Nursing 163-Unit 1 Perioperative Nursing Questions and Answers 100% Pass

Nursing 163-Unit 1 Perioperative Nursing Questions and Answers 100% Pass The Case John Egan, 53, has a history of type 1 diabetes, cigarette smoking 40 pack years, CAD, and PVD. Six weeks ago, he developed a wound of his left heel which measured 4 cm by 2 cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10 am. His meds include daily insulin, aspirin 325 mg/day, Pletal 100mg BID. He has advanced directives and NKDA. Identify the priority nursing care for Mr. Egan -complete pre-operative testing/preperation -maintain normal glucose levels -ensure informed consent -ensure correct surgical site -prevent post-op infections -complete pre-operative teaching to prevent complications -address psychological comfort Pre-surgical screening tests -chest x-ray -EKG for 40 yrs -complete blood count -electrolyte levels -urinalysis -x-ray left lower extremity When completing a medication reconciliation for Mr Egan the evening before surgery, which orders increase the nurse's concern? -Insulin 6 units regular with 15 units NPH subq every am -aspirin 325 mg PO q.d. -Pletal 100 mg PO BID -ativan 0.5 mg IVP on call to OR in AM Red Rule Patient Safety Alert Red Letter Rule #3 Medications When administering medications, the medication administration record (MAR) and the medication in the original packet or unit dose must be brought to the patient's bedside The following steps must occur Verify patient ID using 2 different identifiers (neither to be the patient's room)-resolve discrepancies before administering medication Ensure compliance with the 5 rights of Medication Administration -the right patient -the right drug -the right dose -the right route -the right time Validate with another RN a documented double-check for all insulin, heparin, warfarin, and narcotic medications prior to the administration of the medication NO EXCEPTIONS TO THIS RULE Informed Consent for Surgery and Blood Transfusion 3 requirements: -Adequate disclosure of diagnosis-purpose, risks, and consequences of treatment, probability of success, prognosis if not instituted -understanding and comprehension-patient must be drug free prior to signing consent -consent given voluntarily-patient must not be persuaded or coerced to undergo procedure Informed Consent Information -Description of procedure and alternative therapies -Underlying disease process and its natural course -Name and qualifications of person performing procedure -Explanation of risks and how often they occur -Explanation that the patient has the right to refuse treatment or withdraw consent -Explanation of expected outcome, recovery, rehabilitation