Deck 17: Perioperative Care

Question 1

While receiving report from the operating room,the nurse learns that a client's surgical wound after gallbladder removal is classified as III.What does this classification tell the nurse? Select all that apply.

A)The alimentary tract was not entered.
B)The wound is necrotic and infected.
C)Gallbladder contents spilled into the surgical site.
D)A break in sterility occurred during the surgery.
E)The alimentary,respiratory,genital,or urinary tract was entered.

Answer 1

Gallbladder contents spilled into the surgical site.
A break in sterility occurred during the surgery.

Question 2

The postoperative recovery room nurse determines that a client in the postoperative phase of care can be transitioned to phase 2 of recovery.The client is able to take deep breaths and cough,is using oxygen to maintain a saturation of greater than 90%,is fully awake,has a systolic blood pressure that is 130 mmHg now but the preoperative systolic blood pressure was 100 mmHg,and is able to move all four extremities independently.Using the following scale,this client's Aldrete score is ________.
The Aldrete score:
Respiration
2 = Able to take deep breath and cough
1 = Dyspnea/shallow breathing
0 = Apnea
O₂ Saturation
2 = Maintains >92% on room air
1 = Needs O2 inhalation to maintain O₂ saturation >90%
0 = Saturation <90% even with supplemental oxygen
Consciousness
2 = Fully awake
1 = Arousable on calling
0 = Not responding
Circulation
2 = BP 20% preop
1 = BP 20-49% preop
0 = BP 50% preop
Activity
2 = Able to move 4 extremities
1 = Able to move 2 extremities
0 = Able to move 0 extremities

Answer 2

8

Question 3

How often should a client be monitored during the intraoperative phase?

A)Every 5 minutes
B)Every 30 minutes
C)Constantly
D)Occasionally

Answer 3

Constantly

Question 4

The nurse is providing teaching to a client who is scheduled to undergo surgery in 2 weeks.Which topics should the nurse include that will prepare the client to help reduce complications during the postoperative phase? Select all that apply.

A)Maintaining a patent airway
B)Deep breathing and coughing
C)Caring for the surgical incision
D)Managing constipation
E)Managing pain

Question 5

The nurse is preparing an older adult client for surgery.On which topics should the nurse focus when preparing this client's preoperative teaching? Select all that apply.

A)Level of hearing
B)Amount of anesthesia needed during surgery
C)Teaching on deep breathing and coughing
D)Plans for discharge care
E)Actions to prevent pressure ulcers

Question 6

The postoperative care nurse is reviewing the documentation from the intraoperative phase of a client's surgical procedure.Which information should the nurse anticipate finding on the intraoperative documentation? Select all that apply.

A)Pain assessment
B)Start and stop times of anesthesia
C)Medication review
D)Antibiotic infusion times
E)Start and stop times of the procedure

Question 7

A nurse was involved in the perioperative care of a preterm infant requiring cardiothoracic surgery.The infant has now been moved to the NICU.How should the nurse change the focus of her assessment in the postoperative phase?

A)The nurse should assess the client as preterm.
B)The nurse should assess the client's respiratory status.
C)The nurse should assess the client's glucose levels.
D)The nurse should assess the parents' coping mechanisms.

Question 8

Which of the following statements best describes the vital signs the nurse collects during the preoperative phase?

A)They are the only vital signs collected during the perioperative period.
B)When later vital signs are taken,they are compared against the preoperative set.
C)Generally preoperative vital signs are only relevant during the intraoperative process.
D)These are not essential and may be omitted for emergency surgeries.

Question 9

A client with terminal cancer is undergoing surgery to partially remove a tumor that is pressing on a nerve and causing pain.This is classified as what type of surgery?

A)Reconstructive
B)Diagnostic
C)Palliative
D)Emergency

Question 10

What is characteristic of assessment in perioperative care?

A)It is primarily a component of preoperative care.
B)It is used most often during the intraoperative process.
C)It primarily is involved in evaluating clients during postoperative care.
D)It is involved in every part of the perioperative process.

Question 11

What drug may be used to treat nausea and vomiting associated with operative procedures?

A)Metoclopramide
B)Acetaminophen
C)Midazolam
D)Fentanyl

Question 12

A prothrombin time (PT)test measures which of the following?

A)Time required for the client's blood to clot
B)Time required for the client's plasma to clot
C)Time required for platelets to effectively stop bleeding
D)Time required for a surgical procedure

Question 13

The postoperative nurse is planning care for a client recovering from major thoracic surgery.Which nursing diagnoses should the nurse select to plan for this client's immediate care needs? Select all that apply.

A)Risk for Impaired Gas Exchange
B)Risk for Decreased Cardiac Output
C)Deficient Knowledge
D)Risk for Imbalanced Nutrition: Less than Body Requirements
E)Risk for Imbalanced Fluid Volume

Question 14

The nurse is preparing a client for emergency surgery to repair liver and colon lacerations caused by a motor vehicle crash.Which information about this type of surgery will the nurse use to guide the client's care? Select all that apply.

A)An organ is going to be removed.
B)This is an emergency surgery.
C)The client will be hospitalized longer.
D)The client is at risk for blood loss.
E)The client is at risk for hypothermia.

Question 15

Which of the following situations demands that all perioperative staff cover their bodies with lead shields?

A)The surgical team uses a bipolar handpiece to cauterize a client's tissue.
B)The surgical team uses a class 3 laser to cut a client's kidney stone.
C)The surgical team uses a pneumatic tourniquet to cut off circulation to a client's hand.
D)The surgical team uses radiology to take intraoperative photos.

Question 16

A client presents with decreased blood volume,hypotension,tachycardia,and tachypnea during surgery.Which of the following intraoperative complications is most likely?

A)Hypovolemia
B)Hypervolemia
C)Hypokalemia
D)Hypernatremia

Question 17

The nurse is providing teaching to a client who is about to undergo surgery.When discussing whom the client can expect to see in the operating room suite,which individuals should the nurse include? Select all that apply.

A)Surgeon
B)Postoperative nurse
C)Circulating nurse
D)Anesthesiologist
E)Social worker