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RASMUSSEN BLAINE NURSING 1 EXAM #2 QUESTIONS WITH CORRECT ANSWERS
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RASMUSSEN BLAINE NURSING 1 EXAM #2 QUESTIONS WITH CORRECT ANSWERS
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RASMUSSEN BLAINE NURSING 1 EXAM#2 QUESTIONS WITH CORRECT
ANSWERS
Care of pre-operative patients - Answer-The preoperative period begins when the
patient is scheduled for a surgery & ends when they leave the surgical suite.
Categories & Purpose of Surgery - Answer--Diagnostic
-Curative
-Transplant
-Restorative
-Palliative
-Cosmetic
Diagnostic - Answer-Performed to determine the origin and cause of a disorder or the
cell type for cancer
Curative - Answer-Performed to resolve a health problem by repairing or removing the
cause
Transplant - Answer-Replacing malfunctioning structures
Restorative - Answer-Performed to improve a patient's functional ability
Palliative - Answer-Performed to relieve symptoms of a disease process but does not
cure
Cosmetic - Answer-Performed primarily to alter or enhance personal appearance
Urgency of Surgery - Answer--Elective: Planned for correction of an acute problem
-Urgent: Requires prompt intervention; may be life threatening if treatment is delayed
more than 24-48 hrs
-Emergent: Requires immediate intervention because of life-threatening consequences
Surgical Approach - Answer-Simple, Minimally invasive, radical
Simple - Answer-Only the most overtly affected areas involved in the surgery
Minimally Invasive - Answer-Surgery preformed in a body cavity or body area through
one or more endoscopes; can correct problems, remove organs, take tissue for biopsy,
,re-route blood vessels and drainage systems; is a fast-growing and ever-changing type
of surgery
Radical - Answer-Extensive surgery beyond the area obviously involved; is directed at
finding a root cause.
Surgical Settings - Answer--Inpatient
-Outpatient & Ambulatory
Inpatient - Answer-a patient who is admitted to a hospital
Outpatient & Ambulatory - Answer-a patient who goes to the surgical area the day of the
surgery and returns home on the same day
Assessment: Noticing - Answer-Begins in the preoperative phase and continues
throughout the perioperative experience. Focuses the assessment on the patient's
physical, psychosocial, and spiritual needs.
Care of preoperative patients: History - Answer--Age
-Tabacco
-Alcohol
-Drugs
-Herbal drugs
-Medical Hx
-Past surgeries
-Past anesthesia
-Allergies
-General health
-Family Hx
-Knowledge of procedure
-Support system
**Assess the patient for problems that increase the risk for complications during and
after surgery FIRST!**
Factors that Increase Risks for Complications - Answer--Age, medications, medical hx,
prior surgical experience, health history, family history, and type of surgical procedure
planned
Smoking before or after surgery - Answer-increases levels of carboxyhemoglobin, which
decreases oxygen delivery to organs. After surgery, the patient has a higher risk for
infection (pneumonia) and atelectasis (collapse of alveoli).
Allergies - Answer-Povidone-iodine (e.g., Betadine) used for skin cleansing contains the
same allergens found in shellfish. Patients who are allergic to shellfish may have an
,adverse reaction to povidone-iodine. Patients with an allergy to avocados, bananas,
strawberries, and other fruits may also have a latex sensitivity or allergy.
Blood donations - Answer-Patients can choose to have their own blood donated, also
called autologous donations, up to 3 weeks prior to surgery. Also, patients can have a
family member with the same blood type as you which is called direct blood donation.
Discharge Planning - Answer-Always done before the surgery
Physical Assessment/Signs & Symptoms - Answer--Want to determine Pts baseline
before surgery
-Report any abnormal assessment findings to the surgeon and to the anesthesia
personal
Physical Assessment/Signs & Symptoms: Cardiac - Answer--Ask if pt has had venous
thrombeoembolism.
-Listen to heart sounds
-Assess pts hands feet for temp, color, pulses, edema, and cap refill.
-Report abnormal findings to surgeon
Physical Assessment/Signs & Symptoms: Respiratory - Answer-Listen & get history of
complications or smoking
Physical Assessment/Signs & Symptoms: Kidney - Answer--Ask about frequency,
dysuria, nocturia, difficulty starting flow, and oliguria.
Meds: Scopolamine (Buscopan image), morphine, other opioids, benzodiazepines, and
barbiturates often cause confusion, disorientation, apprehension, and restlessness
when given to patients with decreased kidney function
Physical Assessment/Signs & Symptoms: Neuro - Answer-The Joint Commission
NPSGs require that you ensure patient SAFETY by assessing the patient's risk for
falling, especially older patients. Determine the patient's baseline. LOC.
Physical Assessment/Signs & Symptoms: Musculoskeletal - Answer-Assess for any
joint problems because it could affect the positioning of the patient.
Physical Assessment/Signs & Symptoms:Nutrition - Answer-Malnutrition & obestity
increase risk for surgery, increases metabolic rate and depletes potassium and vitamins
C and B, all of which are needed for WOUND healing and BLOOD clotting.
Psychosocial Assessment - Answer--Anxiety is very common before surgery
, -Perform a psychosocial assessment to determine the patient's level of anxiety, coping
ability, and support systems.
Laboratory Assessment - Answer-Urinalysis
• Blood type and screen
• Complete blood count or hemoglobin level and hematocrit
• Clotting studies (prothrombin time [PT], international normalized ratio [INR], activated
partial thromboplastin time [aPTT], platelet count)
• Electrolyte levels
• Serum creatinine and blood urea nitrogen levels
• Pregnancy test may also be needed
Hypokalemia (decreased serum potassium level) increases the risk for toxicity if the
patient is taking digoxin, slows recovery from anesthesia, and increases cardiac
irritability. Hyperkalemia (increased serum potassium level) increases the risk for
dysrhythmias, especially with the use of anesthesia.
Imaging Assessment - Answer-A chest x-ray determines the size and shape of the
heart, lungs, and major vessels and provides evidence of the presence of pneumonia or
tuberculosis.
For emergency surgery, x-ray results help the anesthesia provider select anesthesia
type.
Other Diagnostic Assessment - Answer-An electrocardiogram (ECG) may be required
for patients older than a specific age (40-45) who are to have general anesthesia
Planning & interventions - Answer-_ensure patient knows what to expect before and
after surgery
-Use teach back method to ensure they understand
-Adhereing NPO requirements
-Demonstrate correct exercises to be used after surgery
Ensuring Informed consent - Answer--Nature and reasoning for surgery
-Who is preforming surgery
-Benefits & risks; potential outcomes, use of anesthesia, use of blood products
Preoperative Nurse Role - Answer--The preoperative nurse is not responsible for
providing detailed information about the surgical procedure.
-The nurse's role is to clarify facts that have been presented by the surgeon and dispel
myths that the patient or family may have about the surgical experience.
-The nurse must verify that the consent form is signed, and he or she may serve as a
witness to the signature, not to the fact that the patient is informed.
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