Chapter 50 Perioperative Nursing Care-Fundamentals of Nursing

Chapter 50: Perioperative Nursing Care
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MULTIPLE CHOICE ra




1. The nursing attendant is caring for a surgical hospital client , when the family member
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asks what perioperative nursing means. How should the nursing attendant respond?
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Perioperative nursing occurs in preadmission testing. ra ra ra ra ra




b. Perioperative nursing occurs primarily in the postanesthesia care unit. ra ra ra ra ra ra ra ra




c. Perioperative nursing includes activities before, during, and after surgery. ra ra ra ra ra ra ra ra




d. Perioperative nursing includes activities only during the surgical procedure. ra ra ra ra ra ra ra ra




ACCURATE ar



ANSWER:-C
Perioperative nursing care occurs before, during, and after surgery. Preadmission testing occu
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rs before surgery and is considered preoperative. Nursing care provided during the surgical p
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rocedure is considered intraoperative, and in the postanesthesia care unit, it is considered pos
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toperative. All of these are parts of the perioperative phase, but each individual phase does not
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explain the term completely. ra ra ra




DIF:Understand (comprehension) ra



OBJ:Discuss the three phases of perioperative nursing. TOP:Teaching/Learning MSC: ra ra ra ra ra ra ar ra



Management of Care ra ra




2. The nursing attendant is caring for a hospital client who is scheduled to undergo a surgica
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lp
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rocedure. The nursing attendant is completing an assessment and reviews the hospital clie
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nt ’ ar



s laboratory tests and allergies and prepares the hospital client for surgery. In which perio
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pe rative nursing phase is the nursing attendant working? a. Perioperative
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b. Preoperative
c. Intraoperative
d. Postoperative
ACCURATE ANSWER:-B ra



Reviewing the hospital client ’s laboratory tests and allergies is done before surgery in the pre
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operative phase. Perioperative means before, during, and after surgery. Intraoperative means
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during the surgical procedure in the operating suite; postoperative means after the surgery an
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d could occur in the postanesthesia care unit, in the ambulatory surgical area, or on the hospita
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l unit.
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DIF:Understand (comprehension) ra



OBJ:Discuss the three phases of perioperative nursing. TOP:Implemen ra ra ra ra ra ra ar



tation MSC: Management of Care ra ra




3. The nursing attendant is caring for a hospital client in the postanesthesia care unit. The ho
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spital client has developed profuse bleeding from the surgical site, and the surgeon has det
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ermined the need to return to the operative area. How will the nursing attendant classify t
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h is procedure? a. Major
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, b. Urgent
c. Elective
d. Emergency
ACCURATE ANSWER:-D ra



An emergency procedure must be done immediately to save a life or preserve the function of a
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body part. An example would be repair of a perforated appendix, repair of a traumatic amputa
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tion, or control of internal hemorrhaging. An urgent procedure is necessary for a hospital clien
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t ’s health and often prevents additional problems from developing. An example would be exci
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sion of a cancerous tumor, removal of a gallbladder for stones, or vascular repair for an obstruct
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ed artery. An elective procedure is performed on the basis of the hospital client ’s choice; it is n
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ot essential and is not always necessary for health. An example would be a bunionectomy, plas
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tic surgery, or hernia reconstruction. A major procedure involves extensive reconstruction or al
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teration in body parts; it poses great risks to ra ra ra ra ra ra ra ra ra



wellbeing. An example would be a coronary artery bypass or colon resection.
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DIF:Understand (comprehension) ra



OBJ:Discuss the three phases of perioperative nursing. TOP:Implemen tation ra ra ra ra ra ra ar MSC:
Management of Care ra ra




4. The nursing attendant is caring for a hospital client in preadmission testing. The hospita
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l client has been assigned a physical status classification by the American Society of Anes
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thesiologists of ASA III. Which assessment will support this classification? ra a. ra ra ra ra ra ra ra ra



Normal, healthy hospital client ra ra ra




b. Denial of any major illnesses or conditions ra ra ra ra ra ra




c. Poorly controlled hypertension with implanted pacemaker ra ra ra ra ra




d. Moribund hospital client not expected to survive without the operation ra ra ra ra ra ra ra ra ra




ACCURATE ANSWER:-C ra



An ASA III rating is a hospital client with a severe systemic disease, such as poorly controlle
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d hypertension with an implanted pacemaker. ASA I is a normal healthy hospital client wit
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h no major illnesses or conditions. ASA II is a hospital client with mild systemic disease. ASA
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V is a moribund hospital client who is not expected to survive without the operation and in
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cludes hospital client s with ruptured abdominal/thoracic aneurysm or massive trauma.
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DIF:Understand (comprehension) ra



OBJ:Discuss the three phases of perioperative nursing. TOP:Assessment MSC: ra ra ra ra ra ra ar ra



Reduction of Risk Potential ra ra ra




5. The hospital client presented to the ambulatory surgery center to have a colonoscopy is sch
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eduled to receive moderate sedation (conscious sedation) during the procedure. How will t
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h e nursing attendant interpret this information?
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a. The procedure results in loss of sensation in an area of the body.
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b. The procedure requires a depressed level of consciousness.
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c. The procedure will be performed on an outhospital client basis.
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d. The procedure necessitates the hospital client to be immobile.
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ACCURATE ANSWER:-B ra



Moderate sedation (conscious sedation) is used routinely for procedures that do not require c
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omplete anesthesia but rather a depressed level of consciousness. Not all hospital client s who a
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re treated on an outhospital client basis receive moderate sedation. Regional anesthesia such a
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s local anesthesia provides loss of sensation in an area of the body. General anesthesia is used fo
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r hospital client s who need to be immobile and to not remember the surgical procedure.
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, DIF:Understand (comprehension) ra



OBJ:Discuss the three phases of perioperative nursing. TOP:Evaluation MSC: ra ra ra ra ra ra ar ra



Reduction of Risk Potential ra ra ra




6. The nursing attendant is caring for a hospital client in the postanesthesia care unit who has
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undergone a left total knee arthroplasty. The anesthesia provider has indicated that the ho
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spital client received regional anesthesia in the form of a left femoral peripheral nerve bloc
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k. Which assessment will be an expected finding for this hospital client ?
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a. Sensation decreased in the left leg ra ra ra ra ra




b. Hospital client report of pain in the left foot ra ra ra ra ra ra ra ra




c. Pulse decreased at the left posterior tibia ra ra ra ra ra ra




d. Left toes cool to touch and slightly cyanotic
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ACCURATE ANSWER:-A ra



Induction of regional anesthesia results in loss of sensation in an area of the body—
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in this case, the left leg. The peripheral nerve block influences the portions of sensory pathwa
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ys that are anesthetized in the targeted area of the body. Decreased pulse, toes cool to touch,
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and cyanosis are indications of decreased blood flow and are not expected findings. Reports
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of pain in the left foot may indicate that the block is not working or is subsiding and is not a
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n expected finding in the immediate postoperative period.
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DIF:Understand (comprehension) ra



OBJ:Explain the rationale for a nursing assessment of a hospital client ’s surgical risk f
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actors. TOP:Assessment raMSC: Reduction of Risk Potential ra ra ra ra




7. Which nursing goal is a priority for assessing the hospital client before surgery?
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a. Plan for care after the procedure. ra ra ra ra ra




b. Establish a hospital client ’s baseline of normal function. ra ra ra ra ra ra ra ra




c. Educate the hospital client and family about the procedure. ra ra ra ra ra ra ra ra




d. Gather appropriate equipment for the hospital client ’s needs. ra ra ra ra ra ra ra ra




ACCURATE ANSWER:-B ra



The goal of the preoperative assessment is to identify a hospital client ’s normal preoperative f
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unction and the presence of any risks to recognize, prevent, and minimize possible postoperat
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ive complications. Gathering appropriate equipment, planning care, and educating the hospit
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al client and family are all important interventions that must be provided for the surgical hosp
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ital client ; they are part of the nursing process but are not the priority reason/goal for completin
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g an assessment of the surgical hospital client .
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DIF:Understand (comprehension) ra



OBJ:Explain the rationale for a nursing assessment of a hospital client ’s surgical risk facto
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rs. TOP:PlanningMSC: Reduction of Risk Potential
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8. The nursing attendant is completing a medication history for the surgical hospital client i
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n preadmission testing. Which medication should the nursing attendant instruct the hosp
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ital client to hold (discontinue) in preparation for surgery according to protocol? a.
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Warfarin
b. Vitamin C ra




c. Prednisone
d. Acetaminophen