NUR 242 MEDICAL LATEST
SURG EXAM
What are you first 5 nursing actions for Susan Akers? - ANSWERS--
ADDS Score
-Full blood work up
-Abdominal Ax
-Collect pre op data
-Ensure patient documentation is correct
What is the recovery room criteria? - ANSWERS--They are conscious
and oriented
-Able to maintain a clear and stable airway
-Vital signs are stable or consistent with preoperative vital signs for at
least 30 mins
-Pretective reflexes are in tact
-They are able to move all of their extremities
-Intake and output is satisfactory (30mL/hr)
-They are afebrile or a febrile condition is being managed
-Dressings are dry and intact
END OF
PAGE
1
, NUR 242 MEDICAL LATEST
SURG EXAM
Susan Akers three nursing diagnoses - ANSWERS--Acute pain
-Impaired nutrition
-Risk of infection
What are your nursing diagnosis for Hussien Khan? - ANSWERS--Risk
of urinary retention
-Risk of developing UTI
-Risk of TURP syndrome
What are your nursing diagnosis for Tom Burgundy? - ANSWERS--
Risk of urinary retention
-Risk of systemic infection
-Risk of falls
What are your 5 nursing actions for Tom Burgundy? - ANSWERS--
Resp Ax
-Vitals
-Bladder scan
-Neurovascular Ax
END OF
PAGE
2
, NUR 242 MEDICAL LATEST
SURG EXAM
-Falls risk Ax
What are your 5 nursing actions for Bart Orange? - ANSWERS--Check
patients BGLs
-Cardiac Ax
-Wound care and plan
-Neurovascular obs
-Braden scale Ax
What are your nursing diagnosis for Bart Orange? - ANSWERS--Risk of
blood glucose fluctuations
-Risk of systemic infection
-Risk of pressure injury
What are your first 5 actions for Matilda Tan? - ANSWERS--
Neurovascular Ax
-Pain Ax
-Obtain full blood workup
-Wound care Ax
END OF
PAGE
3
, NUR 242 MEDICAL LATEST
SURG EXAM
-Collect pre op data
What are your three nursing diagnoses for Matilda Tan? - ANSWERS--
Acute pain
-Risk of peripheral neurovascular dysfunction
-Risk of infection
What are your first 5 actions for Adele pink? - ANSWERS--Weigh
-Implement strict FBC
-Abdominal Ax
-Cardiac and electrolyte Ax
-Pain Ax
What are your three nursing diagnoses for Adele Pink? - ANSWERS--
Risk for excess fluid volume
-Acute main
-Impaired ability to metabolise medications
END OF
PAGE
4
SURG EXAM
What are you first 5 nursing actions for Susan Akers? - ANSWERS--
ADDS Score
-Full blood work up
-Abdominal Ax
-Collect pre op data
-Ensure patient documentation is correct
What is the recovery room criteria? - ANSWERS--They are conscious
and oriented
-Able to maintain a clear and stable airway
-Vital signs are stable or consistent with preoperative vital signs for at
least 30 mins
-Pretective reflexes are in tact
-They are able to move all of their extremities
-Intake and output is satisfactory (30mL/hr)
-They are afebrile or a febrile condition is being managed
-Dressings are dry and intact
END OF
PAGE
1
, NUR 242 MEDICAL LATEST
SURG EXAM
Susan Akers three nursing diagnoses - ANSWERS--Acute pain
-Impaired nutrition
-Risk of infection
What are your nursing diagnosis for Hussien Khan? - ANSWERS--Risk
of urinary retention
-Risk of developing UTI
-Risk of TURP syndrome
What are your nursing diagnosis for Tom Burgundy? - ANSWERS--
Risk of urinary retention
-Risk of systemic infection
-Risk of falls
What are your 5 nursing actions for Tom Burgundy? - ANSWERS--
Resp Ax
-Vitals
-Bladder scan
-Neurovascular Ax
END OF
PAGE
2
, NUR 242 MEDICAL LATEST
SURG EXAM
-Falls risk Ax
What are your 5 nursing actions for Bart Orange? - ANSWERS--Check
patients BGLs
-Cardiac Ax
-Wound care and plan
-Neurovascular obs
-Braden scale Ax
What are your nursing diagnosis for Bart Orange? - ANSWERS--Risk of
blood glucose fluctuations
-Risk of systemic infection
-Risk of pressure injury
What are your first 5 actions for Matilda Tan? - ANSWERS--
Neurovascular Ax
-Pain Ax
-Obtain full blood workup
-Wound care Ax
END OF
PAGE
3
, NUR 242 MEDICAL LATEST
SURG EXAM
-Collect pre op data
What are your three nursing diagnoses for Matilda Tan? - ANSWERS--
Acute pain
-Risk of peripheral neurovascular dysfunction
-Risk of infection
What are your first 5 actions for Adele pink? - ANSWERS--Weigh
-Implement strict FBC
-Abdominal Ax
-Cardiac and electrolyte Ax
-Pain Ax
What are your three nursing diagnoses for Adele Pink? - ANSWERS--
Risk for excess fluid volume
-Acute main
-Impaired ability to metabolise medications
END OF
PAGE
4
