NUR113 EXAM 2 Questions And 100% Correct Answers
Hypocalcemia S/S & TX
-irritability/confusion, paresthesia's, increased DTRs, seizures
-tetany (+Trousseaus sign/ +Chvostek's sign)
-increase Ca intake (foods, supplements or IV), Seizure precautions: bed in low position,
padded side rails, maintain airway: laryngeal spasm (always have suction)
-if lactose intolerant: milk safe for them that is fortified with Ca++
Hyperkalemia Causes
-too much potassium >5.0 mEq/L
-renal failure, K+ supplements, burns or crushing injuries
-severe infection, K+ sparing diuretics, ACE inhibitors
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Position during Surgery: Supine/Dorsal
-legs are uncrossed, slightly apart and both arms are at the side or at the arm boards.
-palms of hands facing the body to prevent unnecessary muscle strain on the arms.
-This type of surgical position is used during the induction of general anesthesia,
abdominal surgeries, open-heart surgeries, surgeries on neck, face and mouth, and
most surgeries on extremities
Preoperative Phase
Time frame from decision for surgery until pt is transferred into operating room
Intraoperative Phase
time frame from when pt is transferred into OR to admission to post anesthesia care unit
(PACU)
Postoperative Phase
time frame from when the pt is admitted to PACU to follow ip evaluation in clinical
setting or at home
Diagnostic/Exploratory
biopsy, laparoscopy (peritoneal cavity), endoscopy (GI tract)
Curative
excision of tumor, removal of inflamed appendix
Repair
wound debridement
Reconstructive/Cosmetic
mammoplasty, face lift
Palliative
tumor removal, removal of non-functioning gall bladder
,(cancer patients)
Rehabilitative
joint replacement, pain reduction, prevent further degradative osteoarthritis
Common Preop Screening Test
-CXR
-12-lead EKG
-CBC
-Chemistries (BMP vs CMP)
-Urinalysis
-Thyroid & liver function test, toxicology screens if hx of problems
-Clotting studies
-Blood type. screen & crossmatch
-Pregnancy test
-Cardiac clearance if hx of CV disease
Universal protocol for procedure verification
-Pre-procedure verification process
-Mark the procedure site
-time out
-hand off report
Time out
an immediate stop by the medical team to verify correct pt, procedure and site. Verify
any allergies, all the equipment needed and introduce each team member. Necessary to
prevent "never events"
Clotting Studies
ordered as a baseline
-Partial Thromboplastin Time (PTT)
-Prothrombin Time (PT)
-International Normalized Ratio (INR)
, Anticoagulants
increase risk of hemorrhage
Diuretics
risk for electrolyte imbalances, respiratory depression from anesthesia
Tranquilizers
increase hypotensive effects of anesthetic drugs
Adrenal steroids
don't stop abruptly - abrupt withdrawal may cause cardiovascular collapse
Antibiotics in -mycin group
avoid this group - causes respiratory paralysis when combined w/ some muscle
relaxants
Pre-op Nursing
-patient teaching
-assessment
-informed consent
-nursing diagnosis & interventions
-prep surgical site
-document --- or it didn't happen!
BUN normal range
5-20 mg/dL
Creatinine normal range
0.5-1.5 mg/dL
BUN/Creatinine Ratio
5-35
GFR (Glomerular
Filtration Rate) normal range
90-120 mL/min
Hypocalcemia S/S & TX
-irritability/confusion, paresthesia's, increased DTRs, seizures
-tetany (+Trousseaus sign/ +Chvostek's sign)
-increase Ca intake (foods, supplements or IV), Seizure precautions: bed in low position,
padded side rails, maintain airway: laryngeal spasm (always have suction)
-if lactose intolerant: milk safe for them that is fortified with Ca++
Hyperkalemia Causes
-too much potassium >5.0 mEq/L
-renal failure, K+ supplements, burns or crushing injuries
-severe infection, K+ sparing diuretics, ACE inhibitors
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:00
,/
0:15
Full screen
Brainpower
Read More
Position during Surgery: Supine/Dorsal
-legs are uncrossed, slightly apart and both arms are at the side or at the arm boards.
-palms of hands facing the body to prevent unnecessary muscle strain on the arms.
-This type of surgical position is used during the induction of general anesthesia,
abdominal surgeries, open-heart surgeries, surgeries on neck, face and mouth, and
most surgeries on extremities
Preoperative Phase
Time frame from decision for surgery until pt is transferred into operating room
Intraoperative Phase
time frame from when pt is transferred into OR to admission to post anesthesia care unit
(PACU)
Postoperative Phase
time frame from when the pt is admitted to PACU to follow ip evaluation in clinical
setting or at home
Diagnostic/Exploratory
biopsy, laparoscopy (peritoneal cavity), endoscopy (GI tract)
Curative
excision of tumor, removal of inflamed appendix
Repair
wound debridement
Reconstructive/Cosmetic
mammoplasty, face lift
Palliative
tumor removal, removal of non-functioning gall bladder
,(cancer patients)
Rehabilitative
joint replacement, pain reduction, prevent further degradative osteoarthritis
Common Preop Screening Test
-CXR
-12-lead EKG
-CBC
-Chemistries (BMP vs CMP)
-Urinalysis
-Thyroid & liver function test, toxicology screens if hx of problems
-Clotting studies
-Blood type. screen & crossmatch
-Pregnancy test
-Cardiac clearance if hx of CV disease
Universal protocol for procedure verification
-Pre-procedure verification process
-Mark the procedure site
-time out
-hand off report
Time out
an immediate stop by the medical team to verify correct pt, procedure and site. Verify
any allergies, all the equipment needed and introduce each team member. Necessary to
prevent "never events"
Clotting Studies
ordered as a baseline
-Partial Thromboplastin Time (PTT)
-Prothrombin Time (PT)
-International Normalized Ratio (INR)
, Anticoagulants
increase risk of hemorrhage
Diuretics
risk for electrolyte imbalances, respiratory depression from anesthesia
Tranquilizers
increase hypotensive effects of anesthetic drugs
Adrenal steroids
don't stop abruptly - abrupt withdrawal may cause cardiovascular collapse
Antibiotics in -mycin group
avoid this group - causes respiratory paralysis when combined w/ some muscle
relaxants
Pre-op Nursing
-patient teaching
-assessment
-informed consent
-nursing diagnosis & interventions
-prep surgical site
-document --- or it didn't happen!
BUN normal range
5-20 mg/dL
Creatinine normal range
0.5-1.5 mg/dL
BUN/Creatinine Ratio
5-35
GFR (Glomerular
Filtration Rate) normal range
90-120 mL/min