Med/Surg Test 1

Normal level PcCO2 - correct answer 35-45 mmHg, 40 mmHg. ablative surgery - correct answer surgery to remove a diseased body part elective surgery - correct answer surgery that is not essential palliative surgery - correct answer surgery that relieves symptoms without producing a cure major surgery - correct answer surgery that poses great risks to the client's well-being urgent surgery - correct answer surgery that is necessary for the client's health and may prevent other problems emergency surgery - correct answer surgery that must be done immediately to save the client's life cosmetic surgery - correct answer surgery performed to improve personal appearance procurement - correct answer surgery to remove organs from a client that is brain dead An obese client is at risk for poor wound healing postoperatively because: - correct answer Fatty tissue has a poor blood supply The nurse asks each client preoperatively for the name and dose of all prescription and over-the-counter medications taken before surgery because these medications: - correct answer May increase the risks for anesthetic and surgical complications A client who smokes two packs of cigarettes per day is most at risk postoperatively for: - correct answer Atelectasis, fever, and pneumonia Family members should be included when the nurse teaches the client preoperative exercises so they can: - correct answer Coach the client postoperatively. Maintaining normal glucose levels during the postoperative period reduces which complication? - correct answer Wound infection In the postanesthesia care unit the nurse notes that the client is having difficulty breathing because of an obstruction. The nurse would first: - correct answer Position the client so that the tongue falls forward Because an older adult is at increased risk for respiratory complications after surgery, the nurse should: - correct answer Encourage the client to turn, deep breathe, and cough frequently, and ensure adequate pain control. A client with a longer than normal prothrombin time (PT) or activated partial thromboplastin time (APTT) is at risk postoperatively for: - correct answer Bleeding. A client with a prolonged PT or APTT is at risk of bleeding. When a nonbariatric client is deep breathing and coughing the client should be sitting because this position: - correct answer Facilitates expansion of the thorax The nurse notes that a postsurgical client has a heart rate of 130 beats per minute and a respiratory rate of 32 breaths per minute. The nurse also assesses jaw muscle rigidity and rigidity of the limbs, abdomen, and chest. What does the nurse suspect and what intervention is indicated? - correct answer The nurse suspects malignant hyperthermia and should notify the surgeon/anesthesiologist immediately, prepare to administer dantrolene sodium, and monitor vital signs frequently. The nurse will immediately administer dantrolene sodium ordered by the health care providers. Through experience and knowledge, the nurse knows that the client will commonly experience the most severe postoperative pain at what time? - correct answer The first 12 to 36 hours after surgery Surgical procedures are classified in terms of seriousness, urgency, and purpose. The designation of a procedure as an "emergency surgical procedure" relates to which of the following categories? - correct answer Urgency The American Society of Anesthesiologists has assigned surgical classifications to clients based on what characteristic? - correct answer Physical status of the client On admission to the ambulatory surgical unit the client tells the nurse, "I take naproxen for arthritic pain." Why should the nurse inform the surgeon of this? - correct answer NSAIDs inhibit platelet aggregation and may prolong bleeding time. While assessing a client after surgery, the nurse notes dull breath sounds and dyspnea. What are the most appropriate nursing interventions? - correct answer Encourage deep breathing and coughing exercises and increase mobility. Dull breath sounds and dyspnea may suggest atelectasis. Nursing has made significant contributions in what areas promoting positive client outcomes after surgery? - correct answer Demonstration of the benefits of preoperative education The nurse taking a medication history preoperatively asks the client about allergies. Which of the following is the most appropriate way of asking the client about this issue? - correct answer "Have you ever had a problem with a medication or substance?" Surgical procedure permitting, in what position should the client be placed during the immediately postanesthetic stage of recovery? - correct answer Side-lying, face down The nurse conducts a partial or complete physical examination depending on the amount of time available. The nursing assessment should complement the physical examinations performed by the surgeon and anesthetist or anesthesiologist. Which of the following assessments should the nurse perform immediately in the postanesthesia stage? - correct answer Airway, level of consciousness, cardiovascular status, and safety Encouraging the client to perform coughing exercises every 2 hours while awake is an appropriate measure for the majority of postsurgical clients. After what surgical procedures may coughing exercises be contraindicated? - correct answer Eye, intracranial, and spinal conscious sedation - correct answer Administration of central nervous system depressant drugs and/or analgesics to supplement topical, local, or regional anesthesia during surgical or diagnostic procedures. convalescence - correct answer Period of recovery after an illness, injury, or surgery. dermatome - correct answer Area on the surface of a body innervated by afferent fibers from one spinal root. latex sensitivity - correct answer An allergy to latex and products containing latex. moribund - correct answer Near death or in the process of dying. perioperative nursing - correct answer Refers to the role of the operating room nurse during the preoperative, intraoperative, and postoperative phases of surgery. postanesthesia recovery score (PARS) - correct answer Score that measures various criteria, including oxygen saturation, level of consciousness, circulation, activity, and respiration. postanesthesia recovery score for ambulatory patients (PARSAP) - correct answer Score that includes five more areas of assessment than the PARS; includes the condition of the dressing, the intensity and location of pain, the ability to stand and ambulate, tolerance of oral fluids and/or food, and the ability to urinate spontaneously. preoperative teaching - correct answer Ensured by knowledge pertaining to adult learning principles, coupled with the client's unique needs. ambulatory surgery - correct answer Scheduled outpatient procedures provided for clients who do not remain overnight in a hospital. bariatrics - correct answer Field of medicine that focuses on the treatment and control of obesity and diseases associated with obesity. cholecystectomy - correct answer Surgical removal of the gallbladder. Association of Operating Room Nurses (AORN) - correct answer National association for professional surgical nurses local anesthesia - correct answer Loss of sensation at the desired site of action. informed consent - correct answer Process of obtaining permission from a client to perform a specific test or procedure after describing all risks, side effects, and benefits. malignant hyperthermia - correct answer Autosomal dominant trait characterized by often fatal hyperthermia in affected people exposed to certain anesthetic agents. regional anesthesia - correct answer Loss of sensation in an area of the body supplied by sensory nerve pathways. paralytic ileus - correct answer Usually temporary paralysis of intestinal wall that may occur after abdominal surgery or peritoneal injury and that causes cessation of peristalsis; leads to abdominal distention and symptoms of obstruction. atelectasis - correct answer Collapse of alveoli, preventing the normal respiratory exchange of oxygen and carbon dioxide. Which of the following signs or symptoms in an opioid naïve client is of greatest concern to the nurse when assessing the client 1 hour after administering an opioid? - correct answer Difficulty arousing the client A physician wrote the following order for an opioid naïve client who has returned from the operating room after total hip replacement: "Fentanyl patch 100 mcg, change every 3 days." Based on this order, the nurse takes which of the following actions? - correct answer Calls the physician and questions the order A client is being discharged to home with an order for an around the clock opioid for relief of chronic back pain. Because of this drug regimen, for which class of medication does the nurse request an order? - correct answer Stimulant laxative An intern new to the service writes an order for OxyContin SR 10 mg by mouth every 12 hours as needed. Which part of the order does the nurse question? - correct answer The time interval After returning from vacation, the nurse notices that the client has been receiving Percocet, 2 tablets by mouth every 3 hours for the past 3 days. The nurse is most concerned about what? - correct answer Amount of acetaminophen received daily A client with chronic low back pain who has been receiving an opioid around the clock for the past year decided to abruptly stop the medication for fear of addiction. He is now experiencing shaking chills, abdominal cramps, and joint pain. The nurse recognizes that this client is experiencing symptoms of: - correct answer Physical dependence After a client receives 0.2 mg of naloxone via intravenous push, the client's respiratory rate and depth are within normal limits. The nurse now plans to implement which of the following actions? - correct answer Assess the client's vital signs every 15 minutes for 2 hours. Which of the following instructions is it crucial for the nurse to give to both the client and family members when the client is about to be started on morphine delivered via a patient - correct answer controlled analgesia (PCA) device?-Only the client should push the PCA button. A client with a history of a stoke that left her confused and unable to communicate has returned from the interventional radiology department after placement of a gastrostomy tube. The physician's order reads: "Vicodin 1 tablet, per tube, every 4 hours as needed." Which is the best action by the nurse? - correct answer Request to have the order changed to around the clock administration for the first 48 hours. The results of many diagnostic tests performed to identify the cause of a client's chronic low back pain come back negative. This indicates to the physician and nurse that the client's pain is: - correct answer Currently idiopathic