Nur 313 Med Surg Exam 1: Nursing care
of the adult surgical patient Questions
And Solved Solutions.
Preoperative phase: preadmission process - Answer -preoperative assessment
-teaching is started (patient and family)
-diagnostic testing
-verifies understanding of surgeon-specific preoperative orders
-advance directive review
-discharge planning
Preoperative assessment - Answer History:
-medical, surgical, drug/ETOH use, medications, psychosocial (anxiety), spiritual, cultural beliefs,
nutrition/fluid status
Baseline head to toe physical assessment
Preoperative special considerations - Answer -obesity: concerned about airway, body weight is a lot of
stress during surgery
-disease: preexisting disease can effect how the patient will tolerate surgery
-elderly: more sensitive to meds
-ambulatory surgery: patient gets surgery and goes home the same day (making sure they are fully safe
to go home)
-emergency surgery
Medications - Answer need to know what they are on and have an accurate list, have them elaborate if
they are prescribed and if they are actually taking them
-corticosteroids: delay healing and increased WBC which tells us if you have infection
, -diuretics
-anti-diabetics: can harm kidneys, stop before surgery
-anticoagulants: high risk of bleeding in surgery
-anticonvulsants
-opioids
-OTC: can cause stomach ulcer and cause bleeding
-illegal drugs: may interfere
Informed consent - Answer components of an informed consent
-explanation of diagnosis, treatment, risks, prognosis
-patient must demonstrate a clear understanding
-must be freely given without coercion
option to withdraw their consent or refuse treatment
completed by the health care provider (NOT the nurse)
-patient's signature must be witnessed by a health care professional
-patient must be competent
Who is an incompetent patient? - Answer -cognitively impaired
-mentally ill
-neurologically incapacitated
-<18 years of age
consent must come from responsible party:
-next of kin (spouse, any adult children, parents)
-guardian
-healthcare power of attorney (healthcare POA)
of the adult surgical patient Questions
And Solved Solutions.
Preoperative phase: preadmission process - Answer -preoperative assessment
-teaching is started (patient and family)
-diagnostic testing
-verifies understanding of surgeon-specific preoperative orders
-advance directive review
-discharge planning
Preoperative assessment - Answer History:
-medical, surgical, drug/ETOH use, medications, psychosocial (anxiety), spiritual, cultural beliefs,
nutrition/fluid status
Baseline head to toe physical assessment
Preoperative special considerations - Answer -obesity: concerned about airway, body weight is a lot of
stress during surgery
-disease: preexisting disease can effect how the patient will tolerate surgery
-elderly: more sensitive to meds
-ambulatory surgery: patient gets surgery and goes home the same day (making sure they are fully safe
to go home)
-emergency surgery
Medications - Answer need to know what they are on and have an accurate list, have them elaborate if
they are prescribed and if they are actually taking them
-corticosteroids: delay healing and increased WBC which tells us if you have infection
, -diuretics
-anti-diabetics: can harm kidneys, stop before surgery
-anticoagulants: high risk of bleeding in surgery
-anticonvulsants
-opioids
-OTC: can cause stomach ulcer and cause bleeding
-illegal drugs: may interfere
Informed consent - Answer components of an informed consent
-explanation of diagnosis, treatment, risks, prognosis
-patient must demonstrate a clear understanding
-must be freely given without coercion
option to withdraw their consent or refuse treatment
completed by the health care provider (NOT the nurse)
-patient's signature must be witnessed by a health care professional
-patient must be competent
Who is an incompetent patient? - Answer -cognitively impaired
-mentally ill
-neurologically incapacitated
-<18 years of age
consent must come from responsible party:
-next of kin (spouse, any adult children, parents)
-guardian
-healthcare power of attorney (healthcare POA)
