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Flashcards in Pre/Post-Op Deck (6):
1

A client has returned from a cardiac catheterization that was two hours ago. Which finding would indicate that the client has a potential complication from the procedure?

A: Decreased UO

B: Increased HR

C: No pulse in affected extremity

D: Increased BP

C: No pulse in affected extremity

Loss of the pulse in the extremity would indicate a potential severe spasm of the artery or clot formation to the extent of an occlusion below the site of insertion. It is not uncommon that initially the pulse may be intermittently weaker from the baseline. However, a total loss of the pulse is a nursing emergency. The health care provider needs immediate notification.

2

The nurse is providing discharge teaching to a client who has had a total hip prosthesis implanted. During teaching, the nurse should include which content in the instructions for home care?

A: Ambulate using crutches only

B: Do not cross legs at the ankles or knees

C: Sleep only on your back and not on your side

D: Avoid climbing stairs for three months

B: Don't cross legs

These clients should avoid the bringing of the knees together. Clients are to use a pillow between their legs when lying down and can lie on the back or side. Crossing the legs or bringing the knees together results in a strain on the hip joint. This increases the risk of a malfunction of the prosthesis where the ball may pop out. A walker or crutches may be used as assistive devices. These and other precautions are minimally followed for six weeks postoperative and sometimes longer as indicated.

3

A client who is two days postop, has these vital signs: blood pressure of 120/70, heart rate of 110 BPM, respiratory rate of 26, and a temperature of 100.4 F (38 C). The client suddenly becomes profoundly short of breath (SOB) and the skin color becomes grayish in color. Which assessment should the a nurse do first based on the client's change in condition?

A: Check for orthostatic hypotension

B: Palpate the pulses for bounding and irregularity

C: Auscultate for diminished lung sounds

d: Assess the pupils for unequal responses to light

C: Auscultate for diminished lung sounds

The findings suggest pulmonary embolus as a result of a piece of a clot in the legs that has broken off. Thus, the breath sound will most likely be diminished or absent in the lung where the embolus lodged.

4

The nurse is teaching effective stress management techniques to a client one hour before surgery. Which of these actions should the nurse recommend?

A: Imagery

B: Distraction

C: Biofeedback

D: Deep Breathing

D: Deep breathing

Deep breathing is a reliable and valid method for stress reduction and can be taught and reinforced in a short period of time preoperatively. The other approaches require more time and repetition over time for maximum effectiveness.

5

A client has just returned to the medical-surgical unit postop for a segmental lung resection. After assessing the client, which is the first action the nurse should take?

A: Suction excessive tracheobronchial secretions

B: Administer the prn pain medication

C: Assist the client to turn, deep breathe and cough

D: Monitor oxygen saturation with the application of an oximeter

A: Suction excessive tracheobronchial secretions

Suctioning the excessive tracheobronchial secretions that are present in post-thoracic surgery clients is the priority to maintain an open airway. The application of the pulse oximeter would be next with pain medication given and the mobility last.

6

The client undergoes a gastrectomy. Several hours after surgery, the nasogastric (NG) tube stops draining. What should the nurse do at this time?

Reposition the tube until it begins to drain

Increase the amount of suction

Follow the orders to gently irrigate the tube with sterile normal saline

Notify the surgeon

Follow the orders to gently irrigate the tube with sterile normal saline

The nurse will assess the position and patency of the NG tube, as well as the color and amount of gastric drainage. The nurse can gently irrigate the NG tube with sterile normal saline if it becomes clogged. But if that does not resolve the issue or repositioning the tube is needed, the nurse must call the surgeon. The NG tube inserted in surgery should not be repositioned by the nurse because of the risk of disrupting any internal sutures. The NG tube should be connected to low suction; it would be contraindicated to increase the suction.