Surgical Nursing Pre and Post-operative Quiz

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Questions and Answers

What is an essential action during the pre-operative preparation phase?

Monitor the patient's respiratory rate

Complete the checklist for post-operative care

Ensure that patient identifiers are correct (correct)

Educate the patient about pain management post-surgery

Which assessment is crucial for determining surgical risk in patients?

Their dietary preferences

Their last intake and output (correct)

Their level of physical fitness

Their favorite type of anesthesia

In post-operative management, which of the following is a priority?

Monitor blood glucose levels

Administer prophylactic antibiotics

Ensure the patient is comfortable (correct)

Begin physical therapy sessions

What component is critical to discuss with the patient during pre-operative teaching?

The post-operative medication plan Signup and view all the answers

Which of these actions is NOT part of the pre-operative assessment?

Administer pain management concurrent with surgery Signup and view all the answers

During the post-operative phase, what should be monitored aside from vital signs?

Pain levels Signup and view all the answers

Which of the following is a primary risk factor mentioned for surgical procedures?

The patient's smoking or tobacco use Signup and view all the answers

What is the primary aim of conducting a patient assessment prior to surgery?

To identify potential complications Signup and view all the answers

What is the normal range for pH in arterial blood gas analysis?

7.35-7.45 Signup and view all the answers

Which of the following represents the normal range for partial pressure of carbon dioxide (paCO2)?

35-45 mmHg Signup and view all the answers

What is the normal range for bicarbonate (HCO3) levels in arterial blood gas analysis?

22-26 mEq/L Signup and view all the answers

Which of the following values would indicate potential respiratory acidosis when looking at arterial blood gas results?

paCO2 50 mmHg and pH 7.30 Signup and view all the answers

What does a low pH value (below 7.35) indicate in arterial blood gas analysis?

Metabolic acidosis Signup and view all the answers

What potential complication should be monitored when managing a patient with parenteral nutrition?

Phlebitis Signup and view all the answers

What is a critical action to take if a new bag of TPN is not ready before the current one runs out?

Administer dextrose in water Signup and view all the answers

Which of the following is NOT a reason a patient might require infusion therapy?

Blood sample extraction Signup and view all the answers

In the context of parenteral nutrition, what does 'FVO' stand for?

Fluid Volume Overload Signup and view all the answers

What is a primary goal when monitoring a patient receiving TPN?

Assess for complications Signup and view all the answers

Which complication involves localized swelling and pain at the IV site during parenteral nutrition?

Infiltration Signup and view all the answers

When initiating parenteral nutrition, what aspect of patient monitoring is considered critical?

Fluid intake versus output Signup and view all the answers

What should be the focus when educating a patient about the reasons for requiring infusion therapy?

Identifying nutritional needs Signup and view all the answers

What is a key action to take to prevent complications related to central lines?

Monitor the patient for signs of infiltration and phlebitis Signup and view all the answers

What should be ensured regarding the central line dressing and cleaning?

The area is clean and dressed appropriately at all times Signup and view all the answers

Which of the following actions is NOT part of preventing complications from central lines?

Perform hand hygiene only before inserting the central line Signup and view all the answers

What does proper hand hygiene help prevent in the context of central lines?

Reduce the risk of line-related infections Signup and view all the answers

When should the tubing of a central line be changed?

As needed based on clinical judgment and observation Signup and view all the answers

Which of the following signs would NOT indicate a need for immediate clinical attention in central line management?

Patient requesting to adjust the position of the line Signup and view all the answers

Which best describes why regular monitoring is vital for patients with central lines?

To promptly identify complications like infiltration or embolus Signup and view all the answers

What is a common misconception regarding hand hygiene when dealing with central lines?

Hand hygiene only needs to be performed after contact with each patient Signup and view all the answers

What is the primary function of the kidneys in maintaining acid-base balance?

Retaining bicarbonate and excreting other substances Signup and view all the answers

Which of the following statements about chemical buffers is true?

Buffers operate quickly to address small fluctuations in pH. Signup and view all the answers

What role do lungs play in acid-base balance?

Breathing out carbon dioxide to increase blood pH Signup and view all the answers

Which buffer is primarily responsible for controlling pH in blood and interstitial fluid?

Bicarbonate buffer Signup and view all the answers

What mechanism do kidneys use to lower blood pH?

Excreting hydrogen ions Signup and view all the answers

In which part of the body are phosphate buffers primarily found?

Intracellular fluid Signup and view all the answers

What happens to blood pH when kidneys retain bicarbonate?

Blood pH increases Signup and view all the answers

Which of the following is a characteristic of bicarbonate as a buffer?

It weakens strong acids and bases effectively. Signup and view all the answers

What condition can lead to alveolar pneumonia?

Pulmonary embolism Signup and view all the answers

Which of the following is associated with hyperventilation?

Thyroid toxicity Signup and view all the answers

What is a common symptom of pulmonary embolism?

Nervousness Signup and view all the answers

Which treatment is recommended for the removal of causative agents in respiratory distress?

Supplemental oxygen therapy Signup and view all the answers

Which of these can cause a decrease in responsiveness?

CNS head trauma Signup and view all the answers

What can result from metabolic acidosis?

Decreased pH Signup and view all the answers

What is NOT a treatment for hyperventilation?

Increase physical activity Signup and view all the answers

Which factor is associated with decreased concentration?

Hepatic failure Signup and view all the answers

What is a common symptom of lightheadedness?

Drowsiness Signup and view all the answers

Which of the following can cause pulmonary infection?

Salicylate overdose Signup and view all the answers

Which symptom is associated with pulmonary edema?

Restlessness Signup and view all the answers

Which of these conditions is an autoimmune disease?

Myasthenia gravis Signup and view all the answers

What is one available therapy for metabolic alkalosis?

Diuretics Signup and view all the answers

What can cause pulmonary hyperventilation?

Anxiety Signup and view all the answers

Study Notes

Test Plan One

Parenteral Nutrition Management: Monitor patients for complications like infection, infiltration, evisceration, hematoma, phlebitis, emboli, and fluid volume overload (FVO). If a new TPN bag isn't ready, hang 10% dextrose in water to prevent hypoglycemia.

Reasons for Infusion Therapy

Fluid and Electrolyte (F&E) Replacement: Essential for restoring balance.
Medication Administration: Delivering drugs intravenously.
Blood Product Administration: Transfusing blood or blood components.
Nutritional Support: Providing nutrients via intravenous fluids.
Major IV Solutions: These include crystallòids and colloids, fulfilling various needs.
- Crystalloids: Electrolytes dissolved in water (e.g., dextrose, sodium chloride, balanced electrolyte solutions, alkalizing/acidifying solutions).
- Colloids: Large molecules (e.g., proteins or starches in fluids), used for volume expansion.

Safe and Effective Venipuncture

Review Order: Ensures patient safety and the correct steps.
Pt. Preparation: Check patient identification, thoroughly explain procedure.
Gather Supplies and Equipment: Includes catheters, tubes, pumps, and sterile materials.
Hand Hygiene and Gloves: Essential for minimizing infection risk .
Positioning for Comfort: Securely place the patient and use appropriate padding.
Site Selection: Choose a suitable vein.
Site Cleaning: Properly clean the puncture area for sterile access.
Tourniquet Placement: Apply proximal to the venipuncture site.
Venipuncture Technique: Insert the catheter to obtain access.
Catheter Advancement: If a flashback occurs, advance the catheter further for better circulation.
Release Tourniquet: After catheter insertion, release the tourniquet.
Attach Primed Tubing: Securely attach the IV solution tubing to the catheter.
Dressing Application: Cover the site with a sterile dressing.
Disposal of Supplies: Dispose of used materials.
Hand Hygiene: Clean hands once more to prevent spread of infections.
Post-procedure Assessment: Assess the patient's condition after the procedure.

Preventing IV Complications

Hand Hygiene: Essential for preventing pathogen transmission.
Patient Care: Ensure the patient is getting daily care.
Environment: Maintain a clean and sterile environment.
Monitoring: Watch for infections, infiltration, or emboli.
Tubing Changes: Replace tubing as necessary.

Acid-Base Balance

Kidneys and Lungs: Regulate pH by excreting or retaining CO2. 
Chemical Buffers:
- Bicarbonate Buffer: Maintains pH in blood and interstitial fluids.
- Phosphate Buffer: Effective in renal tubules.
- Protein Buffer: The most abundant in cells; neutralizes acids and bases.

Fluid Volume Excess (FVE) Symptoms

Edema: Swelling in various body areas.
Bounding Pulse: A strong, forceful pulse.
Distended Veins: Visible bulging in veins.
Wet Lung Sounds: Abnormal sounds during auscultation.
Increased Respiratory Rate: Faster breathing rate.
Increased Heart Rate: Accelerated heartbeats.
Increased Blood Pressure: Elevated blood pressure values.
Weight Gain: Increased body mass.
Other Symptoms: Thirst, shortness of breath.

Fluid Volume Deficit (FVD) Symptoms

Dehydration: Significant fluid loss.
Dry Skin and Mucous Membranes: A noticeable lack of moisture.
Poor Skin Turgor: Skin elasticity is reduced.
Decreased Blood Pressure: Lowered pressure readings.
Increased Heart Rate: Rapid heart rate.
**Decreased Urine Output:**Reduced urine production.
Weight Loss: Significant decrease in body mass.
Changes in Mental Status: Confusion or lethargy.

Fluid Volume Management

FVE Management: Restrict fluids and sodium, assess for edema and administer diuretics.
FVD Management: Encourage oral fluids if possible, administer isotonic solutions (like Lactated Ringer's (LR) or Normal Saline (NS)) if not and closely monitor the patient.

Safe and Effective IV Fluid Management

Patient Verification: Verify patient details.
Proper Fluid Administration: Ensure proper administration rate.
Fluid Labels: Label appropriately for patient and time of use.
Tubing Changes: Change tubing when necessary.
Pump Settings: Ensure pump settings are appropriate.
Carefully Monitor IV Lines: Watch for complications or issues.

Interpreting ABGs

Normal Values: pH (7.35-7.45), PaCO2 (35-45 mmHg), HCO3 (22-26 mEq/L), and SaO2 (95-100%).

Acid-Base Imbalances

Respiratory Acidosis: Low pH, elevated PaCO2, caused by hypoventilation. Underlying issues include COPD, asthma, and trauma.
Respiratory Alkalosis: Elevated pH, decreased PaCO2, often resulting from hyperventilation. Potential causes include anxiety or fever, and some medications
Metabolic Acidosis: Low pH, low HCO3, triggered by conditions like DKA, diarrhea, renal failure, or shock. Treatment includes fluid and electrolyte replacement and correction of the root cause.
Metabolic Alkalosis: High pH, high HCO3, frequently linked to vomiting, excessive antacids, or diuretic use. Treatment centers on addressing the underlying cause (vomiting, medication effects).

Surgical Risk Factors

Patient History: Medical history, allergies, current medications, and tobacco use.

Post-Operative Management

Vitals: Monitor vital signs.
Pain Management: Administer pain medication.
Nausea Management: Administer antiemetics.
Education: Teach patients about their condition and recovery.

Pre-Operative Preparation

Complete Checklist: Fulfill required steps for a safe operation.
Gather necessary information: Collect paperwork, and history, etc..
Pre-op orders: Follow the doctor's instructions and fulfill requests.
Verify patient identity: Confirm patient details to prevent errors.
Complete assessments: Fully evaluate patient's status.
Prepare pt. for surgery: Ensure the patient is adequately prepared, and all necessary steps have been followed.

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Description

Test your knowledge on key nursing actions during the pre-operative and post-operative phases of surgical care. This quiz covers essential assessments, management priorities, and vital signs monitoring relevant to patient surgery. Prepare to evaluate the critical aspects of surgical nursing!