Class 23&24 Review Questions Nursing

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1

1.What is diagnostic/exploratory surgery?

2.What is ablative surgery?

3.What is palliative surgery?

1. To confirm or rule out dx. Exploratory – to determine sources of something like bleeding.
2. Surgery to remove diseased body part.
3. Surgery to improve quality of life

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4.What is reconstructive surgery?
5.What is cosmetic surgery?
6.What is transplant surgery?

4. Surgery to restore function.
5. Surgery to improve appearance
6. Replaces dysfunctional organ.

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7.What is the most common type of transplant surgery?
8.What is procurement surgery?
9.What are urgent surgeries?

7. Kidney.
8. Procuring organ from one patient to be placed in another.
9. Emergent. To relieve current S/S

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10.Elective surgery.

11.What is inpatient surgery?

12.What is outpatient surgery?

10. Time doesn’t matter. Isn’t life threatening, patient is given options by doctor and chooses to have it done.
11. Surgery done when patient is admitted to hospital and needs monitoring of post surgery complications. Like heart surgery.
12. Surgery where patient goes into surgical area and goes home after on the same day.

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13.What is perioperative nursing?

14.Why are the very young at risk during surgery? Why?

13. Care provided to clients before, during, and after surgery/invasive procedures.
14. Because of their immature body systems. They are unable to regulate body temperature, smaller blood volume, limited understanding, etc.

6

15.Why are older people at risk during surgery?

16.What are some preexisting conditions that may increase surgical risk?

15. More likely to have preexisting conditions, organ function is decreased, time needed for healing is increased, decreased CO and weakened immune system.
16. Cardiovascular (heart disease, etc), respiratory such as pneumonia, asthma, COPD, etc, Coagulation disorders, endocrine disorders (diabetes – effects patients healing time), renal, neurological, nutritional (decreased protein = decreased healing).

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17.Why is it important to know if a patient is on antipsychotics?

18.Which anticoagulant must be held 5-7 days prior to surgery?

19.Can antihypertensives be taken on day of surgery?

17. They can interact with meds given during surgery.
18. Plavix
19. Yes, with only a sip of water.

8

20.What myst you do before surgery with a patient that is on beta-blockers?

21.When assessing patient ebfore surgery, what things should you be looking for aside from previous history, medications, age, etc?

22.Why can smoking affect surgery?

20. You have to document date and time received before surgery
21.allergies, personal habits.
22. It constricts blood vessels which delays healing.

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23.Patients with excessive alcohol use are at risk for what?

24.How can marijuana effect surgery?

25.Why is an assessment done before surgery?

23. Decreased liver function, which effects how efficiently it metabolises medications and coagulates blood.
24. If affects patients pain receptors in patient which might mean you need higher doses of pain meds because of a tolerance they have built up.
25. To establish baseline.

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26.What are you looking for during physical assessment when looking at cardiovascular?

27.What are you looking for during physical assessment when looking at Respiratory?

26. Heart rate, BP, Dvt’s, edema, capillary refill, pulses.
27. Rate, rhythm, smoking, are they using accessory muscles?

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28.What are you looking for during physical assessment when looking at kidneys?

29.What are you looking for during physical assessment when looking at Neurologic?

28. Renal function, dialysis.
29. LOC, alert and oriented? Good to know especially before brain surgery cause if they are disoriented before surgery, they might be after. If not, something went wrong in surgery.

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30.What are you looking for during physical assessment when looking at musculoskeletal?

31.What are you looking for during physical assessment when looking at psychosocial status?

30. Ambulation, gait, may effect patient positioning during surgery.
31. Anxiety. Scared? Nonverbal? Twiddling thumbs, crying, sweating, shaking, do they have family? Coping ability?

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32.Why do we want to do pediatric surgeries as early as possible?

33.Do we do IV’s before or after sedation in children?

34.What is an ECG used for r/t surgery?

32. Because we want them to be NPO for as little time as possible
33. After.
34. Generally done on people who will be under general anesthesia. Detects abnormalities that could be worsened by anesthesia.

14

35.What is a CBC?

36.What do BUN and creatinine lab values check for?

37.What are the 4 main electrolytes?

35. Complete blood count, including RBC, WBC, H/H, platelets. Tells composition of blood, any infections, risk for bleeding.
36. Renal function.
37. Calcium, Phosphorus, sodium, and potassium.

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38.What do PT, INR, and PTT check for?

39.What is the normal range for HGB?

38. They check for risk for bleeding r/t coagulation.
39. 11-17

16

41.HCT?

42.PT?

43.INR?

44.PTT?

41.34-49
42. 10-13
43. 2-3
44. 20-35

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45.Platelets?
46.RBC?
47.NA+?
48.K+?
49.CA+?
50.PHOSPHOROUS?

45. 150,000-450,000
46. 3.7-5.8
47. 135-145
48. 3.5-5
49. 8.2-10.2
50. 2.5-4.5

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51.What is the physicians role in informed consent?

52.What is the nurses role in informed consent?

51. They assess competency of patient and explain procedure.
52. They act as patient advocate and witness. The do not explain procedure, the doc must do this. We witness that they’ve been given the info, and if the patient still has questions, we have to get the doc to come back and answer them.

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53.If a patient is unable to sign because they are illiterate, what must happen?

54.If a patient is going into surgery and has a DNR, are the healthcare personnel allowed to resuscitate during surgery?

53. They can sign with an X, but it must be witnessed by two health care personnel, or two nurses.
54. Yes, DNR doesn’t apply while patient is under anesthesia.

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55.What are the goals for preoperative teaching?

56.When performing preoperative teaching, why is it important to assess health literacy?

57.If a nurse goes in for surgery, is it OK to assume she already knows everything that’s going on?

55. Decrease fear and anxiety, increase cooperation and participation, and decrease postoperative complications.
56. If they have decreased health literacy, theyre much more likely to have to go back to hospital due to complications stemming from inadequate knowledge.
57. No.

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58.Why is it important to let the patient know the importance of maintain NPO status before a surgery?

59.What are some things to let patient know about before the surgery?

58. If they eat something, they could aspirate. Aspirate bad.
59. How long itll take, what they’ll be doing, who will be in there, overall recovery process, where they’ll wake up, pain treatment, etc.

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60.What are some ways to prevent DVT’s?

61.What are some ways to prevent pneumonia & atelectasis?

62.What percentage of HAI’s are surgical site infections?

60. Early ambulation, scd’s, ted hose, anticoagulants.
61. Deep breathing, incentive spirometer 10x per hour, coughing, ambulating, splinting.
62. 32.

23

63.What is it important to teach patient and family about preventing surgical site infections?

64.What are the components of preoperative checklist?

65.If a patient has latex allergy, what color is the armband?

63. Don’t smoke, wash hands well before and after coming in contact, know s/s of infection.
64. Vitals, diagnostic test, head to toe assessment, preoperative meds.
65. Green.

24

66.Is removal of personal clothing always necessary for inpatient or outpatient surgery?

67.Why are patients sometimes given laxatives or enemas before a surgery?

68.What things should patients expect to wake up to after surgery?

66. Inpatient.
67. To reduce intestinal bacteria or colon injury. More important if its intestinal surgery or abdominal.
68. Tubes and drains, catheters, hemovacs and stuff.

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69.What are anxiolytics?

70.Why are patients sometimes given sedatives or hypnotics before surgery?

71.What are anticholinergics?

69. Medicines to control anxiety.
70. It may let the patient require less anesthesia.
71. Medications that reduce oral and pulmonary secretions and prevent bradycardia.

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72.What are H2 receptor antagonists?

73.What kind of medicine is Zofran and phynergan?

74.Pertinent info to be given to anesthesia personnel during handoff communication:

75.Does teaching help soothe anxiety?

72. Anti emetics that work by reducing acidity of stomach.
73. Anti emetics.
74. patient history, vitals, medications.
75. Yes.

27

What are the two systems that are most likely to impact surgical outcome?

Why is obesity a risk during surgery?

Which vitamins are essential for healing?

Cardiovascular and respiratory.

Because fatty tissue is very vascular and can bleed a lot and very easily.

Vitamin a, b and c.

28

*If question on test tells about a “minor has lived on their own for 2 years” – assume this is emancipated minor & they CAN consent*

If a patient is placed on NPO status, are they allowed to smoke?

*Test question says, “Tell me why you are nervous about having surgery?” –Nontherapeutic because of “why”. No ‘why’s’ in question.*

No!

29

Why is it good to encourage patients to do breathing exercises after surgery?

Why is IS good to use after surgery?

*a low grade fever that persists for 71 hours and 58 minutes; on the 72nd hour- atelectasis will turn into pneumonia*

Loosens secretions, opens alveoli, prevents atelectasis.

lung expansion, open alveoli, prevent atelectasis

30

What does a platelet count of <100,000 indicate r/t surgery?

What could a PT level of >20 seconds indicate r/t surgery?

INR is drawn for patients on what?

They might be at a high risk for bleeding during surgery.

Could indicate risk for bleeding with surgery.

Warfarin (Coumadin).

31

PT is drawn for patients that aren’t taking ______.

Why is K+ important?

What can an elevated BUN indicate?

What can an elevated BUN and creatinine level require r/t anesthesia?

Blood thinners.

Essential for muscle contraction, including the heart.

Renal insufficiency.

A lower amount of it.