Preoperative Care

Question 1

Ambulatory

Answer 1

Same day or outpatient (24 hours)

Question 2

Nurses Role Preop (4 things)

Answer 2

Knowledge of disorder
patients response to stress
Results of Preop tests
Identify possible risks/complications

Question 3

Nursing Assessment goals

Answer 3

Baseline data
psychologic/physiologic factors
Drugs/OTC/Herbs
cultural & ethnic factors
consent

Question 4

Patient fears

Answer 4

i. Death or disability
ii. Pain and discomfort
iii. Mutilation/alteration in body image
iv. Disruption of life functioning

Question 5

Familial diseases

Answer 5

cardiac, endocrine, malignant hypothermia

Question 6

Cardiovascular system report (3 things)

Answer 6

1. any cardiac problems during intraoperative
2. Use of cardiac drugs
3. Presence of pacemaker/ICD

Question 7

Respiratory System

Answer 7

infections/chronic resp. disease

2. COPD/asthma
3. smokers to stop at least 6 weeks before surgery
4. sleep apnea, obesity, airway deformities

Question 8

Nervous system

Answer 8

1. vision/hearing loss

2. Cognitive deficits (can affect informed consent)

Question 9

GU system

Answer 9

1. history of Renal & UTI

2. neg pregnancy tests & enlarged prostate

Question 10

iiRenal dysfunction is associated with

Answer 10

1. Fluid and electrolyte imbalances
2. Increased risk of infection
3. Impaired wound healing
4. Altered response to drugs and their elimination

Question 11

Musculoskelatal system

Answer 11

Report problems affecting neck or lumbar spine to ACP (spinal anesthesia)

Question 12

Patients with diabetes are at risk for

Answer 12

a. Hypo/hyperglycemia
b. Ketosis (when fat takes over)
c. Cardiovascular alterations
d. Delayed wound healing
e. Infection

Question 13

Pts with addison’s disease related too

Answer 13

abruptly stopping replacement corticosteroids

may need increased dose of IV corticosteroids

Question 14

Patients with history of compromised immune system or use of immunosuppressive drugs can have

Answer 14

delayed wound healing

increased risk for infection

Question 15

Immunosuppressive drugs

Answer 15

may need to be tapered before surgery

Question 16

Identify dietary habits that may affect recovery

Answer 16

caffeine

protein & vitamin deficient

Question 17

Preoperative teaching includes:

Answer 17

Sensory Info
Process teaching
Procedural teaching

Question 18

Ambulatory surgery information

Answer 18

i. Basic information before arrival
ii. Time and place
iii. What to wear and bring
iv. Responsible adult needed
v. Fluid and food restrictions

Question 19

Informed consent must include:

Answer 19

1. Adequate disclosure
2. Clear understanding
3. Voluntarily given consent
4. Diagnosis, treatments, risks, consequences, probability of success, what other options

Question 20

Surgeon is responsible for

Nurse is responsible for

Answer 20

obtaining consent

Witness signature, verify pt understanding

Question 21

Legally appointed representative of family may consent if patient is

Answer 21

i. Minor
ii. Unconscious
iii. Mentally incompetent

Question 22

Nursing management preop

Answer 22

voiding before surgery
Preop meds (60-90min before) 
i.	Benzodiazepines
ii.	Anticholinergics (decrease secretions) 
iii.	Opioids (pain) 
iv.	Antiemetics (nausea/vomiting) 
v.	Antibiotics
vi.	β-Adrenergic blockers (β-blockers) (history of hypertension/cardiac disease)

Question 23

Culturally competent care

Answer 23

1. Patient’s expression of pain
2. Family expectations
3. Ability to verbally express needs
4. Decision making

Question 24

Nursing assessment: exams enable ACP to

Answer 24

1. rate pt for anesthesia admin

2. indicator of preop risks & overall outcome

Question 25

On exams go through:

Answer 25

Complete PE
Document relevant findings & share with periop team
lab tests
blood glucose for diabetics