Med surg. Chapter 17 Questions and Answers with verified solutions

Med surg. Chapter 17 Questions and Answers with verified solutions A blood patch may help treat? - ANS -Post spinal headache A patient is recovering from a surgical procedure that was done using a spinal anesthesia. The PACU nurse assessed whether the patient has sensation and movement in his legs. Why is this data especially important? - ANS -The extremities are susceptible to injury because movement returns before sensation. A patient with an abdominal incision reports that his dressing is soaked with drainage and that he felt a pulling sensation when getting out of bed. On inspection the nurse observes that a loop of intestines is producing from the open wound. The appropriate action is to: - ANS -Apply saline-soaked gauze and cover with a sterile dry dressing A patient with diabetes is scheduled for removal of a skin lesion this patient is at risk for? - ANS -Infection A patient with liver disease is scheduled for knee surgery the patient piece is a postoperative risk for? - ANS -Impaired blood clotting A post operative patient complains of pain fever swelling and purulent drainage the size of symptoms are indications of? - ANS -Wound infection A postoperative patient is receiving morphine for pain and is experiencing decreasing blood oxygenation levels in the recovery unit which factor in the patient history increases the risk of postoperative airway obstruction? - ANS -Obstructive sleep apnea A soft tube that permits passive movement of fluids from the wound is called? - ANS -Penrose drain A week after surgery the patient develops pain fever swelling and purulent drainage around the room site which action should the nurse take to prevent complications? - ANS -Good hand hygiene After surgery patient avoids 10 to 20 mL of urine at frequent intervals. You should suspect? - ANS -Urinary retention with overflow After the first 24 hours following surgery which finding should be reported to the healthcare provider if it is observed? - ANS -Continued or excessive bleeding An older adult who is scheduled for a surgical procedure expresses fear that he is too old for surgery and asks what you think. Your response should be based on the knowledge that: - ANS -An older adult in good health is likely to be just as well in surgery as a younger person And outcome criterion related to absence of thrombophlebitis is? - ANS -No redness or swelling in legs Catheterization is usually post operatively if the patient does not void in? - ANS -Eight hours Clean sutured incisions heal by? - ANS -First intention Complications that are most likely to occur during the immediate postoperative period include which of the following? Select all that apply - ANS -1.Shock 2.Hypoxia Do use of IV drugs to reduce pain intensity or awareness without loss of reflexes is called question - ANS -Conscious sedation During the shift handoff a postoperative patient reportedly has a paralytic lieu's.The nursrvahould anticipate which of the following? Select all that apply - ANS -1. A nasogastric tube and suction may be in place sounds should be auscultated Electrolyte imbalance may predisposed the surgical patient to? - ANS -Cardiac arrhythmias Emboli may be treated with? - ANS -Heparin and Thrombolytic agents Enfluorane (ethane)and nitrous oxide are administered by? - ANS -Inhalation Gas pains typically occur? - ANS -On second or third day after surgery Guidelines to prevent wrong site surgery include select all that apply - ANS -•Confirm that the operative site is marked before giving any sedating drugs •Verify that the appropriate equipment is available for the procedure •confirm that the surgical consent form has been signed and witnessed •verify with the patient the procedure that is expected to be performed •conduct a time out before the first decision to resolve any concerns How does smoking delay wound healing? - ANS -Capillary constriction from the nicotine If evisceration occurs the usual practice is to cover the wound with? - ANS -Sailing so far is with a dry dressing over it If the patient is a minor who signs of surgical consent form? - ANS -Parent or guardian If withdrawal from recreational drugs is anticipated after surgery how can this complication be minimized? - ANS -Intraoperative and postoperative drug therapy In the PACU a patients vital signs are as follows: temperature 98F(36.66c) pulse is 66bpm and regular respiration's 14 bpm,blood pressure 100/56 mm hg. Which other piece of information is most important to allow the nurse to evaluate these vital signs? - ANS -Patients preoperative vital signs New LVNs/LPNs are being oriented to an ambulatory surgical center. The educator should explain that the nurses responsibility when obtaining a patients signature on a surgical consent form includes: - ANS -Obtaining the signature before the patient is given sedatives Once immediate postoperative phase has passed which risk lessons? - ANS -shock and hemorrhage Post spinal headache can be relieved? - ANS -Lying flat Preoperative medications typically include: Select all that apply - ANS -1. Sedative-hypnotic agent d analgesics matic agent holinergic Pulmonary emboli usually originate from thrown by that developed in veins of the? - ANS -Legs and pelvis Signs and symptoms of wound infection usually do not develop until? - ANS -The 3rd to 5th day after surgery The injection of a anesthetic agent into an under the skin around the area treatment is called? - ANS -Local infiltration The nurse has just attended a workshop on the universal protocol for preventing wrong site wrong procedure and wrong person surgery principles which are requirements for the time out procedure? Select all that apply - ANS -•Do not start the procedure until all questions or concerns are resolved •the timeout must be done before an incision is made •have a patient identify the site and procedure document the time out The nurse has just received a change of shift report which patient should she check on first? - ANS -A patient who is two days post lobectomy The patient develops ruptured of the suture line and states my seizures breaking open which action should the nurse take to prevent complications in this patient? - ANS -Keep the patient in bed The patient states that his wound feels as if it is falling apart this is an indication of? - ANS -Dehiscence