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Unit 3. Perioperative Concepts and Nursing Management Questions with Solutions
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Unit 3. Perioperative Concepts and Nursing Management
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Unit 3. Perioperative Concepts andNursing Management
The nurse expects informed consent to be obtained for insertion of: - answer A
gastrostomy tube
Informed consent is required for invasive procedures that require sedation and are
associated with more than usual risk to the client.
The nurse discovers that the client did not sign the operative consent before receiving
the preoperative medication. The appropriate nursing action is: - answer To notify the
surgeon
Preoperative medication can impair the thinking ability of the client. For informed
consent to be valid, the client must be competent to give consent. The surgery will be
canceled.
The nurse recognizes that written informed consent is required for insertion of a(n): -
answerPeripherally-inserted central catheter.
Nonsurgical invasive procedures, such as insertion of a peripherally-inserted central
catheter, that carry more than a slight risk to the client require written informed consent.
When does the nurse understand the patient is knowledgeable about the impending
surgical procedure? - answerThe patient participates willingly in the preoperative
preparation.
The nurse knows that the patient understands the surgical intervention when the patient
participates in preoperative preparation. The other answers pertain to the patient
experiencing decreased fear or anxiety, not knowledge about the procedure.
A client is undergoing preoperative assessment. During admission paperwork, the client
reports having enjoyed a hearty breakfast this morning to be ready for the procedure.
What is the nurse's next action? - answerNotify the surgeon.
If the client has not carried out a specific portion of preoperative instructions, such as
withholding foods and fluids, the nurse immediately notifies the surgeon. This scenario
does not include information to support documentation of the client's food intake or
giving the client water at this point. It is not the nurse's responsibility to cancel the
surgery.
,An anxious client being prepared for surgery is encouraged to concentrate on a
pleasant experience or restful scene. What cognitive coping strategy would the nurse
document as being used? - answerImagery
Imagery has proven effective for anxiety in surgical clients. Optimistic self-recitation is
practiced when the client recites optimistic thoughts such as, "I know all will go well."
Distraction is used when the client is encouraged to think of an enjoyable story or recite
a favorite poem. Progressive muscular relaxation requires contracting and relaxing
muscle groups and is a physical coping strategy as opposed to a cognitive strategy.
A nurse is teaching a client with chronic bronchitis about breathing exercises. Which
instruction should the nurse include in the teaching? - answerUse diaphragmatic
breathing.
In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing helps to
strengthen the diaphragm and maximizes ventilation. Exhalation should be longer than
inhalation to prevent collapse of the bronchioles. The client with chronic bronchitis
should exhale through pursed lips to prolong exhalation, keep the bronchioles from
collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing —
increases lung expansion.
The nurse is aware that a religious group that refuses blood transfusions for religious
reasons is: - answerJehovah's Witnesses
Jehovah's Witnesses decline blood transfusions for religious reasons.
A patient with uncontrolled diabetes is scheduled for a surgical procedure. What chief
life-threatening hazard should the nurse monitor for? - answerHypoglycemia
The patient with diabetes who is undergoing surgery is at risk for both hypoglycemia
and hyperglycemia. Hypoglycemia may develop during anesthesia or postoperatively
from inadequate carbohydrates or excessive administration of insulin. Hyperglycemia,
which can increase the risk of surgical wound infection, may result from the stress of
surgery, which can trigger increased levels of catecholamine. Other risks are acidosis
and glucosuria, but hypoglycemia is a bigger risk. Dehydration is a lesser risk for a
patient with diabetes than is hypoglycemia.
A client is scheduled for a surgical procedure. When planning the client's care, the
nurse should consider that which of the following conditions will increase the client's risk
of complications after surgery? - answerA history of diabetes
As a chronic condition that affects many body systems, diabetes is a risk factor for
surgical complications. The client's blood glucose level and insulin requirements need to
be closely monitored before and after surgery. Being sensitive to aspirin does not pose
a risk for the client in surgery. Osteoarthritis is not a systemic condition and does not
place the client at risk during surgery. Chronic low back pain is not a systemic condition
, that places the client at risk during surgery; however, it can be exacerbated by
positioning on the operating room table.
A client is scheduled to have surgery to address a cleft palate. What type of surgery
would the nurse be preparing this client for? - answerreconstructive
Clients have surgery for many different reasons. Reconstructive surgery is intended to
repair or reconstruct physical deformities and abnormalities caused by traumatic
injuries, birth defects, developmental abnormalities, or disease. Corrective surgery
usually involves fixing a problem. Diagnostic surgery is the removal and study of tissue
to make a diagnosis. Prophylactic surgery is the removal of tissue that does not yet
contain cancer cells but has a high probability of becoming cancerous in the future.
A nurse is teaching a client about pain management after surgery. Which client
statement indicates the teaching was effective? - answer"I will support my incision with
my hands when I cough and do my deep breathing exercises."
Splinting of the incision provides support to the incision and helps to control pain, so this
client statement is correct. Clients should take pain medication routinely and frequently
after surgery. Pain medications for postoperative clients are given orally at home. Pain
is a subjective feeling, so comparison is difficult.
A gunshot wound would be classified under which category of surgery based on
urgency?
a. urgent
b. emergent
c. elective
d. required - answerEmergent
Emergent surgery occurs when the patient requires immediate attention. An elective
surgery is classified as a surgery that the patient should have. A required surgery
means that the patient needs to have surgery. An urgent surgery is one which the
patient required prompt attention.
A nurse is assessing a postoperative client with hyperglycemic blood glucose levels.
Which post-surgical risk factor would decrease if the surgical client maintained strict
blood glycemic control? - answerwound healing
In caring for a postoperative client, the nurse is correct to correlate hyperglycemia with
an increased risk of surgical incision infections and delayed wound healing. Strict
control of glycemic blood levels at the therapeutic range of 80-110 mg/dL would reduce
this risk factor. There is no direct correlation between blood glucose levels and nutrient
deficiencies, respiratory complications, or liver dysfunction.
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