ADVANCED MED SURG UPDATED END OF COURSE
QUESTIONS AND SOLUTIONS GUARANTEE A+
✔✔What does the PR interval represent? - ✔✔The time required for the impulse to
travel from the atria through the AV node
✔✔If the U wave is most prominent, what condition might the nurse suspect? -
✔✔Hypokalemia
✔✔Describe the calculation of the heart rate using an ECG rhythm strip - ✔✔Count the
number of RR intervals in the 30 large squares and multiple by 10 to determine the
heart rate for 1 minute
✔✔What is the most important assessment data for the nurse to obtain in a client with
an arrhythmia? - ✔✔Ability of the client to tolerate the arrhythmia
✔✔HH 29 - ✔✔Marking the operative site is required for procedures involving right/left
distinctions, multiple structures and levels. Site marking should be done with the
involvement of the client
✔✔HH 30 - ✔✔Wound dehiscence is separation of the wound edges, it is more likely to
occur with vertical incisions. It usually occurs after the early postop period, when the
clients own granulation tissue is taking over the wound, after absorption of the sutures
has begun.
Evisceration of the wound is protrusion of the intestinal contents and is more likely in
clients who are older, diabetic, obese, malnourished and have prolonged paralytic ileus
✔✔HH 31 - ✔✔A 43 year old mother of two teen daughters enters the hospital to have
her gallbladder removed in a same day surgery using an endoscope instead of incision.
What nursing needs will dominate each phase of her short hospital stay?
-Preparation phase: education about postop care and assistance with meeting familys
needs
-Operative phase: assessment, management of operative suite
-Postanesthesia phase: pain management, precautions
-Post op phase: prevents of complications, assessment of pain, teaching about dietary
restrictions, activity levels
✔✔HH 32 - ✔✔Time out project
Hand off communication are all best practices implemented to prevent serious medical
error during per op period.
Time out occurs before making the incision and the entire surgery team aloud. The
team confirms that this information is correct.
✔✔List five variables that increase surgical risk - ✔✔Age: very young and very old
, obesity and malnutrition
preoperative dehydration/hypovolemia, preoperative infection
use of anticoagulants (aspirin) preoperatively
✔✔why is a client with liver disease at increased risk for operative complications? -
✔✔impairs ability to detoxify medications used during surgery
impairs ability to produce prothombin to reduce hemorrhage
✔✔Preoperative teaching should include demonstration and explanation of expected
postop client activities. What activities should be included? - ✔✔Respiratory activities:
coughing, breathing, use of spirometer
Exercise: range of motion, leg exercises, turning
Pain management: medication, splinting
Dietary: NPO, evolving to progressive diet
Dressings and drains
Orientation to recovery room environment
✔✔What items should the nurse assist the client in removing before surgery? -
✔✔Contact lenses, glasses, dentures, partial plates, wigs, jewelry, prostheses, makeup,
nail polish
✔✔How is the client positioned in the immediate postop period and why? - ✔✔Usually
on the side or with head to side to prevent aspiration of any emesis
✔✔List three nursing interventions that prevent postop would dehiscence and
eviseration - ✔✔Teaching client to splint incision when coughing
Encouraging coughing and deep breathing
Monitoring for signs of infection, malnutrition, dehydration
Encourage high protein diet
✔✔Identify three nursing interventions that prevent postop paralytic ileus - ✔✔Early
ambulation
Limit use of narcotic analgesics
NG tube decompression
✔✔List four nursing interventions that prevent postop thrombophlebitis - ✔✔Teaching
performance of in bed leg exercises
Encouraging early ambulation
Applying stockings
Teaching avoidance of positions and pressures that obstruct venous blood flow
✔✔During the intraop period, what activities should the OR nurse perform to ensure
safety during surgery? - ✔✔Ascertain correct sponge, needle, instrument count
Position client to avoid injury
QUESTIONS AND SOLUTIONS GUARANTEE A+
✔✔What does the PR interval represent? - ✔✔The time required for the impulse to
travel from the atria through the AV node
✔✔If the U wave is most prominent, what condition might the nurse suspect? -
✔✔Hypokalemia
✔✔Describe the calculation of the heart rate using an ECG rhythm strip - ✔✔Count the
number of RR intervals in the 30 large squares and multiple by 10 to determine the
heart rate for 1 minute
✔✔What is the most important assessment data for the nurse to obtain in a client with
an arrhythmia? - ✔✔Ability of the client to tolerate the arrhythmia
✔✔HH 29 - ✔✔Marking the operative site is required for procedures involving right/left
distinctions, multiple structures and levels. Site marking should be done with the
involvement of the client
✔✔HH 30 - ✔✔Wound dehiscence is separation of the wound edges, it is more likely to
occur with vertical incisions. It usually occurs after the early postop period, when the
clients own granulation tissue is taking over the wound, after absorption of the sutures
has begun.
Evisceration of the wound is protrusion of the intestinal contents and is more likely in
clients who are older, diabetic, obese, malnourished and have prolonged paralytic ileus
✔✔HH 31 - ✔✔A 43 year old mother of two teen daughters enters the hospital to have
her gallbladder removed in a same day surgery using an endoscope instead of incision.
What nursing needs will dominate each phase of her short hospital stay?
-Preparation phase: education about postop care and assistance with meeting familys
needs
-Operative phase: assessment, management of operative suite
-Postanesthesia phase: pain management, precautions
-Post op phase: prevents of complications, assessment of pain, teaching about dietary
restrictions, activity levels
✔✔HH 32 - ✔✔Time out project
Hand off communication are all best practices implemented to prevent serious medical
error during per op period.
Time out occurs before making the incision and the entire surgery team aloud. The
team confirms that this information is correct.
✔✔List five variables that increase surgical risk - ✔✔Age: very young and very old
, obesity and malnutrition
preoperative dehydration/hypovolemia, preoperative infection
use of anticoagulants (aspirin) preoperatively
✔✔why is a client with liver disease at increased risk for operative complications? -
✔✔impairs ability to detoxify medications used during surgery
impairs ability to produce prothombin to reduce hemorrhage
✔✔Preoperative teaching should include demonstration and explanation of expected
postop client activities. What activities should be included? - ✔✔Respiratory activities:
coughing, breathing, use of spirometer
Exercise: range of motion, leg exercises, turning
Pain management: medication, splinting
Dietary: NPO, evolving to progressive diet
Dressings and drains
Orientation to recovery room environment
✔✔What items should the nurse assist the client in removing before surgery? -
✔✔Contact lenses, glasses, dentures, partial plates, wigs, jewelry, prostheses, makeup,
nail polish
✔✔How is the client positioned in the immediate postop period and why? - ✔✔Usually
on the side or with head to side to prevent aspiration of any emesis
✔✔List three nursing interventions that prevent postop would dehiscence and
eviseration - ✔✔Teaching client to splint incision when coughing
Encouraging coughing and deep breathing
Monitoring for signs of infection, malnutrition, dehydration
Encourage high protein diet
✔✔Identify three nursing interventions that prevent postop paralytic ileus - ✔✔Early
ambulation
Limit use of narcotic analgesics
NG tube decompression
✔✔List four nursing interventions that prevent postop thrombophlebitis - ✔✔Teaching
performance of in bed leg exercises
Encouraging early ambulation
Applying stockings
Teaching avoidance of positions and pressures that obstruct venous blood flow
✔✔During the intraop period, what activities should the OR nurse perform to ensure
safety during surgery? - ✔✔Ascertain correct sponge, needle, instrument count
Position client to avoid injury
