Perioperative Post Lecture Assessment

A 68-year-old male scheduled for hernia repair at an ambulatory surgical center expresses concern that he will not have enough care at home and asks if he can stay in the hospital after the surgery. Which response would the nurse provide?

• a. “Who is available to help you at home after the surgery?”

• b. “I’m sure you will be able to manage at home after surgery. It is a simple procedure.”

• c. “We will teach you everything you need to know to be able to care for yourself after surgery.”

• d. “Your health insurance will pay for inpatient care only if complications develop during surgery.”

Which preoperative instruction is appropriate for all patients?

• Techniques of deep breathing and coughing.

• Descriptions of the planned surgical procedure.

• Physical procedures or preparation required before surgery.

• Withholding of all oral fluids or food after midnight on the day of surgery.

During admission of the patient to the holding area or operating room before surgery, the perioperative nurse must:

• verify the patient’s understanding of the risks of surgery.

• ensure the patient’s identity with a formal identification process.

• prepare the skin by scrubbing the surgical site with an antimicrobial agent.

• perform a preoperative assessment with a patient history and physical examination.

During the administration of any regional anesthetic, it is most important that the nurse:

• monitor for ascending neurologic depression and unconsciousness.

• ensure that airway equipment, emergency drugs, and monitors are immediately available.

• monitor the patient’s response to the anesthesia, assessing the extent of loss of sensation.

• ensure that reversal drugs such as anticholinesterase agents (e.g., neostigmine) are available in case of respiratory arrest.

A patient becomes restless and agitated in the postanesthesia care unit (PACU) as he begins to regain consciousness. Which action would the nurse take first?

• Turn the patient to a lateral position.

• Check the patient’s oxygen saturation.

• Orient the patient and tell him surgery is over.

• Give the ordered postoperative pain medication.

While in the PACU, the patient’s blood pressure drops from an admission pressure of 126/82 to 106/78 with a pulse change of 70 to 94. After administering oxygen, which action would the nurse take next?

• Increase the rate of the IV fluids.

• Notify the anesthesia care provider.

• Perform neurovascular checks on the lower extremities.

• Use a cardiac monitor to assess the patient’s heart rhythm.

The nurse is preparing to discharge a patient from the ambulatory surgery center following an inguinal hernia repair. The nurse delays the release of the patient upon discovering that the patient:

• had IV morphine 45 minutes ago.

• has an oxygen saturation of 92%.

• has not voided since before surgery.

• had an episode of vomiting 30 minutes ago.

A 38-yr-old woman is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment must be communicated to the anesthesiologist and surgeon before surgery?

• The patient’s concern about being able to resume lifting heavy items

• The patient’s report that her last menstrual period was 8 weeks ago

• The patient’s history of an infection following a cholecystectomy

• The patient’s lack of knowledge about postoperative pain control

Which topic would the nurse discuss preoperatively with a patient who is scheduled for an open cholecystectomy?

• Medications to be used during surgery

• Care for the surgical incision

• Deep breathing and coughing

• Oral antibiotic therapy after discharge

Five minutes after receiving the ordered preoperative midazolam by IV injection, the patient asks to get up to go to the bathroom to urinate. Which action would the nurse take?

• Assist the patient to ambulate to the bathroom.

• Tell the patient that a catheter will be placed in the operating room.

• Perform a straight catheterization.

• Offer the patient a urinal or bedpan.