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A scrub nurse is assisting a surgeon with a kidney transplant. What are the patient responsibilities of the scrub nurse? Select all that apply.
- A. Maintaining sterile technique
- B. Draping and handling instruments and supplies
- C. Identifying and assessing the patient on admission
- D. Integrating case management
- E. Preparing the skin at the surgical site
- F. Providing exposure of the operative area
Correct Answer: A,B
Rationale: The scrub nurse is a member of the sterile team who maintains sterile technique while draping and handling instruments and supplies. Two duties of the circulating nurse are to identify and assess the patient on admission to the OR and prepare the skin at the surgical site. The perioperative registered nurse actively assists the surgeon by providing exposure of the operative area. The advanced practice registered nurse coordinated nurse and integrates care activities, collaborates with physicians and nurses in all phases of perioperative and postanesthesia care, and integrates care management, critical paths, and research into care of the surgical patient.
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A nurse is preparing a patient for a cesarean birth using spinal anesthesia. Which effects of anesthesia will the nurse teach the patient to expect? Select all that apply.
- A. Loss of consciousness
- B. Inability to speak
- C. Reduction or loss of deep tendon reflexes
- D. Loss of sensation below the injection
- E. Inability to move the lower extremities
- F. Prolonged pain relief after other anesthesia wears off
Correct Answer: D,E
Rationale: A localized loss of sensation, loss of motor function, and possible loss of reflexes occur with a regional anesthetic. Loss of consciousness, including speech and relaxation of skeletal muscles, occurs with general anesthesia. Prolonged pain relief after other anesthesia wears off and infiltration of the underlying tissues in an operative area occur with topical anesthesia.
A nurse is planning caring for a patient who had thoracic surgery. Which nursing interventions are most appropriate for patients undergoing this type of surgery?
- A. Observing for incisional wound healing
- B. Monitoring vital signs, especially pulse and blood pressure
- C. Instructing the patient on the proper use of the incentive spirometer
- D. Applying antiembolism stockings
Correct Answer: A,B,C
Rationale: A thoracic incision, near or overlying the lungs, makes it difficult or painful for patients to take deep breaths and cough. The nurse uses analgesics, repositioning, coughing and deep breathing, and an incentive spirometer to promote respiratory expansion and airway clearance to decrease the risk for respiratory complications. Monitoring vital signs is also critical to detect complications early.
A nurse has been asked to witness a patient signature on an informed consent form for surgery. What communication from the surgeon does the nurse expect the patient to receive before signing the form? Select all that apply.
- A. Option of nontreatment
- B. Underlying disease process and its natural course
- C. Notice that once the form is signed, the patient cannot withdraw the consent
- D. Explanation of the guaranteed outcome of the procedure or treatment
- E. Name and qualifications of the provider of the procedure or treatment
- F. Explanation of the risks and benefits of the procedure or treatment
Correct Answer: A,B,E,F
Rationale: The information communicated while obtaining informed consent includes the description of the procedure or treatment; potential alternative therapies; the option of nontreatment; the underlying disease process and its natural course; the name and qualifications of the health care provider performing the procedure or treatment; explanation of the risks and benefits; explanation that the patient has the right to refuse treatment; explanation that consent can be withdrawn; and explanation of expected (not guaranteed) outcome, recovery, and rehabilitation plan and course.
A nurse is providing teaching for a patient scheduled to have same-day surgery. Which teaching method would be most effective in preoperative teaching for ambulatory surgery?
- A. Lecture
- B. Discussion
- C. Audiovisuals
- D. Written instructions
Correct Answer: D
Rationale: Written instructions are most effective in providing information for same-day surgery.
When caring for a patient who returned from the operating room 8 hours ago, which finding requires follow-up assessment by the nurse?
- A. Patient reports discomfort at surgical site, scale of 5/10
- B. Patient voids small amounts every 20-30 minutes
- C. Patient is sleepy and awakens only to touch
- D. Patient reports thirst and dry mouth
Correct Answer: B
Rationale: This patient is displaying typical signs of urinary retention, voiding small frequent amounts. Discomfort is expected and can be managed with prescribed analgesics. Anesthesia or opioid analgesia promotes sedation from which this patient awakens to touch. Dry mouth and thirst can result from NPO status and possible anticholinergic medication intended to dry respiratory secretions during surgery.