Funds Exam 3 - The Surgical Client

Contains information from the following sources: surgical client ATI, exam 3 blueprint, canvas slideshows

possible manifestations of _____ include: bp of less than 90 systolic, tachycardia, tachypnea

bleeding

surgical attire for the surgical suite consists of which items?

cap, shoe covers, gown, mask, gloves

diabetes mellitus, BMI greater than 30, smoking, regular corticosteroid use, and age above 65y are all risk factors that put a patient at risk for _____

poor or delayed wound healing

some possible manifestations of _____ include: pain, redness, swelling in the lower extremity, extremity is warm to touch

deep vein thrombosis

neurological deficits like confusion, impaired speech or understanding, dizziness, numbness/weakness on one side of the body are possible manifestations of _____

thrombotic stroke

hypotension, confusion, tachycardia, oliguria are possible manifestations of _____

hypovolemic shock

chest pain, shortness of breath, tachycardia, hypoxia are some possible manifestations of _____

pulmonary embolism

A time-out is performed at what point during a surgery?

at the beginning of the procedure, prior to any additional procedures performed, and at the completion of the procedure

when planning postoperative care for a client, what action is the nurses priority?

monitor oxygen saturation

minimal peristalsis, nausea, and mild abdominal discomfort are possible manifestations of _____

an ileus

_____ anesthesia is medications or inhalants used to depress the central nervous system. the cardiopulmonary system is depressed, and the client has no response to painful stimuli.

general

_____ anesthesia affects the motor and sensory nerves at the surgical site. this type of anesthesia is injected into the tissue and works to block pain impulses. used for minor procedures. ex: lidocaine, benzocaine

local

With _____ anesthesia, the client will experience a temporary loss of feeling to an area of the body. this type is injected near a cluster of nerve endings to block pain impulses to one area of the body. ex: spinal or epidural blocks

regional

_____ anesthesia is combined with general anesthesia and is generally used for abdominal and thoracic surgeries.

epidural

_____ is prescribed for a postoperative client to assist with deep breathing to reduce the risk of atelectasis and pneumonia.

incentive spirometry

a nurse is planning care for a client with a distended bladder and has not voided 8hr after surgery. what intervention is most likely to be implemented?

straight catheter

a history of regular tobacco use places a preoperative client at an increased risk for _____

blood clots

Anticholinergics are given to decrease secretions in the upper airway, but they can cause which two unfavorable side effects?

delirium, urinary retention

Effective preoperative teaching can reduce the _____ by decreasing complications such as pneumonia, infection, and thrombophlebitis.

length of the client's hospital stay

when planning postoperative care for a client, the nurse should plan to reposition the client every _____ to promote lung expansion and decrease the risk of muscle weakness, blood clots, and pneumonia.

1hr

The nurse should instruct the client to cough and deep breathe every _____ to promote lung expansion and clear secretions.

2hr

The nurse should instruct the client to perform ankle pump exercises every _____ while awake to promote venous return and decrease the risk for a thrombus formation.

1hr

The nurse should instruct the client to perform _____ repetitions of an incentive spirometer every _____ to promote lung expansion and clear secretions.

10, 1hr

how do you identify an older patients risk for developing postoperative delirium?

complete a comprehensive geriatric assessment (GCA)

what condition are older adults and patients with pre-existing neurocognitive disorders (such as parkinsons, alzheimers, hx of stroke) at risk for developing when undergoing anesthesia?

postoperative cognitive dysfunction (POCD)

permanent long-term memory loss, and changes in behavior and neurocognition that can last weeks or months are s/s of what condition in older patients who have recently undergone anesthesia?

postoperative cognitive dysfunction (POCD)

due to prolonged inactivity during/after surgery, intraoperative and postoperative patients are at risk for developing a _____ in the form of DVT or PE.

venous thromboembolism (VTE)

some possible manifestations of _____ include: dehydration/electrolyte imbalance, nausea, vomiting. risk factors for this condition include: hx motion sickness, abdominal procedures, use of opioid analgesics

postoperative nausea and vomiting (PONV)

postoperative complications: risk factors for _____ include lack of fluids due to NPO status, bowel prep, intraoperative blood loss and sepsis.

hypovolemia

postoperative complications: risk factors for _____ include conditions that cause fluid retention such as CHF or renal insufficiency/failure, IV fluid/blood replacement

hypervolemia

possible manifestations of _____ include: tachypnea, hypoxemia, tachycardia, diminished lung sounds, can cause pneumonia & respiratory failure

atelectasis

_____ is the separation of the incisional edges

dehiscence

_____ is a medical emergency in which the internal organs underlying the surgical incision begin to slip out of the abdominal cavity

evisceration

_____ is a temporary, short-term disturbance in the peristaltic movement of the intestines. this condition is more common after abdominal surgery when the intestines have been manipulated.

ileus

s/s of _____ include: jugular vein distention (JVD), edema, hypertension

hypervolemia

risk factors for _____ include: chronic kidney conditions, older adult age, diabetes, heart failure, hypertension, and peripheral vascular disease (PVD)

acute kidney injury (AKI)

_____ sedation is induced using medications in the IV. client is drowsy but arousable, breathing spontaneously, and can follow simple instructions. used for minor procedures. ex: diazepam, lorazepam, midazolam

moderate

when assessing circulation using the ABC framework, patient should be on ______ cardiac monitoring and have their BP checked every _____.

continuous, 5-15 minutes

distraction, music, breathing exercises, positioning, heat/cold application, and splinting are all examples of what kind of intervention?

non-pharmacological