A postoperative client has respiratory depression after rece...

A postoperative client has respiratory depression after receiving midazolam (Versed) for sedation. Which medication and dose does the nurse prepare to administer?

A. Flumazenil (Romazicon) 0.2 to 1 mg
B. Flumazenil (Romazicon) 2 to 10 mg
C. Flumazenil (Romazicon) 3 to 15 mg
D. Naloxone (Narcan) 0.4 to 2 mg

Correct Answer: A

Rationale: Flumazenil is a benzodiazepine antagonist used to reverse the effects of midazolam. The correct dose is 0.2 to 1 mg. Naloxone is an opioid antagonist and would not be appropriate for reversing benzodiazepine-induced respiratory depression.

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A postoperative client states that the sequential compression devices itch and are too hot. The client asks the nurse to remove them. What response by the nurse is best?

A. Let me call the surgeon to see if you really need them.
B. No, you have to use those for 24 hours after surgery.
C. OK, we can remove them since you are stable now.
D. To prevent blood clots, you need them a few more hours.

Correct Answer: D

Rationale: According to the Surgical Care Improvement Project (SCIP), prophylactic measures to prevent thrombembolic events, such as sequential compression devices, are continued for 24 hours after surgery. The nurse should explain this to the client to promote compliance. Calling the surgeon is unnecessary, and simply refusing or agreeing to remove them does not address the client's concerns or provide education.

A client is experiencing pain after leg surgery but cannot yet have more pain medication. What comfort measures can the nurse provide? (Select all that apply.)

A. Apply stimulation to the contralateral leg.
B. Assess the client's willingness to try meditation.
C. Elevate the client's operative leg and apply ice.
D. Reduce the noise level in the client's environment.
E. Turn the TV on loudly to distract the client.

Correct Answer: A,B,C,D

Rationale: Nonpharmacologic measures like contralateral stimulation, meditation, leg elevation with ice, and reducing environmental noise can help manage pain. Loud TV is not an effective diversion and may increase discomfort.

A postoperative client is being discharged with a prescription for oxycodone hydrochloride with acetaminophen (Percocet). What instructions does the nurse give the client? (Select all that apply.)

A. Check all over-the-counter medications for acetaminophen.
B. Do not take more pills each day than you are prescribed.
C. Eat a high-fiber diet and drink plenty of water.
D. If this gives you diarrhea, loperamide (Imodium) can help.
E. You shouldn't drive while you are taking this medication.

Correct Answer: A,B,C,E

Rationale: Percocet contains acetaminophen, so the client must check other medications to avoid exceeding the 3000 mg daily limit. Adhering to the prescribed dose, maintaining a high-fiber diet to prevent constipation, and avoiding driving due to drowsiness are key instructions. Diarrhea is not a common side effect of opioids.

The postanesthesia care unit (PACU) charge nurse notes vital signs on four postoperative clients. Which client should the nurse assess first?

A. Client with a blood pressure of 100/50 mm Hg
B. Client with a pulse of 118 per minute
C. Client with a respiratory rate of 8 breaths/min
D. Client with a temperature of 96°F (35.6°C)

Correct Answer: C

Rationale: The respiratory rate is the most critical vital sign for any client who has undergone general anesthesia or is a postoperative client. A respiratory rate of 8 breaths/min is abnormally low and requires immediate assessment. The other vital signs, while concerning, are less critical in this context.

A nurse on the postoperative nursing unit provides care to reduce the incidence of surgical wound infection. What actions are best to achieve this goal? (Select all that apply.)

A. Administer antibiotics for 72 hours.
B. Dispose of dressings properly.
C. Ensure a sterile environment in the operating room.
D. Perform proper hand hygiene.
E. Remove and replace wet dressings.

Correct Answer: B,D,E

Rationale: Proper disposal of soiled dressings, performing hand hygiene, and removing wet dressings reduce infection risk. Prophylactic antibiotics are typically stopped after 24 hours if no infection is present, and the operating room environment is not the nurse's responsibility on the postoperative unit.