Nokea
A patient is seen at the health care provider's office several weeks before hip surgery for preoperative assessment. The patient reports use of Echinacea, ginseng, glucosamine, and chondroitin. Which of the following actions should the nurse take?
- A. Ascertain that there will be no interactions with anaesthetic agents.
- B. Discuss the supplement use with the patient's health care provider.
- C. Teach the patient that these products may be continued preoperatively.
- D. Advise the patient to stop the use of all herbs and supplements at this time.
Correct Answer: B
Rationale: The nurse should discuss the medication use with the patient's health care provider because ginseng may increase bleeding, heart rate, and blood pressure. The nurse should not advise the patient to stop the supplements or to continue them without consulting with the health care provider. Determining the interactions between the supplements and anaesthetics is not within the nurse's scope of practice.
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The nurse is interviewing a patient who is to have outpatient surgery using a general anaesthetic. Which of the following information is most important to communicate to the surgeon and anaesthesiologist before surgery?
- A. The patient drinks three or four cups of coffee every morning before going to work.
- B. The patient takes a baby Aspirin daily but stopped taking Aspirin 2 weeks ago.
- C. The patient drank 120 mL of apple juice 3 hours before coming to the hospital.
- D. The patient's father died after receiving general anaesthesia for abdominal surgery.
Correct Answer: D
Rationale: The information about the patient's father suggests that there may be a family history of malignant hyperthermia and that precautions may need to be taken to prevent this complication. Current research indicates that having clear liquids 3 hours before surgery does not increase the risk for aspiration in most patients. Patients are instructed to discontinue Aspirin 1-2 weeks before surgery. The patient should be offered caffeinated beverages postoperatively to prevent a caffeine-withdrawal headache, but this does not have preoperative implications.
The nurse is completing a preoperative assessment of a patient scheduled for a colon resection and the patient tells the nurse about using St. John's wort to prevent depression. Which of the following information should the nurse alert the staff in the postanaesthesia recovery area about?
- A. Increased pain
- B. Hypertensive episodes
- C. Increased postanaesthesia waking time
- D. Increased postoperative bleeding
Correct Answer: C
Rationale: St. John's wort may prolong the effects of anaesthetic agents and increase the time to waken completely after surgery. It is not associated with increased bleeding risk, hypertension, or increased pain.
The nurse is obtaining the health history for a patient who is scheduled for outpatient knee surgery. Which of the following statements by the patient is most important for the nurse to report to the health care provider?
- A. I had a heart valve replacement last year.
- B. I had bacterial pneumonia 6 months ago.
- C. I have knee pain whenever I walk or jog.
- D. I have a strong family history of breast cancer.
Correct Answer: A
Rationale: A patient with a history of valve replacement is at risk for endocarditis associated with invasive procedures and may need antibiotic prophylaxis. A current respiratory infection may affect whether the patient should have surgery, but a history of pneumonia is not a reason to postpone surgery. The patient's knee pain is the likely reason for the surgery. A family history of breast cancer does not have any implications for the current surgery.
The nurse is preparing a patient for surgery. Which of the following information about medication use is most important for the nurse to communicate to the health care provider?
- A. The patient uses acetaminophen occasionally for aches and pains.
- B. The patient takes garlic capsules daily but did not take any on the surgical day.
- C. The patient has a history of cocaine use but quit using the drug over 10 years ago.
- D. The patient took a sedative medication the previous night to assist in falling asleep.
Correct Answer: B
Rationale: Persistent use of garlic may predispose to intraoperative and postoperative bleeding. The use of a sedative the previous night, occasional acetaminophen use, and a distant history of cocaine use will not usually affect the surgical outcome.
The clinic nurse is reviewing the complete blood cell count (CBC) results for a patient who is scheduled for surgery in a few days. The results are white blood cell count (WBC) 10.2 ?? 10/1, hemoglobin 150 g/1, hematocrit 45%, platelets 150 ?? 10/1. Which of the following actions should the nurse take?
- A. Send the CBC results to the surgery facility.
- B. Call the surgeon and anaesthesiologist immediately.
- C. Ask the patient about any symptoms of a recent infection.
- D. Discuss the possibility of blood transfusion with the patient.
Correct Answer: A
Rationale: The nurse should be sure that the CBC results, which are normal, are available at the surgical facility to avoid delay of the procedure. With normal results, there is no need to notify the surgeon or anaesthesiologist, discuss blood transfusion, or ask about recent infection.