NUR 425 - Exam 1 Practice Questions
and 100% Correct Answers
Malignant hyperthermia ✅- genetically linked
- adverse reaction to anesthesia with succinylcholine
- very rapid increase in temp, tachycardia, hypotension, muscle rigidity
- cyanosis
- antidote = dantrolene (muscle relaxer) with 60ml sterile water
- administer cold fluids
- anything to reduce temp
Pre-op instructions / information ✅- npo
- chlorhexidine bath
- meds: none except thyroid, insulin, beta blocker
- allergies: latex, iodine (allergy pt goes first)
- family hx: malignant hyperthermia
- no jewelry or underwear
Pre-op at hospital ✅- informed consent: given by surgeon, nurse as witness
- site marking: done by surgeon, verified by nurse
- start iv: for meds and fluids
- check labs
- vital signs: baseline, must be fever free, diabetes increase risk for infection,
obese/asthma increased risk for resp depression
- pt. Education: before sedatives
Meds and fluids through iv ✅- sedative: benzo (midazolam)
- beta blocker
- ppi: atropine
- antiemetic: ondansetron
- pain meds
- insulin
- abx
Intraop: before pt. Enters surg suite ✅- surgical safety checklist: ensuring everything
needed is there
- safety: surgical site infection, position related injury, retained items (increased risk for
adhesions), fire (gas / electricity)
Intraop: pt enters ✅anestesia
- induction: putting pt under
- intubation: placing et tube
- maintenance: keeping them under
- emergency: removing tube
, - recovery: post op
Time-out:
- right before first cut
- verify pt, side, procedure, needed equipment
- every person must say "i agree"
Sterile field ✅- chest down to sterile table
- 2 in. Above elbows down to finger tips
- within box in front of you
Post-op ✅most important: abc's
- airway: pt. Might need to be re-intubated
- breathing: turning, coughing, deep breathing, is (10x per hr q hr while awake),
prevention of aspiration pneumonia
- circulation: monitor bp and hr
Pacu - aldrete score: ✅aldrete score: determines post surgery status compared to pre-
op and if they can be d/c'd
- must have pre-op vitals before performing score
- higher the score, closer to d/c (out of 10)
- activity, breathing, consciousness, circulation, spo2
Pacu - pain control ✅meds:
- pca
- meds before pt
- don't wait too long to give
Non-pharm:
- splinting incision: places pressure on incision when coughing
- prevents dehiscence in abdominal incisions
Incision dehiscence ✅- medical emergency: infection can occur
Interventions:
- don't leave pt, call for help
- tell them not to move, touch, and remain calm
- cover with sterile towels soaked in sterile saline
- call physician
Pacu - monitoring for dvt's ✅- risk factor: surgery
- preventions: tedhoes, scds, avoid pressure behind knees, admin anticoags, early
ambulation
- s/s: swelling, pain, redness, heat typically in calf
- can lead to a pulmonary embolism
Interventions for dvt ✅- venous duplex to confirm
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