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A patient is on call to the OR for an aortobifemoral bypass and the nurse administers the ordered preoperative medication. After administering a preoperative medication to the patient, what should the nurse do?
- A. Encourage light ambulation
- B. Place the bed in a low position with the side rails up
- C. Tell the patient that he will be asleep before he leaves for surgery
- D. Take the patients vital signs every 15 minutes
Correct Answer: B
Rationale: When the preoperative medication is given, the bed should be placed in low position with the side rails raised. The patient should not get up without assistance. The patient may not be asleep, but he may be drowsy. Vital signs should be taken before the preoperative medication is given; vital signs are not normally required every 15 minutes after administration.
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The admitting nurse in a short-stay surgical unit is responsible for numerous aspects of care. What must the nurse verify before the patient is taken to the preoperative holding area?
- A. That preoperative teaching was performed
- B. That the family is aware of the length of the surgery
- C. That follow-up home care is not necessary
- D. That the family understands the patient will be discharged immediately after surgery
Correct Answer: A
Rationale: The nurse needs to be sure that the patient and family understand that the patient will first go to the preoperative holding area before going to the OR for the surgical procedure and then will spend some time in the PACU before being discharged home with the family later that day. Other preoperative teaching content should also be verified and reinforced, as needed. The nurse should ensure that any plans for follow-up home care are in place.
The nurse is caring for a hospice patient who is scheduled for a surgical procedure to reduce the size of his spinal tumor in an effort to relieve his pain. The nurse should plan this patient care with the knowledge that his surgical procedure is classified as which of the following?
- A. Diagnostic
- B. Laparoscopic
- C. Curative
- D. Palliative
Correct Answer: D
Rationale: A patient on hospice will undergo a surgical procedure only for palliative care to reduce pain, but it is not curative. The reduction of tumor size to relieve pain is considered a palliative procedure. A laparoscopic procedure is a type of surgery that is utilized for diagnostic purposes or for repair. The excision of a tumor is classified as curative. This patient is not having the tumor removed, only the size reduced.
The nurse is doing preoperative patient education with a 61-year-old male patient who has a 40-pack per year history of cigarette smoking. The patient will undergo an elective bunionectomy at a time that fits his work schedule in a few months. What would be the best instruction to give to this patient?
- A. Reduce smoking by 50% to prevent the development of pneumonia
- B. Stop smoking at least 6 weeks before the scheduled surgery to enhance pulmonary function and decrease infection
- C. Aim to quit smoking in the postoperative period to reduce the chance of surgical complications
- D. Stop smoking 4 to 8 weeks before the scheduled surgery to enhance pulmonary function and decrease infection
Correct Answer: D
Rationale: The reduction of smoking will enhance pulmonary function; in the preoperative period, patients who smoke should be urged to stop 4 to 8 weeks before surgery.
An OR nurse will be participating in the intraoperative phase of a patients kidney transplant. What action will the nurse prioritize in this aspect of nursing care?
- A. Monitoring the patients physiologic status
- B. Providing emotional support to family
- C. Maintaining the patients cognitive status
- D. Maintaining a clean environment
Correct Answer: A
Rationale: During the intraoperative phase, the nurse is responsible for physiologic monitoring. The intraoperative nurse cannot support the family at this time and the nurse is not responsible for maintaining the patients cognitive status. The intraoperative nurse maintains an aseptic, not clean, environment.
The nurse admitting a patient who is insulin dependent to the same-day surgical suite for carpal tunnel surgery. How should this patients diagnosis of type 1 diabetes affect the care that the nurse plans?
- A. The nurse should administer a bolus of dextrose IV solution preoperatively
- B. The nurse should keep the patient NPO for at least 8 hours preoperatively
- C. The nurse should initiate a subcutaneous infusion of long-acting insulin
- D. The nurse should assess the patients blood glucose levels vigilantly
Correct Answer: D
Rationale: The patient with diabetes who is undergoing surgery is at risk for hypoglycemia and hyperglycemia. Close glycemic monitoring is necessary. Dextrose infusion and prolonged NPO status are contraindicated. There is no specific need for an insulin infusion preoperatively.