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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.
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The nurse is caring for a patient in the postoperative period following an abdominal hysterectomy. The patient states, I dont want to use my pain meds because theyll make me dependent and I wont get better as fast. Which response is most important when explaining the use of pain medication?
- A. You will need the pain medication for at least 1 week to help in your recovery. What do you mean you feel you wont get better faster?
- B. Pain medication will help to decrease your pain and increase your ability to breath. Dependency is a risk with pain medication, but you are young and wont have any problems
- C. Pain medication can be given by mouth to prevent the risk of dependency that you are worried about. The pain medication has not been shown to affect your risk of a slowed recovery
- D. You will move more easily and heal more quickly with decreased pain. Dependence only occurs when it is administered for an extended period of time
Correct Answer: D
Rationale: Postoperatively, medications are administered to relieve pain and maintain comfort without increasing the risk of inadequate air exchange. In the responses by the nurse, (response D) addresses the patients concerns about drug dependency and the nurses need to increase the patients ability to move and recover from surgery. The other responses offer incorrect information, such as increasing the patients ability to breathe or specifying the time needed to take the medication. Opioids will cause respiratory depression.
The nurse is preparing to send a patient to the OR for a scheduled surgery. What should the nurse ensure is on the chart when it accompanies the patient to surgery? Select all that apply.
- A. Laboratory reports
- B. Nurses notes
- C. Verification form
- D. Social work assessment
- E. Dieticians assessment
Correct Answer: A,B,C
Rationale: The completed chart (with the preoperative checklist and verification form) accompanies the patient to the OR with the surgical consent form attached, along with all laboratory reports and nurses records. Any unusual last-minute observations that may have a bearing on anesthesia or surgery are noted prominently at the front of the chart. The social work and dieticians assessments are not normally necessary when the patient goes to surgery.
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 performing a preoperative assessment on a patient going to surgery. The patient informs the nurse that he drinks approximately two bottles of wine each day and has for the last several years. What postoperative difficulties can the nurse anticipate for this patient?
- A. Alcohol withdrawal syndrome immediately following surgery
- B. Alcohol withdrawal syndrome 2 to 4 days after his last alcohol drink
- C. Alcohol withdrawal syndrome upon administration of general anesthesia
- D. Alcohol withdrawal syndrome 1 week after his last alcohol drink
Correct Answer: B
Rationale: Alcohol withdrawal syndrome may be anticipated between 48 and 96 hours after alcohol withdrawal and is associated with a significant mortality rate when it occurs postoperatively.
One of the things a nurse has taught to a patient during preoperative teaching is to have nothing by mouth for the specified time before surgery. The patient asks the nurse why this is important. What is the most appropriate response for the patient?
- A. You will need to have food and fluid restricted before surgery so you are not at risk for choking
- B. The restriction of food or fluid will prevent the development of pneumonia related to decreased lung capacity
- C. The presence of food in the stomach interferes with the absorption of anesthetic agents
- D. By withholding food for 8 hours before surgery, you will not develop constipation in the postoperative period
Correct Answer: A
Rationale: The major purpose of withholding food and fluid before surgery is to prevent aspiration. There is no scientific basis for withholding food and the development of pneumonia or interference with absorption of anesthetic agents. Constipation in patients in the postoperative period is related to the anesthesia, not from withholding food or fluid in the hours before surgery.