Nokea
An older adult who is scheduled for a hip replacement is taking several medications on a regular basis. Which group of medications does the nurse identify as a surgical risk for this patient?
- A. Anticoagulants
- B. Antacids
- C. Laxatives
- D. Sedatives
Correct Answer: A
Rationale: Anticoagulant medications increase the risk for hemorrhage intra- and postoperatively.
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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 on a surgical unit is aware that older adults develop reduced vital capacity as a result of normal physiologic changes. Based on these changes, which nursing intervention takes priority?
- A. Taking and recording vital signs every shift
- B. Turning, coughing, and deep breathing every 4 hours
- C. Encouraging increased intake of oral fluids
- D. Assessing bowel sounds daily
Correct Answer: B
Rationale: Reduced vital capacity in older adults decreases respiratory expansion, increasing the risk for pneumonia and atelectasis. Encouraging the patient to turn, cough, and deep breathe every 4 hours helps to prevent complications.
A nurse is caring for a patient who is obese and has had abdominal surgery. The nurse prioritizes a plan to prevent what postoperative complication?
- A. Anesthetic interactions
- B. Impaired wound healing
- C. Weight gain
- D. Flatulence
Correct Answer: B
Rationale: Adipose (fatty) tissue has poor blood supply, which places the obese patient at risk for delayed wound healing, wound infection, and disruption in the integrity of the wound. Medication interactions are not the primary concern and are managed by the nurse anesthetist or anesthesiologist. Postoperative bleeding and flatulence (gas) after anesthesia are concerns for all patients, not just those with obesity.
The nurse documents attainment of expected outcomes in the preoperative phase as part of the perioperative plan of care. Which outcomes were met for Gabrielle? Select all that apply.
- A. Correct return demonstration of postoperative activities designed to prevent complications
- B. Physical and emotional readiness for operative procedure; appropriate for age
- C. Decreased risk for surgical site, catheter-based, and community-acquired infections
- D. Caregiver articulation of when to call the provider for follow-up and/or intervention
- E. Pulse oximetry >98% on room air
Correct Answer: B,D,E
Rationale: Gabrielle's nervous but smiling response indicates physical and emotional readiness (B). The scenario implies her mother was engaged in discussions about postoperative care, suggesting caregiver articulation of follow-up needs (D). Pulse oximetry >98% on room air (E) is a standard preoperative outcome, assumed met given no contrary indications.
Which solution is reasonable and safe for this transition of care?
- A. Gabrielle's mom will be given time alone with Gabrielle in the preoperative room to provide comfort to Gabrielle
- B. Gabrielle's mom will accompany Gabrielle to the surgical suite and remain with Gabrielle until the inhaled anesthesia takes effect
- C. Gabrielle's mom will be at the preoperative bedside while the nurse initiates IV therapy and administers an IV sedative
- D. Gabrielle's mom will administer an oral sedative to Gabrielle under the supervision of the nurse
Correct Answer: B
Rationale: Allowing Gabrielle's mother to accompany her to the surgical suite until anesthesia takes effect is a safe and reasonable solution. It provides comfort and reduces anxiety during the transition, while ensuring clinical safety under controlled conditions.