ADN 240 - Perioperative Nursing Exam
Questions and Answers
Preoperative Care - ✅✅before surgery, thorough assessment of the client's
physical/emotional/psychosocial status.
Preoperative Assessment - ✅✅Detailed medical history, surgical hx, tolerance of anesthesia,
medications, herbal/substance use, cultural considerations, psychosocial hx.
Allergies: medications, latex, contrast, food products.
Anxiety Level: regarding procedure, coping, support
Baseline Date: head to toe, vital signs, oxygen saturation
Venous Thromboembolism Risk
Banana/Kiwi Allergy - ✅✅Can indicate risk for latex allergy
Egg/Soybean Allergy - ✅✅Contraindicated for use of propofol for anesthesia
Shellfish Allergy - ✅✅Indicated reaction to povidone-iodine
Nursing Responsibilities for Informed Consent - ✅✅Verify informed consents is accurate, completed,
signed. We can witness the signature.
- we do not explain the procedure, or obtain the consent. We can clarify information that the surgeon
went over, but may not cover any new information.
- We determine if client is 18yrs old or emancipated, mentally capaable of understanding the
risks/reasons/options/anesthesia, under the influence of medication that affects decision
making/judgement (opioids, benzodiazepines, sedatives)
- Ensure provider gave necessary info, that client understood info, notify provider if client has more
questions or appears to not understand
Nursing Care Preoperative - ✅✅- Skin prep (cleaning, removing hair)
- Jewelry, dentures, prosthetic, makeup, nail polish, glasses are removed
, - NPO of solids for 6hr prior, liquids 2hr prior (for general) for local, 3-4hr. Note on chart the last time pt
ate/drank
- IV access w/18 gauge needle.
- Enemas/laxatives to clear bowels
- Check scheduled meds to see what may be held (antihypertensives, anticoagulants, antidepressants)
- Administer preoperative meds (antiemetics, sedatives, prophylactic antimicrobials): antibiotics given
within 1 hr of surgery, have client void, if client previously took beta blocker have them take one before
surgery
Confirming Site - ✅✅WE stop everybody and verify that we have the correct surgical site, with the
correct client, and we are doing the correct procedure.
Preoperative Baseline Data - ✅✅- Heart rate rhythm
- Tissue perfusion (edema)
- Electrolytes (mainly K, for anesthesia)
- WBC (if elevated some surgeons wait)
- If low hgb some patient's get blood first
- COPD/asthma: Not over oxygenating COPD patient's, having asthma patient's bring inhaler with and
avoid medication triggers
Spiritual Needs - ✅✅Do they want a chaplain to come preoperative or postop and pray. Do they want
you to pray with them
Patient Rights - ✅✅Ensure patient knows that they have the right to change their mind at any time,
nobody is making them have surgery
Family Teaching - ✅✅Let family stay as long as possible before surgery, do an appropriate amount of
family teaching as well.
Informed Consent - ✅✅Ensuring that surgery and anesthesia consents are signed. If patient is capable
of signing have them do it, if POA has to sign document that.
Questions and Answers
Preoperative Care - ✅✅before surgery, thorough assessment of the client's
physical/emotional/psychosocial status.
Preoperative Assessment - ✅✅Detailed medical history, surgical hx, tolerance of anesthesia,
medications, herbal/substance use, cultural considerations, psychosocial hx.
Allergies: medications, latex, contrast, food products.
Anxiety Level: regarding procedure, coping, support
Baseline Date: head to toe, vital signs, oxygen saturation
Venous Thromboembolism Risk
Banana/Kiwi Allergy - ✅✅Can indicate risk for latex allergy
Egg/Soybean Allergy - ✅✅Contraindicated for use of propofol for anesthesia
Shellfish Allergy - ✅✅Indicated reaction to povidone-iodine
Nursing Responsibilities for Informed Consent - ✅✅Verify informed consents is accurate, completed,
signed. We can witness the signature.
- we do not explain the procedure, or obtain the consent. We can clarify information that the surgeon
went over, but may not cover any new information.
- We determine if client is 18yrs old or emancipated, mentally capaable of understanding the
risks/reasons/options/anesthesia, under the influence of medication that affects decision
making/judgement (opioids, benzodiazepines, sedatives)
- Ensure provider gave necessary info, that client understood info, notify provider if client has more
questions or appears to not understand
Nursing Care Preoperative - ✅✅- Skin prep (cleaning, removing hair)
- Jewelry, dentures, prosthetic, makeup, nail polish, glasses are removed
, - NPO of solids for 6hr prior, liquids 2hr prior (for general) for local, 3-4hr. Note on chart the last time pt
ate/drank
- IV access w/18 gauge needle.
- Enemas/laxatives to clear bowels
- Check scheduled meds to see what may be held (antihypertensives, anticoagulants, antidepressants)
- Administer preoperative meds (antiemetics, sedatives, prophylactic antimicrobials): antibiotics given
within 1 hr of surgery, have client void, if client previously took beta blocker have them take one before
surgery
Confirming Site - ✅✅WE stop everybody and verify that we have the correct surgical site, with the
correct client, and we are doing the correct procedure.
Preoperative Baseline Data - ✅✅- Heart rate rhythm
- Tissue perfusion (edema)
- Electrolytes (mainly K, for anesthesia)
- WBC (if elevated some surgeons wait)
- If low hgb some patient's get blood first
- COPD/asthma: Not over oxygenating COPD patient's, having asthma patient's bring inhaler with and
avoid medication triggers
Spiritual Needs - ✅✅Do they want a chaplain to come preoperative or postop and pray. Do they want
you to pray with them
Patient Rights - ✅✅Ensure patient knows that they have the right to change their mind at any time,
nobody is making them have surgery
Family Teaching - ✅✅Let family stay as long as possible before surgery, do an appropriate amount of
family teaching as well.
Informed Consent - ✅✅Ensuring that surgery and anesthesia consents are signed. If patient is capable
of signing have them do it, if POA has to sign document that.
