Nursing Fundamentals NURS108 Final Exam – Competencies Lecture Summary and
Comprehensive Study Guide
Describe the nursing responsibilities witnessing informed consent - ✔✔The surgeon's
responsibility is to provide a clear explanation of the surgery as well as benefits, alternatives,
possible risks, complications, and removal of body parts prior to the patient giving consent.
The nurse needs to...
1. Clarify the information provided
2. Notify physician if the patient requests additional information
3. Make sure the consent form has been signed before administering any premedication
4. Assess if the patient was in sound mind before signing forms (consent is not valid if obtained
while the patient is under the influence of medications that can affect judgment and decision)
Differentiate the different categories of surgical procedures - ✔✔1. Emergent
~Immediate attention/without delay
~Potentially life threatening
2. Urgent
~Requires prompt attention
~Within 24-30hrs
3. Required
~Surgery is needed within a few weeks or month
4. Elective
~Surgery should be performed
,5. Optional
~Patient decides
******
Ambulatory surgery: outpatient, same-day, short-stay
~Nurse quickly assesses patient and prepares for discharge/follow up care
Identify the teaching need for the use of postoperative pain medications - ✔✔1. Opioid
analgesic agents:
~Commonly prescribed for pain and immediate postoperative restlessness
~Taken on a schedule (ex: Q6hrs)
2. PCA pumps:
~Pt can push a button every hour to administer pain meds
~Maintains therapeutic drug levels
3. Epidural infusions:
~Used with caution in chest procedures (may affect respiration)
**For all postop pain meds, advise the patient to stand up slowly and walk with someone to
prevent falls (pt may experience dizziness)
Identify the client safety precautions in the preoperative area - ✔✔1. Have all pts in a hospital
gown
2. Remove jewelry/any metal
3. Tie all long hair back
4. Remove dentures/plates, glasses, any prosthetic devices
, 5. Have all pts void before going to the OR
6. If preanesthetic medication is given, raise all side rails and prevent patient from
standing/walking alone
7. Assess for medication reactions
8. Assist in verifying patient ID, surgical procedure, and surgical site
**#1: prevent patient from injury!!
Identify the gerontologic considerations related to surgery - ✔✔~Decreased perspiration leads
to dry itchy skin that can become fragile. Health care providers need to take precautions when
moving an older adult. ~Decreased subcutaneous fat makes older adults more susceptible to
temperature changes. Pt may c/o feeling cold
The elderly have...
~Less physiologic reserve (the ability for an organ to return to normal after a disturbance)
~Lower cardiac reserves
~Depressed renal and hepatic function
~Reduced GI function
**All of these play a role in how the elderly remain stable throughout surgery and recovery
Identify the nursing considerations related to a surgical client who is NPO - ✔✔Food/drinking
fluids are usually withheld to prevent aspiration during and after surgery
~Normally, restrictions begin 12-24hrs before surgery
~Now, some healthy patients/depending on the procedure, clear liquids are allowed up to 2hrs
before surgery
~If the patient is NPO, they usually are still allowed a sip of water to take w/ oral meds
Comprehensive Study Guide
Describe the nursing responsibilities witnessing informed consent - ✔✔The surgeon's
responsibility is to provide a clear explanation of the surgery as well as benefits, alternatives,
possible risks, complications, and removal of body parts prior to the patient giving consent.
The nurse needs to...
1. Clarify the information provided
2. Notify physician if the patient requests additional information
3. Make sure the consent form has been signed before administering any premedication
4. Assess if the patient was in sound mind before signing forms (consent is not valid if obtained
while the patient is under the influence of medications that can affect judgment and decision)
Differentiate the different categories of surgical procedures - ✔✔1. Emergent
~Immediate attention/without delay
~Potentially life threatening
2. Urgent
~Requires prompt attention
~Within 24-30hrs
3. Required
~Surgery is needed within a few weeks or month
4. Elective
~Surgery should be performed
,5. Optional
~Patient decides
******
Ambulatory surgery: outpatient, same-day, short-stay
~Nurse quickly assesses patient and prepares for discharge/follow up care
Identify the teaching need for the use of postoperative pain medications - ✔✔1. Opioid
analgesic agents:
~Commonly prescribed for pain and immediate postoperative restlessness
~Taken on a schedule (ex: Q6hrs)
2. PCA pumps:
~Pt can push a button every hour to administer pain meds
~Maintains therapeutic drug levels
3. Epidural infusions:
~Used with caution in chest procedures (may affect respiration)
**For all postop pain meds, advise the patient to stand up slowly and walk with someone to
prevent falls (pt may experience dizziness)
Identify the client safety precautions in the preoperative area - ✔✔1. Have all pts in a hospital
gown
2. Remove jewelry/any metal
3. Tie all long hair back
4. Remove dentures/plates, glasses, any prosthetic devices
, 5. Have all pts void before going to the OR
6. If preanesthetic medication is given, raise all side rails and prevent patient from
standing/walking alone
7. Assess for medication reactions
8. Assist in verifying patient ID, surgical procedure, and surgical site
**#1: prevent patient from injury!!
Identify the gerontologic considerations related to surgery - ✔✔~Decreased perspiration leads
to dry itchy skin that can become fragile. Health care providers need to take precautions when
moving an older adult. ~Decreased subcutaneous fat makes older adults more susceptible to
temperature changes. Pt may c/o feeling cold
The elderly have...
~Less physiologic reserve (the ability for an organ to return to normal after a disturbance)
~Lower cardiac reserves
~Depressed renal and hepatic function
~Reduced GI function
**All of these play a role in how the elderly remain stable throughout surgery and recovery
Identify the nursing considerations related to a surgical client who is NPO - ✔✔Food/drinking
fluids are usually withheld to prevent aspiration during and after surgery
~Normally, restrictions begin 12-24hrs before surgery
~Now, some healthy patients/depending on the procedure, clear liquids are allowed up to 2hrs
before surgery
~If the patient is NPO, they usually are still allowed a sip of water to take w/ oral meds
