Nursing 150 exam 6: periop; end of life
(NCLEX Qs came from Nurse Labs,
Fundamentals success,
registerednursern.com, pearson nclex
practice exam)
Save
s
a list of reasonably preventable medical errors that occur in hospitals that will no longer
be paid for by Medicare in an attempt to control costs
after surgery - ANSWERS-Never events
Hemorrhage (hypovolemic shock) causes - ANSWERS-untied vessels, dislodged clot,
perforated vessels, coagulation issues, delayed healing
Signs and symptoms Hemorrhage (hypovolemic shock) - ANSWERS-include
hypotension, weak and rapid pulse, cool and clammy skin, rapid breathing,
restlessness, altered mental status, and reduced urine output.
Systolic blood pressure may be in the normal range during compensated shock
. Because of compensatory mechanisms, the effects of age, and use of certain
medications, some patients in shock will present with a normal blood pressure and
pulse.
Hypostatic Pneumonia CAUSE - ANSWERS-Hypostatic pneumonia is inflammation of
the lungs caused by lack of adequate movement.
Lack of chest expansion, poor position, stasis of fluid and/or circulation in the lung
fields, inadequate ventilation caused by anesthesia or meds.
Hypovolemic shock. - ANSWERS-Inadequate perfusion of tissues, organs, and cells
from loss of circulatory fluid volume
Hypostatic Pneumonia SIGNS AND SYMPTOMS - ANSWERS-Cough, changes in
appearance of sputum, fever, dyspnea, cyanosis, increase in pulse and respiration,
decreasing breath sounds with the presence of rales/crackles and rhonchi.
Hypostatic Pneumonia PREVENTION - ANSWERS-Position to facilitate good chest
expansion and change position frequently. Encourage deep breathing and coughing
exercises. Respiratory therapy especially incentive spirometry.
Thrombus formation - ANSWERS-~prolonged inactivity
-impaired venous return to the heart
-hypercoagulability of the blood
-injury to a vessel wall
Signs and Symptoms DVT - ANSWERS-1. pain and cramping in the calf or thigh of the
involved extremity
,2. Redness, swelling or warmth in the affected area
3. diminished pulses of affected limb
Prevention of DVT - ANSWERS-1. Implement leg exercises and turn Q2/ROM
2. Ambulate with assistance at least 3-4X/day
3. Anti-embolism stockings (TEDS), SCD (sequential pneumatic compression devices)
4. Avoidance of leg massage
5. Avoid positions that impede circulation
6. Monitor fluid balance (maintain hydration)
7. Administer prophylactic anticoagulants if ordered.
Signs and Symptoms of Pulmonary Embolism - ANSWERS-1. Dyspnea
2. Chest pain
3. Cough
4. Cyanosis
5. Rapid respirations
6. Tachycardia
7. Anxiety
8. Decreased Pulse-ox
Prevention- prevent DVT
Nursing Interventions for PE - ANSWERS-1. Maybe life threatening - contact physician
immediately
2. Maintain bed rest with pt in semi-fowlers position
3. Administer O2
4. Maintain IV fluids
5. Administer anticoagulants
Signs and Symptoms Atelectasis - ANSWERS-Respiratory Complication (incomplete
expansion or collapsed alveoli)
1. Decreased lung sounds over affected area
2. Dyspnea
3. Cyanosis
4. Crackles
5. Restlessness
6. Apprehension
Prevention for Atelectasis - ANSWERS-1. Cough and Deep Breath (C&DB)
2. Incentive Spirometer every 1-2 hours
3. Ambulate with assistance at least 3-4 times/day
4. Avoid positions that decrease ventilation
5. Maintain hydration
6. O2 PRN
Treatment/Nursing Interventions Atelectasis - ANSWERS-1. Position pt in semi-fowlers
or full fowlers position (COPD high fowlers)
2. Administer O2 as ordered
3. Maintain fluid and nutritional status
4. Continue deep breathing and incentive spirometer
5. Ensure rest and comfort
Older adults are at increased risk for surgery, explain - ANSWERS-Comorbidities
,Less physiological reserve
More allergies
High risk of delirium and acute confusion
Higher likelihood of a fall and resultant injuries
Decreased: kidney function, immune response, bone & lean body mass, cardiac output,
cough reflex, peripheral circulation
Increased: peripheral vascular resistance, time required for wound healing, BP
1) Major surgery
2) Urgent
3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
Necessary to be performed within 1-2 days ex: heart bypass surgery, removal of
gallbladder, removal of tumor, fractured hip - ANSWERS-2) Urgent
1) Major surgery
2) Urgent
3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
Alleviate symptoms of a disease, intensive of illness, --> not curative ex: partial tumor
removal, debridement - ANSWERS-5) Palliative
1) Major surgery
2) Urgent
, 3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
associated with a high degree of risk - ANSWERS-1) Major surgery
1) Major surgery
2) Urgent
3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
Remove a diseased organ or extremity ex: Amputation, Appendectomy - ANSWERS-9)
Ablative
1) Major surgery
2) Urgent
3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
Restore function: joint replacement - ANSWERS-10) Reconstructive
1) Major surgery
2) Urgent
(NCLEX Qs came from Nurse Labs,
Fundamentals success,
registerednursern.com, pearson nclex
practice exam)
Save
s
a list of reasonably preventable medical errors that occur in hospitals that will no longer
be paid for by Medicare in an attempt to control costs
after surgery - ANSWERS-Never events
Hemorrhage (hypovolemic shock) causes - ANSWERS-untied vessels, dislodged clot,
perforated vessels, coagulation issues, delayed healing
Signs and symptoms Hemorrhage (hypovolemic shock) - ANSWERS-include
hypotension, weak and rapid pulse, cool and clammy skin, rapid breathing,
restlessness, altered mental status, and reduced urine output.
Systolic blood pressure may be in the normal range during compensated shock
. Because of compensatory mechanisms, the effects of age, and use of certain
medications, some patients in shock will present with a normal blood pressure and
pulse.
Hypostatic Pneumonia CAUSE - ANSWERS-Hypostatic pneumonia is inflammation of
the lungs caused by lack of adequate movement.
Lack of chest expansion, poor position, stasis of fluid and/or circulation in the lung
fields, inadequate ventilation caused by anesthesia or meds.
Hypovolemic shock. - ANSWERS-Inadequate perfusion of tissues, organs, and cells
from loss of circulatory fluid volume
Hypostatic Pneumonia SIGNS AND SYMPTOMS - ANSWERS-Cough, changes in
appearance of sputum, fever, dyspnea, cyanosis, increase in pulse and respiration,
decreasing breath sounds with the presence of rales/crackles and rhonchi.
Hypostatic Pneumonia PREVENTION - ANSWERS-Position to facilitate good chest
expansion and change position frequently. Encourage deep breathing and coughing
exercises. Respiratory therapy especially incentive spirometry.
Thrombus formation - ANSWERS-~prolonged inactivity
-impaired venous return to the heart
-hypercoagulability of the blood
-injury to a vessel wall
Signs and Symptoms DVT - ANSWERS-1. pain and cramping in the calf or thigh of the
involved extremity
,2. Redness, swelling or warmth in the affected area
3. diminished pulses of affected limb
Prevention of DVT - ANSWERS-1. Implement leg exercises and turn Q2/ROM
2. Ambulate with assistance at least 3-4X/day
3. Anti-embolism stockings (TEDS), SCD (sequential pneumatic compression devices)
4. Avoidance of leg massage
5. Avoid positions that impede circulation
6. Monitor fluid balance (maintain hydration)
7. Administer prophylactic anticoagulants if ordered.
Signs and Symptoms of Pulmonary Embolism - ANSWERS-1. Dyspnea
2. Chest pain
3. Cough
4. Cyanosis
5. Rapid respirations
6. Tachycardia
7. Anxiety
8. Decreased Pulse-ox
Prevention- prevent DVT
Nursing Interventions for PE - ANSWERS-1. Maybe life threatening - contact physician
immediately
2. Maintain bed rest with pt in semi-fowlers position
3. Administer O2
4. Maintain IV fluids
5. Administer anticoagulants
Signs and Symptoms Atelectasis - ANSWERS-Respiratory Complication (incomplete
expansion or collapsed alveoli)
1. Decreased lung sounds over affected area
2. Dyspnea
3. Cyanosis
4. Crackles
5. Restlessness
6. Apprehension
Prevention for Atelectasis - ANSWERS-1. Cough and Deep Breath (C&DB)
2. Incentive Spirometer every 1-2 hours
3. Ambulate with assistance at least 3-4 times/day
4. Avoid positions that decrease ventilation
5. Maintain hydration
6. O2 PRN
Treatment/Nursing Interventions Atelectasis - ANSWERS-1. Position pt in semi-fowlers
or full fowlers position (COPD high fowlers)
2. Administer O2 as ordered
3. Maintain fluid and nutritional status
4. Continue deep breathing and incentive spirometer
5. Ensure rest and comfort
Older adults are at increased risk for surgery, explain - ANSWERS-Comorbidities
,Less physiological reserve
More allergies
High risk of delirium and acute confusion
Higher likelihood of a fall and resultant injuries
Decreased: kidney function, immune response, bone & lean body mass, cardiac output,
cough reflex, peripheral circulation
Increased: peripheral vascular resistance, time required for wound healing, BP
1) Major surgery
2) Urgent
3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
Necessary to be performed within 1-2 days ex: heart bypass surgery, removal of
gallbladder, removal of tumor, fractured hip - ANSWERS-2) Urgent
1) Major surgery
2) Urgent
3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
Alleviate symptoms of a disease, intensive of illness, --> not curative ex: partial tumor
removal, debridement - ANSWERS-5) Palliative
1) Major surgery
2) Urgent
, 3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
associated with a high degree of risk - ANSWERS-1) Major surgery
1) Major surgery
2) Urgent
3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
Remove a diseased organ or extremity ex: Amputation, Appendectomy - ANSWERS-9)
Ablative
1) Major surgery
2) Urgent
3) Elective
4) Diagnostic
5) Palliative
6) Minor
7) Emergent
8) Cosmetic
9) Ablative
10) Reconstructive
11) Transplant
Which surgery does the below criteria suggest?
Restore function: joint replacement - ANSWERS-10) Reconstructive
1) Major surgery
2) Urgent
