NUR 155 Test 2 Study Guide | Correct Questions And Answers | 2026 Update

Perioperative Nursing
3 phases of perioperative patient care
Preoperative: begins when the decision to proceed with surgical intervention is made
and ends with the transfer of patient onto the OR table.
 Intraoperative: begins when the patient is transferred onto the OR table and ends with
the admission to the PACU.
o Surgical setting
 Emergent: immediate intervention, life-threatening, unexpected
 Elective: Carefully planned, various settings
 Ambulatory: Outpatient, usually minimally invasive, requires < 24hr
stay.
o Surgical Procedures





 Postoperative: begins with the admission of the patient to the PACU and ends with the
follow-up evaluation in the clinical setting or home.

Comprehensive preoperative assessment
 Health History
o Previous surgical procedures
o Problems with previous surgeries
 EX. Malignant hypothermia
o Current health problems
 Social History
 Allergies: latex, medications
 Medication Review: including drug and alcohol use
o Meds to withhold
o Drug interactions
o Herbs, supplements, and OTC
 Vitals
 Baseline physical assessment
o Cardiovascular
 CV conditions, history or risk of VTE, 12 lead ECG and coagulation
studies.
o Respiratory status
 Underlying disease, recent or chronic
 Asthma, COPS, sleep apnea, obesity, and spinal/chest/airway deformities
 May need baseline PFT and ABGs
o Neurological Status
 Orientation and LOC, ability to respond & follow commands
 Sensory deficits
 Acute v. Chronic changes

,  Older adult assessment
 H/o strokes
o Hepatic and Genitourinary Function (toxicity, blood clotting)
 Renal disease, frequent UTIs, hepatic problems
 BUN/Creatinine
 Pregnancy
o Musculoskeletal
 Older adults
 Mobility problems
o Endocrine
 Diabetes
 Insulin/meds
 BGL
 Thyroid conditions
 Addison’s disease
o Immune function
 History of immune condition/immunocompromised
 Immunosuppressive drug
 Acute infection
 Allergies
 Medication sensitivities or reactions
o Nutritional and F&E status
 Assess for recent N/V/D or bowel prep
 Diuretics
 Asses for dehydration
 Obese/very thin
 Older adults
o Skin assessment
 Pressure ulcers
 Lesions and rashes
 Note tattoos and piercings.
 Site marking
 Psychosocial assessment
 Blood test, diagnostic tests: CBC, H&H, Urine function, liver function
 Identify risk factors for surgery: smoking, psychiatric disorder, comorbidities.
 Knowledge about the procedure
 Surgical site identification

Identify health factors that affect patients preoperatively.
 H/o of or risk for VTE
 Respiratory issues
 Cardiovascular issues
 Infection
 Neurological status

Identify potential risks and complications before, during, and after surgery.
Legal and ethical considerations of informed consent
 Nonemergency surgery
 Requires adequate disclosure of:
o Diagnosis

, o Nature and purpose of treatment
o Risk of consequences of tx
o Probability of desired outcome
o Alternative tx, benefits, and risks of procedure
o Prognosis is tx is not done.
 Patient must show clear understanding of information BEFORE receiving any sedating
medications.
 Must be voluntary.
 Nursing responsibility:
o Advocate for patient
o Contact surgeon for more information id the patient is unclear about procedure.
o Witness patient’s signature
o Ensure consent is in the patient’s chart before surgery.
 Special situations:
o Mentally incompetent, unconscious, or minor patient
 Authorized person, guardian, etc.
o Emancipated minor
 Depend on state laws and nurse practice act.
o Patient distress/comfort
o Medical emergency

Immediate preoperative preparation of the patient.
 Assessment and vitals
 Orders are complete
 Verify lab and diagnostic results
 Completion and documentation of skin prep as necessary
 Communicate any important assessment findings
 NPO to prevent aspiration, pneumonia, or death.
o 8 hrs before procedure
 Need for bowel preparations-depending on type of surgery.
 Skin preparations/Hair
 Remove personal items and devices.
 Void immediately before
 Informed consent
o Patients have right to make decisions regarding treatment.
o Ensured patient is provided with necessary information to evaluate the proposed
surgery before agreeing to it.
o Protects the patient from unsanctioned surgery.
o Protects surgeon from claims of unauthorized operation.
o Surgeon responsible for obtaining consent and providing initial education about
the procedure.
o Can be withdrawn at any time.
 Preanesthetic Medications
o Meds given to encourage sedation or treat side effects of anesthesia
o Antibiotics
o Beta-Blockers
o Insulin
o Routine rx medications
o Observe for reactions