Nokea
The nurse is reviewing a preoperative informed consent when preparing the client for surgery. Which content(s) of the informed consent is required? Select all that apply.
- A. Explanation of procedure
- B. Estimated time of procedure
- C. Potential risks
- D. Benefits of surgery
- E. Personnel present
- F. Description of alternatives
Correct Answer: A,C,D,F
Rationale: Informed consents should be in writing and contain an explanation of procedure and risks, description of benefits and alternative, an offer to answer questions about procedure, ability to withdraw consent, and statement informing the client if the protocol differs from customary procedure. An estimated time of procedure and personnel present are not required in the informed consent.
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The nurse is caring for a client 6 hours post surgery. The nurse observes that the client voids urine frequently and in small amounts. The nurse knows that this most probably indicates what?
- A. Requirement of intermittent catheterization
- B. Calculus formation
- C. Urine retention
- D. Urinary infection
Correct Answer: C
Rationale: Voiding frequent, small amounts of urine indicates retention of urine with elimination of overflow. The nurse should assess the volume of first voided urine to determine adequacy of output. If the client fails to void within 8 hours of surgery, the nurse should consult with the physician regarding instituting intermittent catheterization until voluntary voiding returns and is not required in this case. Frequent and small amounts of urine voiding does not indicate urinary infection nor does it indicate the formation of a calculus.
The nurse is caring for a client during the immediate postoperative period. What signs and symptoms indicate that the client may be in shock?
- A. Weak and rapid pulse rate
- B. Warm, dry skin
- C. Pooling of secretions in the lungs
- D. Obstructed airway
Correct Answer: A
Rationale: Signs and symptoms of shock include pallor, fall in blood pressure, weak and rapid pulse rate, restlessness, and cool, moist skin. Pooling of secretions in the lungs and an obstructed airway predispose the client to hypoxia and not to shock.
The nurse is caring for a client during an intraoperative procedure. When assessing vital signs, which result indicates a need to alert the anesthesiologist immediately?
- A. Pulse rate of 110 beats/min
- B. Respiratory rate of 18 breaths/min
- C. Blood pressure of 104/62 mm Hg
- D. Temperature of 102.5?°F (39?°C)
Correct Answer: D
Rationale: Intraoperative hyperthermia can indicate a life-threatening condition called malignant hyperthermia. The circulating nurse closely monitors the client for signs of hyperthermia. The pulse rate, respiratory rate, and blood pressure did not indicate a significant concern.
The nurse is caring for a client needing emergency surgery. Which preoperative teaching can be omitted when preparing a client for surgery?
- A. Effective coughing and deep breathing
- B. Types of postoperative pain medication
- C. Post-discharge diet
- D. Knowledge of surgical procedure
Correct Answer: C
Rationale: The preoperative teaching that could be omitted due to the need to obtain emergency surgery is explaining the post-discharge diet. This is not essential information to improve client participation in the postoperative recovery. Coughing and deep breathing are essential in the immediate postoperative period. Clients are often concerned about postoperative pain so instruction on pain medication can decrease anxiety. Knowledge of the surgical procedure must be explained by a physician when signing a surgical consent.
The nurse is caring for a client who is 2 hours postoperative. The client states, 'I am nauseated.' Which action(s) should the nurse perform? Select all that apply.
- A. Provide an emesis basin.
- B. Check the medication record for antiemetic medication prescription.
- C. Obtain vital signs.
- D. Encourage deep breathing.
- E. Have the client drink 8 oz (240 mL) of water.
Correct Answer: A,B,C,D
Rationale: Nausea is a frequent symptom in the postoperative period. When a client reports nausea, the nurse should provide an emesis basin in case the client vomits, check the medication administration record to provide a prescribed antiemetic, obtain vital signs per postoperative protocol, and encourage deep breathing. Liquids should be held until the nausea subsides.