adult 1_ periop - Sheet1

Question 1

What is the purpose of a preoperative assessment?

Answer 1

To identify risk factors and devise a plan that ensures patient safety.

Question 2

What subjective information is gathered during a preoperative assessment?

Answer 2

Anxiety and fears, hope for positive results, health history (hospitalizations, surgeries, medical issues, menstrual/obstetric history), social history (smoking, alcohol, drug use), current medications (including OTC and herbal), allergies and reactions, family health history (heart/endocrine diseases, adverse reactions), and review of systems (ROS) for comorbidities.

Question 3

What objective information is collected during a preoperative assessment?

Answer 3

Physical examination and diagnostic studies (CBC, CMP, EKG, urinalysis, etc.).

Question 4

What are important nursing interventions before surgery?

Answer 4

Teach deep breathing, coughing, and ambulation; explain lines, drains, and equipment; instruct NPO after midnight; witness consent signing; ensure pre-op orders are completed; admit the patient; prepare paperwork (lab results, signed consent, H&P, baseline vitals); prepare the patient (bathing, shaving, ID bands); encourage voiding; administer pre-op medications; transport patient with chart to OR; provide handoff report.

Question 5

What are key cultural considerations for preoperative care?

Answer 5

Pain tolerance, expectations, and beliefs about surgery.

Question 6

What are important gerontologic considerations for preoperative care?

Answer 6

Sensory limitations, transportation needs, and mobility concerns.

Question 7

What are the three main components of preoperative education?

Answer 7

Sensory (OR temperature, lighting, monitor machines, drugs/antiseptic solutions), Process (flow of procedure from admission to recovery), Procedural (arrival time, food/fluid restrictions, bathing/shaving, vital signs, IV insertion, anesthesia administration).

Question 8

What are the fluid and food restrictions before surgery?

Answer 8

NPO (nothing by mouth) after midnight or 12 hours before surgery.

Question 9

Why is it important for a patient to void before surgery?

Answer 9

To prevent bladder distension and reduce complications during surgery.

Question 10

What documents must be prepared before surgery?

Answer 10

Lab results, signed consent, history & physical (H&P), and baseline vital signs.

Question 11

What is the nurse’s role in patient consent?

Answer 11

Witness the patient signing consent for the procedure, blood products, pelvic exams, etc.

Question 12

What is included in a preoperative handoff report?

Answer 12

Patient condition, completed paperwork, pre-op medications given, and any special considerations for the receiving nurse.

Question 13

What are the primary roles of the RN in the OR?

Answer 13

Maintain patient safety, dignity, and confidentiality; communicate with the patient, surgical team, and other departments; provide quality nursing care.

Question 14

What is the role of the scrub nurse?

Answer 14

Follow surgical antisepsis with sterile precautions; prepare and manage the sterile field and instruments.

Question 15

What is the role of the circulating nurse?

Answer 15

Maintain an unsterile role; facilitate the progress of the procedure; keep documentation.

Question 16

What are key nursing interventions during surgery?

Answer 16

Prepare the OR using sterile procedures, obtain proper equipment, maintain privacy during transfers, apply vital sign monitors and safety straps, assist anesthesia administration, position the patient safely, change patient position if needed, and cleanse the surgical site with antimicrobial agents.

Question 17

How should a nurse maintain safety when electrosurgical equipment is used?

Answer 17

Ground the patient properly.

Question 18

What is a surgical “time-out”?

Answer 18

A safety check before surgery to verify documentation, diagnostics, blood products, proper surgical site, and other critical information.

Question 19

What is the purpose of maintaining aseptic technique in the OR?

Answer 19

To prevent surgical site infections and maintain sterility.

Question 20

How can bony prominences be protected during surgery?

Answer 20

By using padding and proper positioning techniques.

Question 21

What is local anesthesia?

Answer 21

Loss of sensation to a specific part of the body without loss of consciousness.

Question 22

What is regional anesthesia?

Answer 22

Loss of sensation to a region of the body without loss of consciousness.

Question 23

What is moderate anesthesia (conscious sedation)?

Answer 23

A sedative state where the patient is responsive and breathes without assistance.

Question 24

What is general anesthesia?

Answer 24

Loss of sensation and loss of consciousness; requires airway management.

Question 25

What is malignant hyperthermia?

Answer 25

A genetic condition causing a rapid rise in core body temperature and severe muscle rigidity due to calcium overload and muscle breakdown.

Question 26

What are nursing interventions for malignant hyperthermia?

Answer 26

Stop the anesthetic agent, administer dantrolene to relax muscles, give 100% oxygen, and cool the patient with ice packs at the groin, head, and armpits.

Question 27

How can malignant hyperthermia be prevented?

Answer 27

Proper health history intake and avoiding medication triggers.

Question 28

What general information is included in a postoperative transfer report?

Answer 28

Patient name and age, surgeon and ACP, surgical procedure, tubes/lines/catheters/drains, type of anesthesia, use of reversal agents, airway status, pain management interventions, NPO status, and other post-op orders.

Question 29

What patient history should be included in a postoperative report?

Answer 29

Surgical indications, medical history, medications/allergies, pre-op labs/vitals, LOC, specific patient characteristics (hearing, vision, immobility, etc.), cultural preferences, and emotional status on arrival.

Question 30

What intraoperative management details should be reported postoperatively?

Answer 30

Anesthetic drugs, other pre-op/intra-op drugs, last dose of opioid administration, pain management plan, total fluid replacement/loss, and urine output.

Question 31

What intraoperative events should be communicated in a postoperative report?

Answer 31

Unexpected anesthetic events/reactions, unexpected surgical events, most recent vital signs and trends, and lab/x-ray results.

Question 32

What are the first nursing interventions after receiving a postoperative handoff report?

Answer 32

Assess airway, breathing, circulation; monitor vital signs (EKG, BP, SpO2); complete a focused neurological assessment (LOC, AxO, motor, sensory, etc.); assess urinary output and fluid balance; note all lines and drains; assess surgical site and dressings.

Question 33

Why should the head of the bed be elevated postoperatively?

Answer 33

To encourage deep breathing, prevent aspiration, and promote lung expansion to prevent atelectasis.

Question 34

How can atelectasis be prevented postoperatively?

Answer 34

Encourage deep breathing and incentive spirometry use.

Question 35

What intervention helps prevent wound dehiscence when coughing?

Answer 35

Splinting an abdominal incision with a pillow.

Question 36

What should be done for postoperative hypotension?

Answer 36

Administer fluid boluses to maintain blood pressure.

Question 37

What should be done for postoperative hypertension?

Answer 37

Identify and remove the stimulus (pain, respirations, voiding, etc.).

Question 38

Why is early ambulation important postoperatively?

Answer 38

It stimulates circulation, increases muscle tone, and promotes overall well-being.

Question 39

What can help reorient a postoperative patient?

Answer 39

Providing assistive devices like a clock or calendar.

Question 40

What should be included in patient pain education postoperatively?

Answer 40

How to report pain and how it will be managed (oral, IV, PCA pump, etc.).

Question 41

What safety measures should be followed when using warming devices postoperatively?

Answer 41

Monitor temperature to prevent burns or overheating.

Question 42

How can infections be prevented with postoperative lines and drains?

Answer 42

Practicing aseptic technique during care and dressing changes.

Question 43

How is fluid and electrolyte balance maintained in NPO patients postoperatively?

Answer 43

Administering IV fluids.

Question 44

What should be done if a postoperative patient vomits or is at risk of aspiration?

Answer 44

Lay patient in the left lateral position and have suction at bedside.

Question 45

How can postoperative constipation be managed?

Answer 45

Offering a stool softener and encouraging mobility and hydration.

Question 46

What interventions help promote postoperative voiding?

Answer 46

Encouraging natural voiding or using intermittent catheterization if necessary.

Question 47

When should the first postoperative dressing change occur?

Answer 47

It should be done by the surgeon unless the dressing becomes too saturated.

Question 48

What are the three PACU phases?

Answer 48

Phase I: Immediate post-anesthesia care; goal is transfer to Phase II, inpatient unit, or ICU. Phase II:Ambulatory surgical patients; goal is preparing for discharge or extended care. Extended Observation:Goal is preparing for self-care.