Surgical Nursing Responsibilities and Anesthesia

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Questions and Answers

What is a primary consideration when prioritizing the needs of patients undergoing surgery?

Availability of surgical instruments

Prevention of hypothermia (correct)

Patient's surgical consent

Patient's nutritional status

Which piece of personal protective equipment is essential in the semirestricted area of the surgery department?

Shoes covers

Street clothing

Surgical mask

Head cover (correct)

What role does the nurse anesthetist play in the operating room?

Cleaning the operating room after surgery

Assisting the surgeon with instruments

Monitoring the patient’s anesthesia levels (correct)

Coordinating the operating room schedule

What is the role of the perioperative nurse in managing a patient under anesthesia?

Ensuring patient safety and monitoring vital signs (A) Signup and view all the answers

Which component of the MIST memory aid helps predict specific injury patterns?

Mechanism of injury (C) Signup and view all the answers

Which anesthesia technique involves the injection of anesthetic near the spinal cord?

Epidural block (A) Signup and view all the answers

What is the main responsibility of a nurse as a scrub nurse during surgery?

Maintaining the sterile field (B) Signup and view all the answers

While using the SAMPLE memory aid, which aspect should you inquire about to understand a patient's historical allergic reactions?

Allergies (B) Signup and view all the answers

What should be the immediate action when you observe signs and symptoms that were noted before arrival using the MIST approach?

Record and communicate the symptoms (A) Signup and view all the answers

Which of the following is a common anesthesia drug used in the operating room?

Propofol (B) Signup and view all the answers

For an injury involving a fall from a significant height, what specific injuries should be anticipated?

Spinal cord injury or head trauma (D) Signup and view all the answers

What steps should be taken to prevent malignant hyperthermia during surgery?

Identifying family history and allergies to anesthesia (A) Signup and view all the answers

In the SAMPLE history, what does 'P' remind clinicians to consider?

Past history (B) Signup and view all the answers

What does the 'S' in SAMPLE suggest evaluating in terms of patient assessment?

Symptoms from the injury or illness (A) Signup and view all the answers

For a patient with suspected knee injury as a front-seat passenger, what history component is essential?

Mechanism of injury (D) Signup and view all the answers

Which memory aid is used to prompt questions about a patient's history in the emergency department?

SAMPLE (B) Signup and view all the answers

What action is appropriate for a patient with sinus bradycardia at a rate of 32 beats/min and a BP of 80/42 mm Hg reporting faintness?

Apply the transcutaneous pacemaker pads (D) Signup and view all the answers

Which medication is recommended to prevent heart failure following a myocardial infarction?

Angiotensin-converting enzyme (ACE) inhibitor (D) Signup and view all the answers

What is the role of albumin in interpreting a patient’s total calcium level?

It can lead to misinterpretation due to binding with calcium (D) Signup and view all the answers

Why are calcium channel blockers generally not used in the treatment of heart failure?

They do not directly improve cardiac output (C) Signup and view all the answers

What common misconception might lead to reassessment of an isolated elevated calcium level?

Assuming elevated calcium without albumin is valid (B) Signup and view all the answers

Which condition often arises after an acute myocardial infarction and requires specific pharmacological management?

Heart failure (D) Signup and view all the answers

What is the primary reason digoxin is not first-line treatment for heart failure?

It is typically less effective than ACE inhibitors. (A) Signup and view all the answers

What is the primary role of enteral nutrition (EN)?

To supply nutrients through a tube placed in the stomach or intestine (B) Signup and view all the answers

What condition should nurses closely monitor during initial refeeding in a patient with anorexia nervosa?

Hypokalemia (D) Signup and view all the answers

Which of the following is a complication associated with parenteral nutrition?

Electrolyte imbalance (B) Signup and view all the answers

Which diagnostic tool is best for confirming the placement of a small-bore nasogastric feeding tube?

X-ray (C) Signup and view all the answers

What is the first substrate the body uses for energy during starvation?

Glycogen (C) Signup and view all the answers

Which of the following is NOT a clinical manifestation of malnutrition?

Weight gain (B) Signup and view all the answers

In the context of eating disorders, how is bulimia nervosa (BN) typically characterized?

Binge eating followed by purging (D) Signup and view all the answers

Which component is typically included in a comprehensive nutrition assessment?

Anthropometric measurements (B) Signup and view all the answers

Which intervention is most effective for preventing hypertrophic scarring during the rehabilitation phase of burn recovery?

Applying pressure garments (A) Signup and view all the answers

What should the nurse prioritize when planning the discharge of a patient recovering from second- and third-degree burns?

Review the patient’s current health care status and readiness for discharge (C) Signup and view all the answers

Which approach is recommended for managing pain during the acute phase of a burn injury?

Use a multimodal approach, including sustained-release opioids and NSAIDs (D) Signup and view all the answers

Which nonpharmacologic therapy might be used alongside analgesics for pain management in burn patients?

Music therapy (B) Signup and view all the answers

Which technique is pivotal for promoting gas exchange in patients experiencing airway obstruction?

Airway clearance techniques (D) Signup and view all the answers

Why is it important to assess readiness for discharge in burn patients?

To assess their ability to care for themselves (A) Signup and view all the answers

Which is a key sign of patient readiness for mechanical ventilation weaning?

Stable vital signs (B) Signup and view all the answers

What is a major consideration when caring for a patient with a new tracheostomy?

Select appropriate interventions for airway management and preventing infection (C) Signup and view all the answers

What is the highest priority action when suctioning a patient with an oral ET tube or tracheostomy?

Hyperoxygenate with 100% FIO2 before suctioning. (C) Signup and view all the answers

Which complication may arise due to increased pressure in the chest from positive pressure mechanical ventilation?

Signs of cardiovascular insufficiency. (C) Signup and view all the answers

Which of the following findings indicates a patient is ready for weaning from mechanical ventilation? (Select all that apply)

Serum hemoglobin of 15 g/dL (A), ABGS: pH 7.38, PaCO2 37 mm Hg, HCO3− 24 mEq/L, PaO2 94 (C), Patient is alert and follows commands (D), Respirations of 18 breaths/min (E) Signup and view all the answers

What is an immediate care priority in the first few hours for a patient with a new tracheostomy?

Observing for bleeding at the insertion site. (C) Signup and view all the answers

What should be included in discharge teaching for a patient with a permanent tracheostomy after a total laryngectomy? (Select all that apply)

Having a list of emergency contact numbers and where to obtain supplies. (B), Providing pictures and “hands-on” instruction for tracheostomy care. (C), Emphasizing the importance of regular follow-up appointments. (D), Washing around the stoma daily with a moist washcloth. (E) Signup and view all the answers

Which nursing intervention is essential to prevent ET tube dislodgment during mouth care?

Limiting mouth care to lubrication of the lips. (D) Signup and view all the answers

Why might a patient on positive pressure mechanical ventilation experience diuresis and sodium depletion?

Increased release of atrial natriuretic peptide. (B) Signup and view all the answers

What should be done prior to suctioning a patient to reduce the risk of hypoxia?

Hyperoxygenate with 100% FIO2. (D) Signup and view all the answers

Study Notes

Adult Health 4 - Exam 1 Study Notes

Kahoot Topics: Calcium Channel Blockers, ACE Inhibitors (-PRIL), Chest Tubes, Chapter 17: Fluid and Electrolyte Balances, Chapter 18 - Preoperative Care, Chapter 19 - Intraoperative Care, Chapter 20 - Postoperative Care, Chapter 21 - Emergency and Disaster Nursing, Chapter 26 - Burns, Chapter 28 - Supporting Ventilation, Chapter 44 - Nutrition Problems, Chapter 67 - Musculoskeletal Trauma and Orthopedic Surgery
Carbon Monoxide (CO) Poisoning: Symptoms range from dizziness and headache to unconsciousness and death. CO has a much higher affinity for hemoglobin than oxygen. Administering 100% oxygen is crucial. Myocardial injury can occur frequently.
Pseudocholinesterase Deficiency: Individuals with this deficiency have decreased ability to metabolize succinylcholine and mivacurium.
Sudden Vital Sign Changes: Assess blood pressure manually, check lines for kinks, and verify oxygen and IV access.
End-tidal CO2 Monitors: Used for rapid verification of endotracheal tube (ETT) placement.
Ineffective Cough: Causes may include muscle weakness, impaired chest mobility, increased mucus viscosity, and ciliary dysfunction. Intubation may be required if airway protection is compromised
Smoke and Soot Inhalation: Common injuries causing respiratory difficulty.
Burn Patient Care: Early enteral nutrition improves outcomes.
Nutritional Goals: Nutritional goals may not be met due to weight loss, elevated glucose, or overhydration/dehydration in burn patients. Monitor triglycerides and triglycerides during lipid administration.
Parenteral Nutrition (TPN/Lipids): Medications aren't administered via the TPN/lipid lines. Risks include hyperglycemia, infection, and volume overload. Monitor glucose levels.
Ventricular Tachycardia: Rapid, life-threatening dysrhythmia originating from an ectopic focus in ventricles.
Captopril: May cause hyperkalemia, angioedema, cough, renal insufficiency, flushing. Should be taken 1 hour before meals.
Wound Care & Patients with Burns: Wear appropriate protective equipment, like gowns, masks, and gloves, when entering the room. Maintaining a minimum of 30 mL urine output per hour for a burn patient is key.
Chest Tube Placement & Care Pneumothorax/Hemothorax - air/blood in the pleural space causes partial/full lung collapse. Signs of hemothorax include respiratory distress, tachypnea, dullness to percussion. Excess fluid from pulmonary contusions can interfere with gas transfer, leading to hypoxia. DVT risk factors include family history, immobility, and in-dwelling catheters.
Chest Tube Complications: Drainage stops in first 24 hours, large amounts of drainage, cloudy drainage indicates infection. Lorazepam is used for anxiety and panic disorders. Hyperkalemia can cause cardiac arrest if severe.
Premature Ventricular Contractions (PVCs): Caused by an ectopic pacemaker in the ventricle, often seen in mass casualty events.
Cardioversion: Administer anesthesia if time permits.
Digoxin and Potassium: Patients with heart failure may need a Digoxin and potassium regimen - not the primary or first-line treatment.
Hyperkalemia: Signs include abdominal cramping, diarrhea, vomiting, confusion, fatigue, irregular pulse.
Hypokalemia: Signs include muscle weakness, cramps, paresthesias, decreased reflexes, tetany.
Acid-Base Imbalances: Recognize the imbalances and the different causes of respiratory and metabolic acidosis and alkalosis.
Fluid and Electrolyte Imbalances: Understand both deficits and excesses.
Intubation: Crucial step for patients at risk for airway compromise.
CO Toxicity: Use pulse CO oximetry for detection.
Chest Tubes: Continuous bubbling in the suction chamber of a wet-suction system usually indicates a leak. Tidaling is the rise and fall of fluid in the water-seal chamber with breathing. Continuous bubbling in the water-seal chamber suggests a lung leak.
Burn Injuries: Classification (superficial/deep); rule of nines. Fluid resuscitation formulas are crucial to survival.
Burn Pain Management: Pain-rating tools, multimodal approaches (use of opioids, NSAIDs, and adjuvant analgesics), nonpharmacologic therapies.
Hypertrophic Scarring: Prevent with methods like pressure garments and active ROM.
Postoperative Care: Focus on airway, breathing, circulation (ABCs), wound care, and pain management.
Fluid Resuscitation: Follow the American Burn Association (ABA) formulas for calculating fluid requirements.
Anesthesia: Recognize various types, associated drugs, and interventions. Patient teaching should include avoiding aspirin given with ACE inhibitors.
Surgical Procedures Different suffix meanings relating to removal of body parts, incisions, or repairs.
Patient Preparation for Surgery: Including patient history, assessment for allergies and current medications.
Postoperative Care Include considerations for patients post surgical procedure.
Tracheostomy Knowledge of normal parameters needed for care such as tidaling, suctioning, and use of sterile technique.
Special Considerations: Recognize considerations regarding obesity, patients with allergies to latex and patients with pre-existing medical conditions.
Patient Safety: Review medications and ensure they are administered appropriately, and check for any allergies.

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Description

This quiz covers essential knowledge for nursing professionals working in surgical settings, including the responsibilities of perioperative nurses and the roles of nurse anesthetists. Test your understanding of personal protective equipment, anesthesia techniques, and patient assessment tools relevant to surgical procedures.