Nokea
The nurse is caring for a patient with diabetes who is scheduled for a mastectomy at 1:00 PM today and it is now 8:30 AM. The patient uses insulin to control blood glucose and has been NPO since midnight. Which of the following actions should the nurse take?
- A. Withhold the usual scheduled insulin dose because the patient is NPO.
- B. Obtain a blood glucose measurement before any insulin administration.
- C. Administer the usual insulin dose because stress will increase the blood glucose.
- D. Administer a lower dose of insulin because there will be no oral intake before surgery.
Correct Answer: B
Rationale: Preoperative insulin administration is individualized to the patient, and the current blood glucose will provide the most reliable information about insulin needs. It Sp?³??
You may also like to solve these questions
The nurse is obtaining the health history for a patient who is scheduled for outpatient knee surgery. Which of the following statements by the patient is most important for the nurse to report to the health care provider?
- A. I had a heart valve replacement last year.
- B. I had bacterial pneumonia 6 months ago.
- C. I have knee pain whenever I walk or jog.
- D. I have a strong family history of breast cancer.
Correct Answer: A
Rationale: A patient with a history of valve replacement is at risk for endocarditis associated with invasive procedures and may need antibiotic prophylaxis. A current respiratory infection may affect whether the patient should have surgery, but a history of pneumonia is not a reason to postpone surgery. The patient's knee pain is the likely reason for the surgery. A family history of breast cancer does not have any implications for the current surgery.
On the day of surgery, the nurse is admitting a patient with a history of cigarette smoking. Which of the following actions is most important at this time?
- A. Auscultate for adventitious breath sounds.
- B. Ask whether the patient has smoked recently.
- C. Remind the patient about harmful effects of smoking.
- D. Calculate the cigarette smoking history in pack-years.
Correct Answer: A
Rationale: Abnormal breath sounds may indicate the presence of an acute respiratory infection or persistent lung disease that will affect the choice of anaesthesia or proceeding with the scheduled surgery. The other nursing actions also are appropriate but will not affect the immediate surgical procedure as much as the presence of abnormal breath sounds.
Before the administration of preoperative medications, the nurse is preparing to witness the patient signing the operative consent form when the patient says, 'I do not really understand what the doctor said.' Which of the following actions is best for the nurse to take?
- A. Provide an explanation of the planned surgical procedure.
- B. Notify the surgeon that the informed-consent process is not complete.
- C. Administer the prescribed preoperative antibiotics and withhold any ordered sedative medications.
- D. Notify the operating room staff that the surgeon needs to give a more complete explanation of the procedure.
Correct Answer: B
Rationale: The surgeon is responsible for explaining the surgery to the patient, and the nurse should wait until the surgeon has clarified the surgery before having the patient sign the consent form. The nurse should communicate directly with the surgeon about the consent form rather than asking other staff to pass on the message. It is not within the nurse's legal scope of practice to explain the surgical procedure. No preoperative medications should be administered until the patient signs the consent form.
Which of the following topics is most important for the nurse to discuss preoperatively with a patient who is scheduled for a colon resection?
- A. Care for the surgical incision
- B. Medications used during surgery
- C. Deep-breathing and coughing techniques
- D. Oral antibiotic therapy after discharge home
Correct Answer: C
Rationale: Preoperative teaching, demonstration, and redemonstration of deep breathing and coughing are needed on patients having abdominal surgery to prevent postoperative atelectasis. Incisional care and the importance of completing antibiotics are better discussed after surgery, when the patient will be more likely to retain this information. The patient does not usually need information about medications that are used intraoperatively.
The nurse is preparing to administer atropine to a patient before surgery. Which of the following symptoms should the nurse teach the patient to expect?
- A. Dizziness
- B. Weakness
- C. Dry mouth
- D. Forgetfulness
Correct Answer: C
Rationale: Anticholinergic medications decrease oral and respiratory secretions, so the patient is taught that a dry mouth is an expected adverse effect. Weakness, forgetfulness, and dizziness are adverse effects associated with other preoperative medications such as opioids and benzodiazepines.