Nokea
The perioperative nurse manager and the postoperative unit manager are concerned about the increasing number of surgical infections in their hospital. What action by the managers is best?
- A. Audit charts to see if the Surgical Care Improvement Project (SCIP) outcomes were met
- B. Encourage staff on both units to provide peer pressure to adhere to hand hygiene policy
- C. Hold educational meetings with the nursing and surgical staff on infection prevention
- D. Monitor staff on both units for consistent adherence to established hand hygiene practices
Correct Answer: A
Rationale: The SCIP project contains core measures that are mandatory for all surgical clients and focuses on preventing infection, serious cardiac events, and venous thromboembolism. The managers should start by reviewing charts to see if the guidelines of this project were implemented. The other actions may be necessary too, but first the managers need to assess the situation.
You may also like to solve these questions
A nurse is giving a client instructions for showering with special antimicrobial soap the night before surgery. What instruction is most appropriate?
- A. After you wash the surgical site, shave the area with your own razor
- B. Be sure to wash the area where you will have surgery very thoroughly
- C. Use a washcloth to wash the surgical sites, do not take a full shower or bath
- D. Wash the surgical site first, then shampoo and wash the rest of your body
Correct Answer: B
Rationale: The proposed surgical site needs to be washed thoroughly and completely with the antimicrobial soap. Shaving, if absolutely necessary, should be done in the operative suite immediately before the operation begins, using sterile equipment. The client needs a full shower or bath (shower preferred). Washing the surgical site last ensures that soap does not run over the cleansed site if other areas are washed first.
A student nurse asks why older adults are at higher risk for complications after surgery. What reasons does the registered nurse give?
- A. Decreased cardiac output
- B. Decreased oxygenation
- C. Frequent nocturia
- D. Mobility issues
- E. Inability to adapt to new surroundings
Correct Answer: A,B,C,D
Rationale: Older adults have many age-related physiologic changes that put them at higher risk of complications after surgery, including decreased cardiac output, decreased oxygenation of tissues, nocturia, and mobility issues. They also have a decreased ability to adapt to new surroundings, but this is not the same as being unable to adapt.
A client is on the phone when the nurse brings a preoperative antibiotic before scheduled surgery. The circulating nurse has requested the antibiotic be started. The client wants the nurse to wait before starting it. What response by the nurse is most appropriate?
- A. Explain the rationale for giving the medicine now
- B. Leave the room and come back in 15 minutes
- C. Provide holistic client care and come back later
- D. Tell the client you must start the medication now
Correct Answer: A
Rationale: The preoperative antibiotic must be given within 60 minutes of the surgical start time to ensure the proper amount is in the tissues when the incision is made. The nurse should explain the rationale to the client for this timing. The other options do not take this timing into consideration and do not give the client the information needed to be cooperative.
A preoperative nurse is reviewing morning laboratory values on four clients waiting for surgery. Which result warrants immediate communication with the surgical team?
- A. Creatinine 2 mg/dL
- B. Potassium 3.8 mEq/L
- C. Hemoglobin 12 g/dL
- D. Platelet count 150,000/mm³
Correct Answer: A
Rationale: A creatinine level of 2 mg/dL is elevated, indicating potential renal impairment, which can affect anesthesia and surgical outcomes. This warrants immediate communication with the surgical team. The other values are within normal ranges and do not require urgent reporting.
A nurse working in the preoperative holding area performs which functions to ensure client safety?
- A. Allow small sips of plain water
- B. Check that consent forms are appropriately completed
- C. Ensure the client has an armband on
- D. Have the client help mark the surgical site
- E. Allow the client to use the toilet before giving sedation
Correct Answer: B,C,D,E
Rationale: Providing for client safety is a priority function of the preoperative nurse. Checking for appropriately completed consent, verifying the client's identity, having the client assist in marking the surgical site if applicable, and allowing the client to use the toilet prior to sedation are important safety measures. The preoperative client should be NPO, so water should not be provided.