Podcast
Questions and Answers
What is the primary concern when using the Trendelenburg position on a patient?
What is the primary concern when using the Trendelenburg position on a patient?
- Decreased risk of blood pooling in the lower extremities.
- Reduced intracranial and intraocular pressures.
- Potential for hypotension upon return to a supine position. (correct)
- Increased diaphragmatic movement and respiratory exchange.
A patient in the lithotomy position is at risk for which complication due to the placement of their legs in stirrups?
A patient in the lithotomy position is at risk for which complication due to the placement of their legs in stirrups?
- Improved blood flow to the legs.
- Reduced pressure on the peroneal nerve.
- Potential for peroneal nerve damage and subsequent foot drop. (correct)
- Decreased risk of deep vein thrombosis (DVT).
Which of the following nursing interventions is the MOST appropriate initial response to a patient exhibiting signs of a hemorrhage post-operatively?
Which of the following nursing interventions is the MOST appropriate initial response to a patient exhibiting signs of a hemorrhage post-operatively?
- Elevating the patient’s legs to promote venous return.
- Administering a bolus of intravenous fluids to combat hypotension.
- Increasing the rate of the patient’s oxygen administration.
- Applying a pressure dressing to the bleeding site and notifying the surgical team. (correct)
What physiological response differentiates shock from other conditions involving hypotension?
What physiological response differentiates shock from other conditions involving hypotension?
Why is it essential to avoid positioning that decreases ventilation when managing a patient at risk for respiratory complications?
Why is it essential to avoid positioning that decreases ventilation when managing a patient at risk for respiratory complications?
Which of the following is the primary goal of administering oxygen to a patient experiencing a pulmonary embolism?
Which of the following is the primary goal of administering oxygen to a patient experiencing a pulmonary embolism?
What is the primary mechanism by which atelectasis leads to poor gas exchange?
What is the primary mechanism by which atelectasis leads to poor gas exchange?
Why is positioning a patient in a semi-Fowler's or Fowler's position a key intervention for preventing pneumonia?
Why is positioning a patient in a semi-Fowler's or Fowler's position a key intervention for preventing pneumonia?
Aseptic technique is crucial when changing surgical site dressings because it directly prevents which post-operative complication?
Aseptic technique is crucial when changing surgical site dressings because it directly prevents which post-operative complication?
Why might hypotension occur when a patient is moved from the Trendelenburg position back to a supine position?
Why might hypotension occur when a patient is moved from the Trendelenburg position back to a supine position?
What is the underlying reason that pressure on the peroneal nerve, associated with the lithotomy position, leads to foot drop?
What is the underlying reason that pressure on the peroneal nerve, associated with the lithotomy position, leads to foot drop?
What is the significance of cold, clammy skin and cool mottled extremities in a patient experiencing a hemorrhage?
What is the significance of cold, clammy skin and cool mottled extremities in a patient experiencing a hemorrhage?
Why is maintaining warmth with covers an important intervention for a patient in shock?
Why is maintaining warmth with covers an important intervention for a patient in shock?
What is the rationale behind turning a patient in bed every 2 hours to prevent respiratory complications?
What is the rationale behind turning a patient in bed every 2 hours to prevent respiratory complications?
For a patient with a diagnosed pulmonary embolism, what is the physiological reason for targeting an oxygen saturation above 90%?
For a patient with a diagnosed pulmonary embolism, what is the physiological reason for targeting an oxygen saturation above 90%?
In the context of atelectasis, why does retention of mucus in the alveoli lead to poor gas exchange?
In the context of atelectasis, why does retention of mucus in the alveoli lead to poor gas exchange?
A patient is post-operative for abdominal surgery. Why should the nurse promote full aeration of the lungs by positioning the patient in semi-Fowler's or Fowler's position?
A patient is post-operative for abdominal surgery. Why should the nurse promote full aeration of the lungs by positioning the patient in semi-Fowler's or Fowler's position?
Why is a diet high in protein, carbohydrates, calories, and vitamins recommended for a patient at risk for surgical site complications?
Why is a diet high in protein, carbohydrates, calories, and vitamins recommended for a patient at risk for surgical site complications?
What is the primary reason behind using proper hand hygiene as an intervention to prevent surgical site complications?
What is the primary reason behind using proper hand hygiene as an intervention to prevent surgical site complications?
Why is the Trendelenburg position contraindicated in patients with increased intracranial pressure?
Why is the Trendelenburg position contraindicated in patients with increased intracranial pressure?
What physiological change is directly responsible for the anxiety often seen in patients experiencing a hemorrhage?
What physiological change is directly responsible for the anxiety often seen in patients experiencing a hemorrhage?
What is the primary rationale for administering intravenous fluids and packed red blood cells to a patient in shock?
What is the primary rationale for administering intravenous fluids and packed red blood cells to a patient in shock?
How does the ICOUGH mnemonic specifically address the prevention of respiratory complications?
How does the ICOUGH mnemonic specifically address the prevention of respiratory complications?
In a patient with a suspected pulmonary embolism, rapid respirations and tachycardia reflect which underlying physiological process?
In a patient with a suspected pulmonary embolism, rapid respirations and tachycardia reflect which underlying physiological process?
What is the primary reason a patient with atelectasis is positioned in a semi-Fowler’s position?
What is the primary reason a patient with atelectasis is positioned in a semi-Fowler’s position?
How does anesthesia increase the risk of pneumonia postoperatively?
How does anesthesia increase the risk of pneumonia postoperatively?
Why is maintaining adequate hydration a crucial nursing intervention to prevent surgical site complications?
Why is maintaining adequate hydration a crucial nursing intervention to prevent surgical site complications?
What is the rationale for avoiding narcotic analgesics in patients at risk for respiratory complications?
What is the rationale for avoiding narcotic analgesics in patients at risk for respiratory complications?
Why are anticoagulants administered to a patient with a pulmonary embolism?
Why are anticoagulants administered to a patient with a pulmonary embolism?
For a patient with atelectasis, what is the rationale for administering analgesics for pain?
For a patient with atelectasis, what is the rationale for administering analgesics for pain?
Why is ensuring rest and comfort a significant aspect in preventing pneumonia?
Why is ensuring rest and comfort a significant aspect in preventing pneumonia?
What is the underlying reason soiled gloves and dressings are disposed of following standard precautions?
What is the underlying reason soiled gloves and dressings are disposed of following standard precautions?
How does applying a pressure dressing to a hemorrhage site directly aid in controlling bleeding?
How does applying a pressure dressing to a hemorrhage site directly aid in controlling bleeding?
Elevating the patient's legs 30 to 45 degrees helps to manage shock because it:
Elevating the patient's legs 30 to 45 degrees helps to manage shock because it:
What is the rationale for prioritizing frequent vital sign assessments in the nursing management of pulmonary embolism?
What is the rationale for prioritizing frequent vital sign assessments in the nursing management of pulmonary embolism?
What is the rationale behind using incentive spirometry for post-operative patients?
What is the rationale behind using incentive spirometry for post-operative patients?
A patient undergoing surgery is placed in the lithotomy position. Postoperatively, the patient reports numbness and tingling in their foot. What is the most likely cause of this complication?
A patient undergoing surgery is placed in the lithotomy position. Postoperatively, the patient reports numbness and tingling in their foot. What is the most likely cause of this complication?
A patient post-abdominal surgery suddenly develops rapid respirations, tachycardia, and reports feeling anxious and apprehensive. The nurse notes a small amount of bloody drainage from the surgical site. What is the priority nursing intervention based on these findings?
A patient post-abdominal surgery suddenly develops rapid respirations, tachycardia, and reports feeling anxious and apprehensive. The nurse notes a small amount of bloody drainage from the surgical site. What is the priority nursing intervention based on these findings?
A post-operative patient exhibits signs of hypovolemic shock. After initiating standard interventions, such as oxygen administration and elevating the legs, which assessment finding would indicate the MOST urgent need for a blood transfusion?
A post-operative patient exhibits signs of hypovolemic shock. After initiating standard interventions, such as oxygen administration and elevating the legs, which assessment finding would indicate the MOST urgent need for a blood transfusion?
A patient develops atelectasis postoperatively. Despite ambulation and coughing exercises, their oxygen saturation remains low. Which intervention should the nurse prioritize to address the underlying cause of the persistent atelectasis?
A patient develops atelectasis postoperatively. Despite ambulation and coughing exercises, their oxygen saturation remains low. Which intervention should the nurse prioritize to address the underlying cause of the persistent atelectasis?
A nurse is caring for a patient at risk for pneumonia postoperatively. Besides encouraging coughing and deep breathing, what is another critical nursing intervention to prevent pneumonia related to increased secretions from anesthesia?
A nurse is caring for a patient at risk for pneumonia postoperatively. Besides encouraging coughing and deep breathing, what is another critical nursing intervention to prevent pneumonia related to increased secretions from anesthesia?
Flashcards
Trendelenburg position
Trendelenburg position
Lowering the upper torso and raising the feet.
Lithotomy position
Lithotomy position
Placement of the legs in stirrups, increasing DVT risk and potentially damaging the peroneal nerve.
Hemorrhage
Hemorrhage
Excessive internal or external blood loss, potentially leading to hypovolemic shock.
Hemorrhage interventions
Hemorrhage interventions
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Shock
Shock
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Shock interventions
Shock interventions
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Preventing respiratory complications
Preventing respiratory complications
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Pulmonary embolism symptoms
Pulmonary embolism symptoms
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Pulmonary embolism interventions
Pulmonary embolism interventions
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Atelectasis
Atelectasis
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Atelectasis interventions
Atelectasis interventions
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Pneumonia
Pneumonia
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Pneumonia interventions
Pneumonia interventions
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Preventing surgical site infections
Preventing surgical site infections
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Study Notes
- Nursing interventions address potential surgical complications
Trendelenburg Position
- Requires lowering the upper torso and raising the feet
- Displacement of abdominal viscera towards the head reduces diaphragmatic movement and respiratory exchange
- Pooling blood increases intracranial and intraocular pressures
- Hypotension can result if returned to the supine position
Lithotomy Position
- Placement of legs in stirrups increases risk of DVT due to blood pooling in the legs
- Can damage the peroneal nerve, causing foot drop
- Can cause back strain
Hemorrhage
- Excessive internal or external blood loss can lead to hypovolemic shock
- Manifestations include increased heart rate, hypotension, restlessness, anxiety, and apprehension
- Cold, clammy skin, cool/mottled extremities, deep/rapid respirations, and decreased urine output are also signs
- Nursing interventions:
- Apply pressure dressing to bleeding site
- Activate medical intervention/rapid response team
- Immediately notify the surgeon
- Prepare patient for potential return to the operating room if bleeding persists
Shock
- Body's response to inadequate organ perfusion
- Compensatory mechanisms are activated to address hypoperfusion, metabolic changes, and inflammatory response
- Nursing interventions:
- Activate medical intervention/rapid response team
- Immediately notify the surgeon
- Establish and maintain the airway
- Place the patient in a flat position with legs elevated 30-45 degrees
- Administer oxygen and monitor vital signs, hematocrit, and blood gas results
- Maintain warmth with covers and administer medications
- Prepare to assist with IV line insertion and administer fluids and blood components
Respiratory Complications
- Nursing interventions to prevent:
- Monitor vital signs
- Implement deep breathing, coughing, and incentive spirometry
- Turn patient in bed every 2 hours
- Encourage ambulation and maintain hydration
- Avoid positions that decrease ventilation
- Monitor responses to narcotic analgesics
- ICOUGH pneumatic includes: incentive spirometry, coughing/deep breathing, oral care, understanding and head of bed elevation
- Getting out of bed at least three times
Pulmonary Embolism
- Characterized by dyspnea, chest pain, cough, cyanosis, rapid respirations, tachycardia, and anxiety
- Nursing interventions:
- Immediately notify healthcare provider
- Activate medical intervention/rapid response team
- Frequently assess vital signs
- Administer oxygen to maintain saturation above 90%
- Administer anticoagulants and other prescribed medications
- Prepare patient for potential diagnostic and interventional procedures
Atelectasis
- Incomplete expansion or collapse of alveoli due to retained mucus, affecting a portion of the lung and causing poor gas exchange
- Nursing interventions:
- Implement measures to prevent or monitor for respiratory complications
- Position patient in semi-Fowler's position
- Administer oxygen and analgesics for pain
- For sudden onset, immediately notify surgeon and activate medical intervention/rapid response team
Pneumonia
- Inflammation of the alveoli caused by infection or foreign material
- Postoperative causes include aspiration, infection, depressed cough reflex, increased secretions (anesthesia), dehydration and immobilization
- Nursing interventions:
- Use measures to prevent or monitor for respiratory complications
- Promote full lung aeration by positioning in semi- or Fowler's position
- Encourage incentive spirometry and ambulation
- Administer oxygen and prescribed medications
- Ensure frequent oral hygiene, rest, and comfort
Surgical Site Complications
- Nursing interventions:
- Assess vital signs
- Maintain hydration and nutritional status
- Encourage a diet high in protein, carbohydrates, calories, and vitamins
- Use proper hand hygiene and aseptic technique for dressing changes at surgical/exit sites
- Dispose of soiled gloves and dressings per standard precautions
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