Nokea
The circulating nurse and preoperative nurse are reviewing the chart of a client scheduled for minimally invasive surgery (MIS). What information on the chart needs to be reported to the surgeon as a priority?
- A. Call the charge nurse.
- B. Consent for MIS procedure only
- C. Call prior anesthesia exposure
- D. Call prior anesthesia last to hours.
Correct Answer: B
Rationale: All MIS procedures have the potential for becoming open procedures depending on findings and complications. The client's consent should include this possibility. The nurse should report this finding to the surgeon prior to surgery taking place. Having allergies noted and an allergy band applied is standard. Calling the charge nurse is not the priority in this case.
You may also like to solve these questions
A client in the operating room has developed malignant hyperthermia. The client's potassium is 6.5 mEq/L. What action by the nurse is most appropriate?
- A. Administer insulin and glucose.
- B. Administer dantrolene sodium (Dantrium).
- C. Increase intravenous fluids.
- D. Monitor the client's electrocardiogram.
Correct Answer: B
Rationale: Malignant hyperthermia is a medical emergency, and dantrolene sodium (Dantrium) is the drug of choice to treat it. Hyperkalemia (potassium 6.5 mEq/L) may occur, but the priority is to administer dantrolene to reverse the malignant hyperthermia. Administering insulin and glucose or increasing fluids may be part of the treatment protocol, but dantrolene is the most critical. Monitoring the ECG is important but not the priority action.
A circulating nurse has transferred an older client to the operating room. What action by the nurse is most important for this client?
- A. Allow the client to keep hearing aids in until anesthesia begins.
- B. Pad the table as appropriate for the surgical procedure.
- C. Position the client for maximum visualization of the site.
- D. Stay with the client, providing emotional comfort and support.
Correct Answer: A
Rationale: Many older clients have sensory loss. To help prevent disorientation, facilities often allow older clients to keep their eyeglasses on and hearing aids in until the start of anesthesia. The other actions are appropriate for all operative clients.
A client has developed malignant hyperthermia. The client weighs 113 pounds. What is the safe dose range for one dose of dantrolene sodium (Dantrium)? (Enter your answer using whole numbers, separated by a hyphen.)
- A. 100-150 mg
- B. 124-155 mg
- C. 200-250 mg
- D. 50-75 mg
Correct Answer: B
Rationale: The safe dose range for dantrolene sodium (Dantrium) in treating malignant hyperthermia is 2.5 mg/kg. For a client weighing 113 pounds (51.36 kg), the dose is calculated as 51.36 kg ? 2.5 mg/kg = 128.4 mg. The safe range is typically rounded to whole numbers, making 124-155 mg appropriate for one dose.
The circulating nurse is in the operating room and sees the surgeon don gown and gloves using appropriate sterile procedure. The surgeon then folds the hands together and places them down below the hips. What action by the nurse is more appropriate?
- A. Ask the surgeon to change the sterile gown.
- B. Do nothing, this is acceptable sterile procedure.
- C. Do the nurse surgeon more quickly and has been broken.
- D. Obtain a new part of sterile gloves for the surgeon to put on.
Correct Answer: C
Rationale: The surgical gown is considered sterile from the chest to the level of the surgical field. By placing the hands down by the hips, the surgeon has broken sterile field. The circulating nurse informs the surgeon of this breach; changing only the gloves or only the gown does not restore the sterile sections of the gown. Doing nothing is unacceptable.
A client is having surgery. The circulating nurse notes the client's oxygen saturation is low and the heart rate is elevated. What is more important?
- A. Assess the client's end-tidal carbon dioxide level
- B. Document the findings in the client's chart.
- C. Inform the anesthesia provider of these findings.
- D. Prepare to administer dantrolene sodium (Dantrium).
Correct Answer: A
Rationale: Malignant hyperthermia is a rare but serious reaction to anesthesia. The triad of early signs includes decreased oxygen saturation, tachycardia, and elevated end-tidal carbon dioxide (CO2) level. The nurse should quickly check the end-tidal CO2 and then report findings to the anesthesia provider and surgeon. Documentation is vital, but not the most important action at this stage. Dantrolene sodium is the drug of choice if the client does have malignant hyperthermia.