Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) - Postoperative Nursing Management

Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) - Postoperative Nursing Management Related

Review Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) - Postoperative Nursing Management related questions and content

The nurse is preparing to change a patients abdominal dressing. The nurse recognizes the first step is to provide the patient with information regarding the procedure. Which of the following explanations should the nurse provide to the patient?

  • A. The dressing change is often painful, and we will be giving you pain medication prior to the procedure so you do not have to worry
  • B. During the dressing change, I will provide privacy at a time of your choosing, it should not be painful, and you can look at the incision and help with the procedure if you want to
  • C. The dressing change should not be painful, but you can never be sure, and infection is always a concern
  • D. The best time for doing a dressing change is during lunch so we are not interrupted. I will provide privacy, and it should not be painful
Correct Answer: B

Rationale: When having dressings changed, the patient needs to be informed that the dressing change is a simple procedure with little discomfort; privacy will be provided; and the patient is free to look at the incision or even assist in the dressing change itself. If the patient decides to look at the incision, assurance is given that the incision will shrink as it heals and that the redness will likely fade. Dressing changes should not be painful, but giving pain medication prior to the procedure is always a good preventive measure. Telling the patient that the dressing change should not be painful, but you can never be sure, and infection is always a concern does not offer the patient any real information or options and serves only to create fear. The best time for dressing changes is when it is most convenient for the patient; nutrition is important so interrupting lunch is probably a poor choice.

You may also like to solve these questions

A surgical patient has been in the PACU for the past 3 hours. What are the determining factors for the patient to be discharged from the PACU? Select all that apply.

  • A. Absence of pain
  • B. Stable blood pressure
  • C. Ability to tolerate oral fluids
  • D. Sufficient oxygen saturation
  • E. Adequate respiratory function
Correct Answer: B,D,E

Rationale: A patient remains in the PACU until fully recovered from the anesthetic agent. Indicators of recovery include stable blood pressure, adequate respiratory function, and adequate oxygen saturation level compared with baseline. Patients can be released from PACU before resuming oral intake. Pain is often present at discharge from the PACU and can be addressed in other inpatient settings.

The intraoperative nurse is transferring a patient from the OR to the PACU after replacement of the right knee. The patient is a 73-year-old woman. The nurse should prioritize which of the following actions?

  • A. Keeping the patient sterile
  • B. Keeping the patient restrained
  • C. Keeping the patient warm
  • D. Keeping the patient hydrated
Correct Answer: C

Rationale: Special attention is given to keeping the patient warm because elderly patients are more susceptible to hypothermia. It is all important for the nurse to pay attention to hydration, but hypovolemia does not occur as quickly as hypothermia. The patient is never sterile and restraints are very rarely necessary.

The nursing instructor is talking with a group of medicalsurgical students about deep vein thrombosis (DVT). A student asks what factors contribute to the formation of a DVT. What would be the instructors best response?

  • A. There is a genetic link in the formation of deep vein thrombi
  • B. Hypervolemia is often present in patients who go on to develop deep vein thrombi
  • C. No known factors contribute to the formation of deep vein thrombi; they just occur
  • D. Dehydration is a contributory factor to the formation of deep vein thrombi
Correct Answer: D

Rationale: The stress response that is initiated by surgery inhibits the fibrinolytic system, resulting in blood hypercoagulability. Dehydration, low cardiac output, blood pooling in the extremities, and bedrest add to the risk of thrombosis formation. Hypervolemia is not a risk factor and there are no known genetic factors.

The nurse is caring for a patient who is postoperative day 2 following a colon resection. While turning him, wound dehiscence with evisceration occurs. What should be the nurses first response?

  • A. Return the patient to his previous position and call the physician
  • B. Place saline-soaked sterile dressings on the wound
  • C. Assess the patients blood pressure and pulse
  • D. Pull the dehiscence closed using gloved hands
Correct Answer: B

Rationale: The nurse should first place saline-soaked sterile dressings on the open wound to prevent tissue drying and possible infection. Then the nurse should call the physician and take the patients vital signs. The dehiscence needs to be surgically closed, so the nurse should never try to close it.

The nurse is caring for a patient after abdominal surgery in the PACU. The patients blood pressure has increased and the patient is restless. The patients oxygen saturation is 97%. What cause for this change in status should the nurse first suspect?

  • A. The patient is hypothermic
  • B. The patient is in shock
  • C. The patient is in pain
  • D. The patient is hypoxic
Correct Answer: C

Rationale: An increase in blood pressure and restlessness are symptoms of pain. The patients oxygen saturation is 97%, so hypothermia, hypoxia, and shock are not likely causes of the patients restlessness.

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