NURS 3730 Exam 1 Questions with
Complete Answers
how can decreased renal function with reduced blood flow to kidneys place an older
adult at higher risk during surgery and what can the nurse do about it? - ANSWER-
increased risk of shock when blood loss occurs; increased risk for fluid and
electrolyte imbalance
for pts hospitalized before surgery, determine baseline UO for 24 hours
how can reduced glomerular filtration rate and excretory times place an older adult at
higher risk during surgery and what can the nurse do about it? - ANSWER-limited
ability to eliminate drugs or toxic substances
assess for adverse responses to drugs
how can decreased bladder capacity place an older adult at higher risk during
surgery and what can the nurse do about it? - ANSWER-increased risk for urgency,
incontinence, and UTI
tell pt to notify nurse when fullness of bladder develops. toliet every 2 hours or more
how can sensory losses, including reduced tactile sense and increased pain
tolerance place an older adult at higher risk during surgery and what can the nurse
do about it? - ANSWER-decreased ability to respond to early warning signs of sx
complications
inspect bony prominences for signs of pressure that patient is unable to sense
how can febrile response during surgery place an older adult at higher risk during
surgery and what can the nurse do about it? - ANSWER-increased risk of
undiagnosed infection
ensure careful, close monitoring of patient temperature; provide warm blankets;
monitor heart function; warm IVF
how can decreased reaction time place an older adult at higher risk during surgery
and what can the nurse do about it? - ANSWER-confusion and delirium after
anesthesia; increased risk for falls
allow adequate time to respond, process info, and perform tasks. perform fall risk
screening and have fall precautions. orient to reality
how can lower BMR place an older adult at higher risk during surgery and what can
the nurse do about it? - ANSWER-reduced total oxygen consumption
,ensure adequate nutritional intake when diet is resumed but avoid intake of excess
calories
how can reduced number of RBCs and Hgb levels place an older adult at higher risk
during surgery and what can the nurse do about it? - ANSWER-reduced ability to
carry adequate oxygen to tissues
administer necessary blood products as needed. monitor blood test results and O2
sat
how can change in total amounts of body potassium and water volume place an
older adult at higher risk during surgery and what can the nurse do about it? -
ANSWER-greater risk for fluid or electrolyte imbalance
monitor electrolyte levels and supplement as necessary. provide cardiac monitoring
as needed
how can bleeding disorders (thrombocytopenia and hemophilia) increase the risk of
surgery? - ANSWER-increases risk of hemorrhage during and after surgery
how can diabetes mellitus increase the risk of surgery? - ANSWER-increases
susceptibility to infection and impairs wound healing from altered glucose
metabolism and associated circulatory impairment. stress of surgery often results in
hyperglycemia
how can heart disease (recent MI, dysrhythmias, HF) and PVD increase the risk of
surgery? - ANSWER-stress of surgery causes increases demand on myocardium to
maintain CO. general anesthetic agents depress cardiac function
how can hypertension increase the risk of surgery? - ANSWER-increases risk for CV
complications during anesthesia (e.g. stroke, inadequate tissue of oxygenation)
how can obstructive sleep apnea increase the risk of surgery? - ANSWER-
administration of opioids increases risk of airway obstruction after surgery. patient
desat as revealed by drop in O2 sat by pulse ox
how can URIs increase the risk of surgery? - ANSWER-increases risk of respiratory
complications during anesthesia (e.g. pneumonia and spasm of laryngeal muscles)
how can renal disease increase the risk of surgery? - ANSWER-alters excretion of
anesthetic drugs and their metabolites, increasing risk for acid base imbalance and
other complications
how can liver disease increase the risk of surgery? - ANSWER-alters metabolism
and elimination of drugs administered during surgery and impairs wound healing and
clotting time because of alteration in protein metabolism
How can fever increase the risk of surgery? - ANSWER-predisposes patient to fluid
and electrolyte imbalances and sometimes indicates underlying infection
,how can chronic respiratory disease (emphysema, bronchitis, asthma) increase the
risk of surgery? - ANSWER-reduces patient's means to compensate for acid base
alterations. anesthetic agents reduce respiratory function, increase risk for severe
hypoventilation
how can immunological disorders (leukemia, AIDS, bone marrow depression, and
use of chemo) increase risk of surgery? - ANSWER-increases risk of infection and
delayed wound healing after surgery
how can alcohol abuse and opioid addiction increase risk of surgery? - ANSWER-
alcohol abuse is associated with liver dysfunction and may interfere with the effects
of anesthesia. opioid addiction may result in health care and self care neglect.
patients may have underlying diseas4es that may affect wound healing
how can chronic pain increase risk of surgery? - ANSWER-regular use of pain meds
often result in higher tolerance. increased doses of analgesics are sometimes
necessary to achieve postop pain control
how can antibiotics have special implications for the surgical patient? - ANSWER-
enhance action of anesthetic agents. if taken within 2 weeks of surgery,
aminoglycosides (gentamycin, neomycin, tobramycin) may cause mild respiratory
depression from depressed neuromuscular transmission
how can antidysrhythmic have special implications for the surgical patient? -
ANSWER-medications (e.g. beta blockers) can reduce cardiac contractility and
impair cardiac conduction during anesthesia
how can anticoagulants have special implications for the surgical patient? -
ANSWER-medications such as warfarin or aspirin alter normal clotting factors and
thus increase the risk of hemorrhage
discontinue at least 48 hours before surgery
how can anticonvulsants have special implications for the surgical patient? -
ANSWER-long term use of certain meds (e.g. phenytoin, phenobarbital) alters
metabolism of anesthetic agents
how can corticosteroids have special implications for the surgical patient? -
ANSWER-with prolonged use, corticosteroids cause adrenal atrophy, reducing the
ability of the body to withstand stress. before and during surgery, dosages are often
increased temprarily
how can insulin have special implications for the surgical patient? - ANSWER-insulin
requirements fluctuate after surgery. some might need increased doses due to stress
response from surgery. others need less due to decreased nutritional intake
following surgery
how can diuretics have special implications for the surgical patient? - ANSWER-
some such as furosemide potentiate electrolyte imbalances (particularly potassium)
after surgery
, how can NSAIDS have special implications for the surgical patient? - ANSWER-
inhibit platelet aggregation and prolong bleeding time, increasing risk of postop
bleeding
how can herbal therapies, ginger, gingko, and ginseng have special implications for
the surgical patient? - ANSWER-have the ability to affect platelet activity and
increase risk of postop bleeding; ginseng increases hypoglycemia with insulin
therapy
Hgb values - ANSWER-F: 12-16
M: 14-18
low vs high Hgb - ANSWER-low = anemia
high = polycythemia
Hct values - ANSWER-F: 37-47%
M: 42-52%
low vs high Hct - ANSWER-low - fluid overload
high - dehydration
platelet count values - ANSWER-150,000 - 400,000
low vs high platelets - ANSWER-low - decreased clotting
high - increased risk of blood clot
WBC values - ANSWER-5000-10,000
low vs high WBC - ANSWER-low - decreased ability to fight infection
high - infection
sodium values - ANSWER-135-145
low vs high sodium - ANSWER-low - fluid overload
high - dehydration
potassium values - ANSWER-3.5-5
low vs high potassium - ANSWER-low & high - cardiac rhythm irregularities
chloride values - ANSWER-98-106
low vs high chloride - ANSWER-low - follows shifts in sodium blood levels
high - follow shift in sodium blood levels
CO2 values - ANSWER-23-30
low vs high CO2 - ANSWER-low & high - affects acid base balance in the blood
Complete Answers
how can decreased renal function with reduced blood flow to kidneys place an older
adult at higher risk during surgery and what can the nurse do about it? - ANSWER-
increased risk of shock when blood loss occurs; increased risk for fluid and
electrolyte imbalance
for pts hospitalized before surgery, determine baseline UO for 24 hours
how can reduced glomerular filtration rate and excretory times place an older adult at
higher risk during surgery and what can the nurse do about it? - ANSWER-limited
ability to eliminate drugs or toxic substances
assess for adverse responses to drugs
how can decreased bladder capacity place an older adult at higher risk during
surgery and what can the nurse do about it? - ANSWER-increased risk for urgency,
incontinence, and UTI
tell pt to notify nurse when fullness of bladder develops. toliet every 2 hours or more
how can sensory losses, including reduced tactile sense and increased pain
tolerance place an older adult at higher risk during surgery and what can the nurse
do about it? - ANSWER-decreased ability to respond to early warning signs of sx
complications
inspect bony prominences for signs of pressure that patient is unable to sense
how can febrile response during surgery place an older adult at higher risk during
surgery and what can the nurse do about it? - ANSWER-increased risk of
undiagnosed infection
ensure careful, close monitoring of patient temperature; provide warm blankets;
monitor heart function; warm IVF
how can decreased reaction time place an older adult at higher risk during surgery
and what can the nurse do about it? - ANSWER-confusion and delirium after
anesthesia; increased risk for falls
allow adequate time to respond, process info, and perform tasks. perform fall risk
screening and have fall precautions. orient to reality
how can lower BMR place an older adult at higher risk during surgery and what can
the nurse do about it? - ANSWER-reduced total oxygen consumption
,ensure adequate nutritional intake when diet is resumed but avoid intake of excess
calories
how can reduced number of RBCs and Hgb levels place an older adult at higher risk
during surgery and what can the nurse do about it? - ANSWER-reduced ability to
carry adequate oxygen to tissues
administer necessary blood products as needed. monitor blood test results and O2
sat
how can change in total amounts of body potassium and water volume place an
older adult at higher risk during surgery and what can the nurse do about it? -
ANSWER-greater risk for fluid or electrolyte imbalance
monitor electrolyte levels and supplement as necessary. provide cardiac monitoring
as needed
how can bleeding disorders (thrombocytopenia and hemophilia) increase the risk of
surgery? - ANSWER-increases risk of hemorrhage during and after surgery
how can diabetes mellitus increase the risk of surgery? - ANSWER-increases
susceptibility to infection and impairs wound healing from altered glucose
metabolism and associated circulatory impairment. stress of surgery often results in
hyperglycemia
how can heart disease (recent MI, dysrhythmias, HF) and PVD increase the risk of
surgery? - ANSWER-stress of surgery causes increases demand on myocardium to
maintain CO. general anesthetic agents depress cardiac function
how can hypertension increase the risk of surgery? - ANSWER-increases risk for CV
complications during anesthesia (e.g. stroke, inadequate tissue of oxygenation)
how can obstructive sleep apnea increase the risk of surgery? - ANSWER-
administration of opioids increases risk of airway obstruction after surgery. patient
desat as revealed by drop in O2 sat by pulse ox
how can URIs increase the risk of surgery? - ANSWER-increases risk of respiratory
complications during anesthesia (e.g. pneumonia and spasm of laryngeal muscles)
how can renal disease increase the risk of surgery? - ANSWER-alters excretion of
anesthetic drugs and their metabolites, increasing risk for acid base imbalance and
other complications
how can liver disease increase the risk of surgery? - ANSWER-alters metabolism
and elimination of drugs administered during surgery and impairs wound healing and
clotting time because of alteration in protein metabolism
How can fever increase the risk of surgery? - ANSWER-predisposes patient to fluid
and electrolyte imbalances and sometimes indicates underlying infection
,how can chronic respiratory disease (emphysema, bronchitis, asthma) increase the
risk of surgery? - ANSWER-reduces patient's means to compensate for acid base
alterations. anesthetic agents reduce respiratory function, increase risk for severe
hypoventilation
how can immunological disorders (leukemia, AIDS, bone marrow depression, and
use of chemo) increase risk of surgery? - ANSWER-increases risk of infection and
delayed wound healing after surgery
how can alcohol abuse and opioid addiction increase risk of surgery? - ANSWER-
alcohol abuse is associated with liver dysfunction and may interfere with the effects
of anesthesia. opioid addiction may result in health care and self care neglect.
patients may have underlying diseas4es that may affect wound healing
how can chronic pain increase risk of surgery? - ANSWER-regular use of pain meds
often result in higher tolerance. increased doses of analgesics are sometimes
necessary to achieve postop pain control
how can antibiotics have special implications for the surgical patient? - ANSWER-
enhance action of anesthetic agents. if taken within 2 weeks of surgery,
aminoglycosides (gentamycin, neomycin, tobramycin) may cause mild respiratory
depression from depressed neuromuscular transmission
how can antidysrhythmic have special implications for the surgical patient? -
ANSWER-medications (e.g. beta blockers) can reduce cardiac contractility and
impair cardiac conduction during anesthesia
how can anticoagulants have special implications for the surgical patient? -
ANSWER-medications such as warfarin or aspirin alter normal clotting factors and
thus increase the risk of hemorrhage
discontinue at least 48 hours before surgery
how can anticonvulsants have special implications for the surgical patient? -
ANSWER-long term use of certain meds (e.g. phenytoin, phenobarbital) alters
metabolism of anesthetic agents
how can corticosteroids have special implications for the surgical patient? -
ANSWER-with prolonged use, corticosteroids cause adrenal atrophy, reducing the
ability of the body to withstand stress. before and during surgery, dosages are often
increased temprarily
how can insulin have special implications for the surgical patient? - ANSWER-insulin
requirements fluctuate after surgery. some might need increased doses due to stress
response from surgery. others need less due to decreased nutritional intake
following surgery
how can diuretics have special implications for the surgical patient? - ANSWER-
some such as furosemide potentiate electrolyte imbalances (particularly potassium)
after surgery
, how can NSAIDS have special implications for the surgical patient? - ANSWER-
inhibit platelet aggregation and prolong bleeding time, increasing risk of postop
bleeding
how can herbal therapies, ginger, gingko, and ginseng have special implications for
the surgical patient? - ANSWER-have the ability to affect platelet activity and
increase risk of postop bleeding; ginseng increases hypoglycemia with insulin
therapy
Hgb values - ANSWER-F: 12-16
M: 14-18
low vs high Hgb - ANSWER-low = anemia
high = polycythemia
Hct values - ANSWER-F: 37-47%
M: 42-52%
low vs high Hct - ANSWER-low - fluid overload
high - dehydration
platelet count values - ANSWER-150,000 - 400,000
low vs high platelets - ANSWER-low - decreased clotting
high - increased risk of blood clot
WBC values - ANSWER-5000-10,000
low vs high WBC - ANSWER-low - decreased ability to fight infection
high - infection
sodium values - ANSWER-135-145
low vs high sodium - ANSWER-low - fluid overload
high - dehydration
potassium values - ANSWER-3.5-5
low vs high potassium - ANSWER-low & high - cardiac rhythm irregularities
chloride values - ANSWER-98-106
low vs high chloride - ANSWER-low - follows shifts in sodium blood levels
high - follow shift in sodium blood levels
CO2 values - ANSWER-23-30
low vs high CO2 - ANSWER-low & high - affects acid base balance in the blood
