of the following factors places a patient at high risk for poor wound healing postoperatively? (SATA)
What is the primary purpose of preoperative patient teaching?
What is the primary purpose of preoperative patient teaching?
Which laboratory value is most critical to check before surgery for a patient on warfarin?
Which laboratory value is most critical to check before surgery for a patient on warfarin?
Which electrolyte imbalance is most concerning before surgery?
Which electrolyte imbalance is most concerning before surgery?
Which action by the nurse best ensures patient safety before surgery?
Which action by the nurse best ensures patient safety before surgery?
A diabetic patient is scheduled for surgery at 0800. Which pre-op order should the nurse question?
A diabetic patient is scheduled for surgery at 0800. Which pre-op order should the nurse question?
What is the primary nursing intervention for a patient with a high risk of postoperative nausea and vomiting?
What is the primary nursing intervention for a patient with a high risk of postoperative nausea and vomiting?
Which patient statement indicates correct understanding of post-op pain management?
Which patient statement indicates correct understanding of post-op pain management?
Which preoperative patient assessment finding requires immediate intervention? (SATA)
Which preoperative patient assessment finding requires immediate intervention? (SATA)
A patient is scheduled for surgery at 0900. The nurse reviews the chart and notices that the consent form is unsigned. What should the nurse do next?
A patient is scheduled for surgery at 0900. The nurse reviews the chart and notices that the consent form is unsigned. What should the nurse do next?
Which patient is at highest risk for a latex allergy?
Which patient is at highest risk for a latex allergy?
A patient refuses surgery after the surgeon explains the procedure. What is the nurse's best response?
A patient refuses surgery after the surgeon explains the procedure. What is the nurse's best response?
Which postoperative complication is most concerning in an elderly patient? (SATA)
Which postoperative complication is most concerning in an elderly patient? (SATA)
A post-op patient is not voiding despite IV fluids. What should the nurse do first?
A post-op patient is not voiding despite IV fluids. What should the nurse do first?
A patient is 2 hours post-op from abdominal surgery and reports severe pain despite opioid administration. What should the nurse do next?
A patient is 2 hours post-op from abdominal surgery and reports severe pain despite opioid administration. What should the nurse do next?
Which assessment finding requires immediate intervention postoperatively? (SATA)
Which assessment finding requires immediate intervention postoperatively? (SATA)
A patient with COPD is extubated postoperatively. What is the priority intervention?
A patient with COPD is extubated postoperatively. What is the priority intervention?
Flashcards
Nurse's role in informed consent
Nurse's role in informed consent
Ensuring the consent form is signed before administering preoperative medication; acting as a witness, not obtaining consent.
Medications requiring close monitoring
Medications requiring close monitoring
Anticoagulants (Warfarin), Anti-hypertensives (Lisinopril), and Diabetic medications (Metformin).
Patient at highest risk for surgical complications
Patient at highest risk for surgical complications
Patients with diabetes and chronic kidney disease are at higher risk for poor wound healing, electrolyte imbalances, and cardiovascular complications.
First action for patient with latex allergy
First action for patient with latex allergy
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Report this preoperative assessment
Report this preoperative assessment
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Actions to reduce postoperative pneumonia
Actions to reduce postoperative pneumonia
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Priority action for patient on warfarin
Priority action for patient on warfarin
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Preoperative care teaching
Preoperative care teaching
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Prevent venous thromboembolism (VTE)
Prevent venous thromboembolism (VTE)
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Priority in preoperative teaching for COPD
Priority in preoperative teaching for COPD
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Study Notes
- The nurse ensures the consent form is signed before administering preoperative medication
- The surgeon explains the procedure, risks, and benefits
- The nurse witnesses the signature but does not obtain consent
- Anticoagulants (warfarin) increase bleeding risk and require close monitoring
- Antihypertensives (lisinopril) may cause hypotension and require close monitoring
- Diabetic medications (metformin) may lead to lactic acidosis and hypoglycemia during fasting and require close monitoring
- A 68-year-old diabetic patient with chronic kidney disease is at highest risk for complications during surgery
- This is due to higher risk for poor wound healing, electrolyte imbalances, and cardiovascular complications
- Inform the surgical team and ensure latex-free products are used for a patient with a latex allergy
- Schedule patients with latex allergies as the first case of the day with latex-free materials
- Report a patient stating, "I don't understand the surgery," to the surgeon immediately
- Lack of understanding indicates inadequate informed consent, requiring clarification
Reducing Postoperative Pneumonia Risk
- Early ambulation reduces the risk
- Incentive spirometry reduces the risk
- Deep breathing and coughing exercises reduce the risk
- Assess the INR level as the priority action for a patient on warfarin scheduled for surgery in 48 hours
- INR guides the management of anticoagulation therapy preoperatively
- "I can eat a light breakfast the morning of my surgery" requires further teaching regarding preoperative care
- Patients are typically NPO after midnight, except for clear liquids following updated guidelines
Preventing Venous Thromboembolism (VTE) Postoperatively
- Low-dose anticoagulants is effective
- Leg exercises are effective
- Sequential compression devices (SCDs) are effective
- The use of an incentive spirometer and controlled coughing should be prioritized for a 74-year-old patient with COPD scheduled for elective colon surgery
- COPD patients have increased risk for atelectasis; incentive spirometry is crucial
- "It's normal to be anxious; let's talk about your concerns" is the best nursing response when a patient is anxious about surgery and asks, “What if I don't wake up?”
- Acknowledging concerns and encouraging discussion helps alleviate anxiety
- Diabetes mellitus places a patient at high risk for poor wound healing postoperatively
- A smoking history places a patient at high risk for poor wound healing postoperatively
- Obesity places a patient at high risk for poor wound healing postoperatively
- Chronic steroid use places a patient at high risk for poor wound healing postoperatively
- Decreasing post-op complications is the primary purpose of preoperative patient teaching
- Preoperative education helps reduce risks such as pneumonia, DVT, and infections
- International Normalized Ratio (INR) is most critical to check before surgery for a patient on warfarin
- INR determines the patient's coagulation status and guides warfarin management
- Potassium 2.8 mEq/L is the most concerning electrolyte imbalance before surgery
- Hypokalemia increases the risk of cardiac arrhythmias during surgery
- Ensuring informed consent is signed and in the chart best ensures patient safety before surgery
- This ensures legal and ethical preparedness before surgery
- Administering long-acting insulin at bedtime should be questioned
- Long-acting insulin may cause hypoglycemia due to fasting
- Administering antiemetics as prescribed is the primary nursing intervention for a patient with a high risk of postoperative nausea and vomiting
- Preventing nausea and vomiting reduces aspiration risk
- "I should report pain before it becomes unbearable" indicates correct understanding of post-op pain management
- Early pain management improves recovery and prevents complications
Immediate Intervention
- A platelet count of 90,000/mm³ requires immediate intervention
- Serum creatinine of 2.5 mg/dL requires immediate intervention
- INR of 3.5 requires immediate intervention
- Notify the surgeon and delay pre-op medications until consent is signed when the consent form is unsigned
- Surgery cannot proceed without valid informed consent
- A patient with a history of multiple surgeries is at highest risk for a latex allergy
- Repeated exposure to latex in surgical settings increases allergy risk
- "Tell me what concerns you about the surgery" is the nurse's best response when a patient refuses surgery after the surgeon explains the procedure
- Exploring patient concerns respects autonomy and encourages informed decision-making
- Delirium is of most concern for postoperative complication in elderly patients
- Urinary retention is of most concern for postoperative complication in elderly patients
- Atelectasis is of most concern for postoperative complication in elderly patients
- Pressure ulcers are of most concern for postoperative complication in elderly patients
- Assess for bladder distention first when a post-op patient is not voiding despite IV fluids
- The nurse must assess before intervening
- Reassess the surgical site for complications for a patient who is 2 hours post-op from abdominal surgery and reports severe pain despite opioid administration
- Uncontrolled pain may indicate hemorrhage or infection
- Hypotension requires immediate intervention postoperatively
- Low urine output requires immediate intervention postoperatively
- Sudden chest pain requires immediate intervention postoperatively
- Encourage deep breathing is the priority intervention for a patient with COPD who is extubated postoperatively
- Preventing atelectasis and hypoxia is critical
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